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CurR Res Diabetes Obes J 12(5):117124 Ali K et al (2020) Association of vitamin B12 deficiency and metformin use in patients presenting with type ii diabetes mellitus

Symptoms of a B12 deficiency include: Excessive fatigue Nerve problems (pain or abnormal sensations like numbness or tingling) Glossitis (tongue inflammation) Low numbers of white blood cells and red blood cells Vitamin B12 deficiency can be diagnosed with a blood test

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There are only few case reports where vitamin B12 deficiency was solely attributed as the cause of pyrexia.[2,3,4] The exact cause of pyrexia in megaloblastic anemia is not known but a proposed mechanism is that megaloblastic anemia leads to hyperplasia and thus increased activity within the bone marrow leading to systemic pyrexia