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These include: Paraesthesia (pins and needles) in hands and feet Difficulty walking or balance problems Memory impairment and cognitive changes Mood disturbances, including depression and irritability Visual disturbances (rare, such as optic neuropathy) Gastrointestinal symptoms such as diarrhoea, constipation, or loss of appetite may also occur, particularly when deficiency results from malabsorption

Researchers have reported lower vitamin B12 levels in some people with cancer

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Lyophilisation, or freeze-drying, is a process that removes water from the peptide, allowing it to be preserved for longer periods