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Surgery, injury, or cancer also can cause blood loss [37]

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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