In addition to fatigue, deficiencies are associated with anemia (large-cell type); degeneration of peripheral nerves progressing to paralysis; sore tongue; loss of appetite; and constipation.

Anemia is a condition that occurs in blood in which a person lacks enough healthy blood cells or haemoglobin. The latter is the main part of the red blood cells which binds with oxygen and transports it to the rest of the body. One of the causes of anemia, as mentioned above, is fatigue. The condition can also be associated with the deficiencies in vitamins and minerals (iron). 

the circled areas are referred to   as sunspots.   the sunspots are cooler than the   surrounding area.

sunspots are temporary phenomena on the photosphere of the sun that appear visibly as dark spots compared to surrounding regions. they correspond to concentrations of magnetic field flux that inhibit convection and result in reduced surface temperature compared to the surrounding photosphere.