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A vitamin B12 deficiency can lead to megaloblastic anemia, a condition characterized by a low number of red blood cells that are larger than normal ( Megaloblastic anemia can cause a variety of symptoms and side effects, including ( shortness of breath headache heart palpitations fatigue poor balance memory loss That said, being low in vitamin B12 doesn’t always lead to megaloblastic anemia, and many people may only experience mild symptoms like fatigue ( Furthermore, while a deficiency in vitamin B12 may not cause weight gain, it can decrease energy levels and contribute to fatigue, making it harder to stay active and manage your weight