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These include: Neurological symptoms : tingling or numbness in hands and feet (peripheral neuropathy), difficulty walking or balance problems, memory difficulties, or mood changes including depression Haematological signs : persistent fatigue, weakness, pale or jaundiced skin, or shortness of breath Glossitis : a sore, red, smooth tongue Cognitive symptoms : difficulty concentrating, confusion, or "brain fog" Seek urgent medical attention if you experience rapidly worsening neurological symptoms, significant difficulty walking, severe paraesthesia, or marked cognitive decline, as these may require immediate assessment

Philos Trans R Soc Lond 352 : 14891503