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Neurological symptoms of vitamin B12 deficiency Neurological symptoms affecting your brain and nervous system can include: numbness muscle weakness problems with balance and coordination pins and needles incontinence

High-Risk Profiles The threshold for testing should be lower if the individual falls into any of these categories: Age 60 or older Long-term use of metformin or proton pump inhibitors (PPIs) Strict vegetarian or vegan diet Family history of pernicious anemia or autoimmune disease Key Clinical Symptoms Neurological and cognitive: tingling, numbness, or a "pins and needles" sensation in the hands or feet

The idea of the brain-gut-muscle axis is gradually being confirmed, and at present it is important for regulating energy homeostasis, which also seems to be relevant to human health