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According to Rukhlenko et al

Topiramate for weight reduction in adolescents with severe obesity

Causes and Symptoms of B12 Deficiency Deficiency can arise from: Poor dietary intake Malabsorption issues (e.g., pernicious anemia, atrophic gastritis) Gastrointestinal surgeries or disorders (e.g., Crohns disease) Certain medications affecting stomach acid or absorption Symptoms of deficiency include fatigue, weakness, numbness or tingling in hands and feet, memory difficulties, mood changes, and in severe cases, neurological damage

Journal of Endocrinology, 236(2), 63-78

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