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Symptoms may include: strange sensations, numbness, or tingling in the hands, legs, or feet difficulty walking (staggering, balance problems) anemia a swollen, inflamed tongue yellowed skin (jaundice) difficulty thinking and reasoning (cognitive difficulties), or memory loss paranoia or hallucinations weakness fatigue While an experienced physician may be able to detect a vitamin B12 deficiency with a good interview and physical exam, a blood test is needed to confirm the condition