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Shortness of Breath and Dizziness : Decreased red blood cell count can lead to feelings of breathlessness or dizziness

If you are taking metformin, colchicine, or proton pump inhibitors long-term, discuss B12 monitoring with your GP, as these medications can affect B12 status over time

"Acromegaly"

Increase in homocysteine as vitamin B12 levels decrease below 250 pmol/L from Elmadfa and Singer 2009 Increase in MMA as serum vitamin B12 decreases below 250 pmol/L - from Shobha etal, 2011 Many people, however, experience symptoms of vitamin B12 deficiency yet their serum levels of vitamin B12 may be normal or much higher than normal