One Minute Health Check – B12 Deficiency signs and symptoms
A quick score will reveal if B12 deficiency, underactive thyroid or iron deficiency anaemia are possible diagnoses, and if the physician should order further tests.

Please rate the symptoms within this survey from 1-10? Please skip questions which are not relevant.
1 indicates that this symptom is mild and infrequent.
10 indicates the patient has it all the time and it is severe and debilitating.
A score of 5 indicates that the patient has the symptom and it affects their daily life to a moderate extent.

*Neurological examination and appropriate referral if indicated
**PHQ9 Patient Health Questionnaire to be completed

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Energy/ haemopoetic

Weariness, Lethargy, tiredness, fatigue, faints

Weariness, Lethargy, tiredness, fatigue, faints

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Sleepy, tired in the afternoon

Sleepy, tired in the afternoon

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Nervous system

Tremor, foot drop

Tremor, foot drop

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Loss of balance (ataxia), seizures, falls*

Loss of balance (ataxia), seizures, falls*

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Tingling or numbness in hands and/or feet, burning sensation*

Tingling or numbness in hands and/or feet, burning sensation*

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Restless leg syndrome

Restless leg syndrome

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Facial Palsy

Facial Palsy

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Spastic movements, Crampy pain in limbs

Spastic movements, Crampy pain in limbs

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Stiffness of limbs, muscle wasting*

Stiffness of limbs, muscle wasting*

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Weakness or loss of sensation in limbs, shooting pain in back/ limbs, paralysis*

Weakness or loss of sensation in limbs, shooting pain in back/ limbs, paralysis*

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Migrainous headache

Migrainous headache

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Psychiatric

Irritable, snappy, disturbed sleep

Irritable, snappy, disturbed sleep

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Confused, Memory disturbance/ forgetful, fogginess

Confused, Memory disturbance/ forgetful, fogginess

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Tension Headaches

Tension Headaches

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Mental slowness, Mood swings, Anxiety/Panic Attacks, depression**

Mental slowness, Mood swings, Anxiety/Panic Attacks, depression**

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Psychosis, hallucinations, delusion**

Psychosis, hallucinations, delusion**

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Eye Ear Throat

Blurred vision/ double vision/ drooping of eyelid (lid lag), orbital pain

Blurred vision/ double vision/ drooping of eyelid (lid lag), orbital pain

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Dizziness, tinnitus

Dizziness, tinnitus

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Difficulty swallowing, persistent cough

Difficulty swallowing, persistent cough

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Immune System

Prone to recurrent URTI, UTI, Respiratory infections

Prone to recurrent URTI, UTI, Respiratory infections

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Other auto-immune conditions

Other auto-immune conditions

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Hypoadrenalism, myxodema/underactive thyroid

Hypoadrenalism, myxodema/underactive thyroid

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Cardiovascular/Respiratory

Shortness of breath, wheeziness

Shortness of breath, wheeziness

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Palpitations, chest pain

Palpitations, chest pain

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Pallor, lemon yellow complexion

Pallor, lemon yellow complexion

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Bruising, Vasculitis

Bruising, Vasculitis

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Gastro-Intestinal (GI)

Sore tongue, bleeding gums

Sore tongue, bleeding gums

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Red beefy tongue

Red beefy tongue

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Cracking the angles of mouth

Cracking the angles of mouth

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Metallic taste, unusual taste, loss of appetite, loss of weight

Metallic taste, unusual taste, loss of appetite, loss of weight

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Gastric symptoms-acidity, heartburn

Gastric symptoms-acidity, heartburn

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Intermittent diarrhoea, IBS

Intermittent diarrhoea, IBS

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Skin hair nail skeletal

Premature greying

Premature greying

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Alopecia, Unexplained hair loss

Alopecia, Unexplained hair loss

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Joint inflammation, swelling, pain

Joint inflammation, swelling, pain

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Dry skin, brittle nails

Dry skin, brittle nails

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Genito-Urinary (GU)

Heavy painful periods, irregular periods, infertility & frequent miscarriages

Heavy painful periods, irregular periods, infertility & frequent miscarriages

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Polycystic ovarian disease

Polycystic ovarian disease

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Loss of libido

Loss of libido

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Shooting pain from groin to perineum

Shooting pain from groin to perineum

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Incontinence

Incontinence

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Personal & Family History

Family history of B12 deficiency (Pernicious Anaemia), underactive thyroid, diabetes, vitiligo, depression

Family history of B12 deficiency (Pernicious Anaemia), underactive thyroid, diabetes, vitiligo, depression

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Vegetarian, vegan, poor diet

Vegetarian, vegan, poor diet

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Alcoholism, Smoking

Alcoholism, Smoking

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