From the Guidelines
Elevated levels of vitamin B12 and iron can be associated with inflammation, and it is crucial to investigate potential causes of inflammation, such as infections, autoimmune disorders, or certain cancers, to determine the underlying cause of these elevated levels. Inflammation can cause elevated B12 levels because inflammatory processes may release stored B12 from the liver and other tissues into the bloodstream 1. Similarly, inflammation can increase ferritin (an iron storage protein) as part of the acute phase response, even when actual iron stores are normal or low 1. Some key points to consider include:
- Inflammatory processes can lead to elevated B12 and iron levels, even in the absence of actual iron deficiency or B12 deficiency 1.
- Other factors, such as supplementation, certain medications, liver disease, or genetic conditions affecting iron metabolism like hemochromatosis, can also cause high B12 and iron levels 1.
- It is essential to discuss these results with a healthcare provider, who can order additional tests like CRP, ESR, complete blood count, and liver function tests to determine the underlying cause 1.
- Patients should not stop any supplements without medical advice and avoid self-medicating with additional iron or B12 supplements until the cause is determined 1. The most recent and highest quality study, published in 2021, suggests that oral iron replacement therapy in patients with inflammatory bowel disease should contain no more than 100 mg elemental iron a day, and intravenous iron is indicated for those who are intolerant of oral iron and have moderate to severe iron deficiency anaemia 1.
From the Research
Vitamin B12 and Iron Levels
- High levels of Vitamin B12 and iron can be associated with various health conditions, including inflammation.
- According to 2, hypercobalaminemia (high serum vitamin B12 levels) can be accompanied by signs of deficiency, reflecting a functional deficiency linked to qualitative abnormalities.
Inflammation and Vitamin B12
- There is evidence to suggest that elevated Vitamin B12 levels may be associated with a higher risk of cancer, as stated in 3.
- However, the relationship between Vitamin B12 and inflammation is not clearly elucidated, and more research is needed to understand the consequences of high Vitamin B12 levels.
Iron Levels and Inflammation
- While the provided studies do not directly address the relationship between high iron levels and inflammation, it is known that iron plays a crucial role in various biological processes.
- 4 discusses the consequences of inadequate intakes of micronutrients, including iron, on the quality of life and morbidity in older persons, but does not specifically address the relationship between high iron levels and inflammation.
Diagnosis and Treatment
- Diagnosis of Vitamin B12 deficiency or insufficiency can be challenging, and various tests are available, including serum B12, holotranscobalamin, serum methylmalonic acid, and plasma homocysteine measurements, as discussed in 5.
- It is essential to recognize the diverse risk factors associated with Vitamin B12 deficiency and insufficiency, including dietary availability, increased physiological needs, and iatrogenic factors, as stated in 6.