From the Research
High vitamin B12 levels typically don't require specific treatment as the body can eliminate excess amounts through urine. If elevated B12 is detected in blood tests, the focus should be on identifying and addressing the underlying cause rather than treating the B12 level itself. Common causes include liver disease, certain blood disorders like myeloproliferative neoplasms, kidney disease, or excessive supplementation 1. If you're taking B12 supplements and levels are high, reducing or stopping supplementation is recommended. For those with high B12 due to medical conditions, treatment should target the primary disorder—for example, managing liver disease or addressing blood disorders with appropriate therapies. No specific medication exists to lower B12 levels directly. During evaluation, your doctor may order additional tests including complete blood count, liver function tests, and kidney function assessments to determine the cause 2. While high B12 itself isn't typically harmful, it's important as a potential indicator of underlying health issues that may require attention. Regular monitoring of B12 levels may be recommended if you have a condition associated with elevated levels. Some studies suggest that high B12 levels can be associated with certain health conditions, such as chronic kidney disease, and that supplementation with folic acid and vitamin B12 may be beneficial in these cases 3. However, the most recent and highest quality study on this topic is from 2022, which highlights the importance of considering vitamin B12 metabolism in patients with chronic kidney disease 2. Overall, the approach to high vitamin B12 levels should prioritize identifying and addressing the underlying cause, rather than treating the B12 level itself.