iron or folic acid deficiency
B12 has many functions in our body, so unfortunately a deficiency will give rise to a wide variety of symptoms, like brain fog, memory problems, cognitive impairment, insomnia, headaches, especially migraine, behavioural changes, learning problems, nominal aphasia, mood swings, irritability, depression, anxiety, hallucinations, delusions, psychosis, peripheral paraesthesia (pins and needles), numbness, neuropathic pains, poor balance, reduced vibration sense or proprioception (joint position sense), tinnitus, ataxia, taste impairment, sometimes myelopathy, fatigue, anaemia (either with larger red blood cells, or with normal size of the red blood cells when there is also iron deficiency), other reduction in blood cells, abdominal complaints, malabsorption, failure to thrive, weight loss, diarrhoea, hyperpigmentation, glossitis, (aphthous) stomatitis, infertility, urinary tract infections, joint and muscle pain, muscle weakness, spasticity, seizures, cardiomyopathy, urinary and/or faecal incontinence, postural hypotension/dizziness, erectile dysfunction, to name a few
The increase in circulating cobalamin levels is predominantly caused by enhanced production of haptocorrin.Several liver diseases like acute hepatitis, cirrhosis, hepatocellular carcinoma and metastatic liver disease can also be accompanied by an increase in circulating cobalamin
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