From the Research
Elevated vitamin B12 levels despite low supplementation can be caused by several medical conditions, and it is crucial to investigate these underlying conditions to prevent morbidity, mortality, and impaired quality of life. The most common causes of elevated vitamin B12 levels include liver disease, which can release stored B12 into the bloodstream 1, certain blood disorders like myeloproliferative diseases, polycythemia vera, and chronic myelogenous leukemia, kidney disease, solid tumors, autoimmune conditions, and certain medications like metformin and oral contraceptives. Some key points to consider:
- Liver disease can disrupt B12 distribution, leading to elevated plasma B12 levels 1
- Blood disorders can increase B12 levels by affecting the cells that carry this vitamin
- Kidney disease may elevate B12 due to decreased clearance
- Solid tumors, particularly hepatocellular carcinoma and secondary liver tumors, can release stored B12
- Autoimmune conditions may create antibodies that interfere with B12 testing, causing falsely high readings
- Certain medications can also affect B12 levels, including metformin and oral contraceptives It is essential to consult a healthcare provider for proper evaluation if you have unexpectedly high B12 levels, especially if you're experiencing unexplained symptoms like fatigue, weight loss, or abdominal pain 2. The diagnosis of B12 deficiency or elevation rests on clinical suspicion followed by laboratory testing, which consists of a panel of tests, including total serum vitamin B12, holotranscobalamin, and methylmalonic acid 3. Therefore, it is recommended to investigate the underlying causes of elevated vitamin B12 levels, and consult a healthcare provider for proper evaluation and management to prevent morbidity, mortality, and impaired quality of life.