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Methylmalonic acid, usually shortened to MMA, and homocysteine are substances the body clears using B12-dependent enzymes

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Symptoms of vitamin B12 deficiency include (1): chronic fatigue shortness of breath heart palpitations tingling or numbness in the extremities poor balance loss of concentration poor memory disorientation mood changes incontinence insomnia People most at risk of developing a deficiency include older adults, as well as those who smoke, abuse alcohol, or follow a vegetarian or vegan diet