"At levels only slightly lower than normal, a range of symptoms such as fatigue, depression, and poor memory may be experienced"

"Vitamin B12 deficiencies occur when the body is unable to properly use the vitamin. Pernicious anemia can make the body unable to absorb vitamin B12 from the intestinal tract. Because vitamin B12 comes primarily from animal products, people who follow a strict vegetarian or vegan diet and do not consume eggs or dairy products may require vitamin B12 supplements (Non-animal sources of vitamin B12 exist but are highly variable in their B12 content. They are considered unreliable sources of the vitamin.)"

"Vitamin B12 is naturally found in animal products, including fish, meat, poultry, eggs, milk, and milk products. ... Vitamin B12 status is typically assessed via serum or plasma vitamin B12 levels. Values below approximately 170 250 pg/mL (120 180 picomol/L) for adults indicate a vitamin B12 deficiency. However, evidence suggests that serum vitamin B12 concentrations might not accurately reflect intracellular concentrations. "