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These include: Paraesthesia (pins and needles) in hands and feet Peripheral neuropathy with numbness or altered sensation Difficulty walking or balance problems (ataxia) Memory problems and cognitive difficulties Mood changes, including depression or irritability In severe cases, confusion or dementia-like symptoms Other manifestations may include: Loss of appetite and unintentional weight loss Constipation Visual disturbances (rare, but can occur with optic neuropathy) Important: The neurological complications of B12 deficiency can progress even in the absence of anaemia, making early detection crucial