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It may be a very late sign in B12 deficiency and the MCV can appear normal in a patient taking high doses of folic acid

After that, it can be several more years before you develop pernicious anemia symptoms

Tsuboi H et al

When B12 levels are low, the signs can be varied: Anemia: fatigue, weakness, pale skin, and dizziness Fatigue: a deep-seated weariness that doesn't improve with rest Nerve Damage: tingling or numbness in hands and feet, balance problems, and memory loss (seek medical advice promptly) Mood Disturbances: depression, irritability, and personality changes Who Is Most at Risk for B12 Deficiency

This molecule is a white to off-white crystalline powder with high water solubility

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