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Other Symptoms of Low Levels of Cobalamin: Anemia can manifest as pale skin and tiredness Nerve damage (numbness or tingling in feet and hands) Dizziness, fatigue, shortness of breath Weakness, weight loss and depression Irregular heart rhythms (arrhythmias) Psychological side effects (mood changes, dementia) How to Restore B12 Levels: Lee points out some important caveats: Often there is a cobalamin deficiency due to lack of production of intrinsic factor in the parietal cells in the fundus of the stomach