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( Unfortunately, this symptom of B12 deficiency overlaps with symptoms related to diabetic neuropathy nerve damage caused by high blood sugar that can cause pain and numbness in the extremities ( People with diabetes taking metformin are at a higher risk of developing B12 deficiency because this medication can reduce vitamin B12 absorption in the body ( So, a B12 deficiency could be misdiagnosed as peripheral neuropathy in people with diabetes

For some people, especially those with certain genetic variations like the MTHFR mutation, converting cyanocobalamin can be a challenge

Additionally, other factors such as having had gastric bypass surgery or taking antacids long-term can lead to deficiency

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