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Common signs include: Ongoing fatigue or weakness Pale skin Numbness or tingling in the hands and feet Brain fog, forgetfulness, or trouble concentrating Low mood, anxiety, or irritability Poor appetite or digestive upset When B12 is low, your metabolism slows, you have less energy for activity, and appetite signals can get thrown off, all of which make weight loss harder

In addition, the prescription of anticoagulants (blood-thinning medicines) or antiplatelet medications (drugs that prevent blood clots) requires careful consideration and monitoring due to hazards associated with these drugs in people with end-stage renal disease

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