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See a doctor if you notice: Persistent numbness or tingling in hands and feet Unexplained fatigue that won't go away Memory problems or difficulty concentrating Sudden weakness in legs or arms Mouth ulcers that keep coming back Vision disturbances Also consult if: You're vegetarian or vegan for long period You've been on Metformin for diabetes long-term You're above 50, absorption naturally drops with age Did You Know: A 2019 NIH study confirmed that nearly 40% of people with neurological B12 symptoms had already suffered irreversible nerve damage before diagnosis , simply because they waited too long

This is qualitatively different from what anti-inflammatory medications produce, because the tissue itself is changing rather than just the symptom signal being blocked