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When B12 levels become too low, people may experience symptoms such as: Fatigue or low energy Memory or concentration problems Numbness or tingling in the hands and feet If B12 deficiency becomes severe and lasts a long time, it can lead to nerve damage

But several factors work against this natural recovery process, including age (collagen production drops roughly 1% per year after age 20), the amount of weight lost (more than 50 pounds creates significantly more laxity), how long the excess weight was carried, sun damage history, smoking, genetics, and the speed at which the weight came off

Improving sleep does not replace medical treatment, but it often improves how the patient tolerates everyday life

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However, one study reported that children and adults with normal to elevated levels of serum vitamin B1 had many symptoms normally associated with vitamin B12 deficiency, including fatigue, depression, anxiety, lack of motivation, poor memory, fuzzy thinking, peripheral neuropathy and difficulty sleeping