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Low levels of vitamin B12 can lead to: Depression Fatigue Poor memory Tingling sensation in the extremities Mania and psychosis (at extreme levels of deficiency) Permanent damage to the brain and nervous system (from long-term deficiency) Common causes of vitamin B12 deficiency include poor absorption (due to age, pernicious anemia, atrophic gastritis, Crohns Disease, long-term use of acid-reducing drugs, etc.) and vegetarian/vegan diets that limit the consumption of meat, dairy, and seafood