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The common causes are the following: Celiac Disease Crohn's Disease Weakened immune system Pernicious Anemia Grave's Disease or Lupus Low B12 status has been associated with a range of symptoms, which should be evaluated by a licensed healthcare provider: Nervousness and muscle weakness Muscle stiffness and muscle spasticity Fatigue and incontinence Low blood pressure Mood disturbances A severe disease that can occur from vitamin B-12 deficiency is megaloblastic anemia