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Sensory Symptoms Numbness, tingling, or pins and needles (paresthesia) typically distal/stocking-glove in polyneuropathy Burning pain, allodynia, hyperalgesia common in small-fiber predominant neuropathy and CIDP Loss of proprioception and vibration sense sensory ataxia, positive Romberg sign Loss of pain/temperature sensation (small fiber) risk of unnoticed wounds Motor Symptoms Distal muscle weakness (foot drop in peroneal neuropathy, wrist drop in radial neuropathy) Atrophy of intrinsic hand muscles (ulnar/median neuropathy) Hyporeflexia or areflexia (ankle jerks lost early in length-dependent polyneuropathy) Fasciculations in severe axonal loss Autonomic Symptoms Orthostatic hypotension, dizziness on standing Gastroparesis, constipation or diarrhea, nausea Neurogenic bladder (hesitancy, retention, incontinence) Anhidrosis or gustatory sweating Sexual dysfunction

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As you are technically absorbing lower amounts of B12 over time, it might take a while for symptoms to reduce

Effects of maternal folic acid supplementation on gene methylation and being small for gestational age

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