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Vitamin B-12 deficiency symptoms may include: strange sensations, numbness, or tingling in the hands, legs, or feet difficulty walking (staggering, balance problems) anaemia a swollen, inflamed tongue difficulty thinking and reasoning (cognitive difficulties), or memory loss weakness fatigue While an experienced physician may notice the symptoms and be able to detect a vitamin B-12 deficiency with a good interview and physical exam, a blood test is needed to confirm the condition

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[480] Section 1861(jjj)(1)(A) of the Act recognizes opioid agonist and antagonist treatment medications (including oral, injected, or implanted versions) that are approved by the FDA under section 505 of the FFDCA for the use in treatment of OUD, but nalmefene is not on the list of drugs for the treatment of OUD