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Vitamin B12 and folate deficiency can cause a wide range of problems, including: extreme tiredness a lack of energy pins and needles (paraesthesia) a sore and red tongue mouth ulcers muscle weakness disturbed vision psychological problems, which may include depression and confusion problems with memory, understanding and judgement Some of these problems can also happen if you have a deficiency in vitamin B12 or folate but do not have anaemia

These differences are reflected in the diagnostic criteria for each type of EDS

Vasculogenic ED in particular is linked with arterial and endothelial damage, often attributed to systemic inflammation

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