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Below are possible Vitamin B12 deficiency symptoms: Weakness, tiredness, or lightheadedness Heart palpitations and shortness of breath Pale skin A smooth tongue Constipation, diarrhea, loss of appetite, or gas Nerve problems like numbness or tingling, muscle weakness, and problems walking Vision loss Mental problems like depression, memory loss, or behavioral changes You can also get vitamin B12 deficiency if you follow a vegan diet or you are a vegetarian who doesn't eat enough eggs or dairy products to meet your vitamin B12 needs

Low blood calcium or magnesium: Low blood levels of either calcium or magnesium directly increase the excitability of both the nerve endings and the muscles they stimulate

For glycemic control in type 2 diabetes, treatment is typically continued indefinitely as long as it remains effective and well-tolerated, with periodic assessment of the ongoing need for therapy

Definitions of smoking status have varied