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[DOI] [PMC free article] [PubMed] [Google Scholar] 14.Liu M, Li L, Chu J, Zhu B, Zhang Q, Yin X, Jiang W, Dai G, Ju W, Wang Z, Yang Q, Fang Z

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Vitamin B12 deficiency symptoms when taking metformin Peripheral neuropathy (which can feel like pain, tingling, or pins and needles) Headaches Nerve damage Visual changes Changes to the tongue Macrocytic anemia (which means red blood cells cannot be properly formed) Fatigue or exhaustion Shortness of breath Rapid heart rate Jaundice or yellowing of the skin Difficulties sleeping Depression Cognitive impairment such as slowed thinking, brain fog and memory problems Psychosis Small intestine bacterial overgrowth RELATED: Can you take too much B12

Feb 12, 2026 What if the problem with your semaglutide results is not the peptide at all, but how you prepared it