Neurological symptoms often develop gradually and may include: Paraesthesia : tingling or 'pins and needles' sensations, typically starting in the feet and hands Numbness : reduced sensation in the extremities, which may affect balance and coordination Burning pain : particularly in the feet, often worse at night Weakness : muscle weakness and difficulty walking Balance problems : unsteady gait and increased fall risk due to proprioceptive impairment Cognitive changes : memory problems, confusion, difficulty concentrating, and mood disturbances Haematological signs may accompany neurological symptoms and include fatigue, weakness, pallor, and shortness of breath due to megaloblastic anaemia
Watchful Waiting For men with mild symptoms, lifestyle modifications and regular monitoring may be sufficient
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Human research used intravenous doses in the range of 25 to 50 micrograms per kilogram
Summary: Yes, vitamin B12 is a water-soluble vitamin, though uniquely it can be stored in the liver for several years despite being excreted through urine when consumed in excess
