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this occurs because there is not enough vitamin B12 in the diet or poor absorption Pernicious anemia—a type of megaloblastic anemia caused by a lack of intrinsic factor so that vitamin B12 is not absorbed Fatigue, weakness Nerve damage with numbness, tingling in the hands and legs Memory loss, confusion Dementia Depression Seizures Toxicity Toxicity Vitamin B12 is a water-soluble vitamin, so any unused amount will exit the body through the urine