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These include: Paraesthesia (pins and needles) in hands and feet Difficulty walking or balance problems Memory impairment and cognitive changes Mood disturbances, including depression and irritability Visual disturbances (rare, such as optic neuropathy) Gastrointestinal symptoms such as diarrhoea, constipation, or loss of appetite may also occur, particularly when deficiency results from malabsorption

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The symptoms of rheumatoid arthritis may also mimic symptoms of vitamin B12 deficiency such as paresthesias in the extremities, loss of fine motor skills, muscle weakness, problem walking and joint pain and inflammation