From the Research
Elevated vitamin B12 levels in the blood are generally not a cause for concern on their own, but they may indicate an underlying health condition that requires investigation, such as liver disease, certain blood disorders, or kidney disease, as suggested by studies including 1. When evaluating elevated B12 levels, it is essential to consider the potential causes and underlying conditions that may be contributing to the elevation.
- Liver disease, such as cirrhosis, can cause elevated B12 levels, as seen in a study published in 2, which found that patients with decompensated cirrhosis had higher vitamin B12 levels compared to controls.
- Certain blood disorders, like myeloproliferative neoplasms or leukemia, can also lead to elevated B12 levels.
- Kidney disease and certain genetic conditions may also contribute to elevated B12 levels. Some medications, such as metformin, can affect B12 levels, as mentioned in 3. No specific treatment is needed for the elevated B12 itself, as the body can typically eliminate excess amounts through urine. Instead, treatment should focus on addressing any underlying condition, as recommended by a Delphi expert consensus published in 4, which emphasized the importance of recognizing clinical symptoms and using laboratory markers to support the diagnosis of B12 deficiency. Unlike low B12, which requires supplementation, high B12 doesn't typically require dietary changes or stopping supplements unless specifically directed by your healthcare provider. The elevation occurs because B12 is bound to proteins in the blood, and conditions that increase these binding proteins or release B12 from damaged cells can cause levels to rise. If you have elevated B12 without explanation, your doctor may recommend additional blood tests, liver function tests, or other diagnostic procedures to determine the cause, as suggested by the example answer. It is crucial to prioritize the evaluation and management of underlying conditions that may be contributing to the elevated B12 levels, rather than focusing solely on the elevated B12 itself, in order to improve morbidity, mortality, and quality of life outcomes.