From the Research
Possible Symptoms
- Elevated vitamin B12 levels may not always present with specific symptoms, but can be associated with various underlying conditions such as liver disease, neoplasias, malignant hemopathies, renal insufficiency, and transient hematologic abnormalities 1
- In some cases, high vitamin B12 levels can be a benign finding, especially in children, but may also be a precursor to severe hematological diseases such as leukemia 2
- Patients with myeloproliferative neoplasms (MPNs) may exhibit elevated vitamin B12 levels, which can serve as a diagnostic and prognostic marker 3
Further Workup
- In cases of elevated vitamin B12 levels, further workup should include a thorough medical history, physical examination, and laboratory tests to rule out underlying conditions such as liver disease, neoplasias, and hematological malignancies 4, 1
- PEG precipitation can be used to distinguish between "real" high vitamin B12 and macro-vitamin B12, which can cause falsely elevated vitamin B12 levels 4
- Imaging studies such as X-rays, MRI, and CT scans may be necessary to evaluate for underlying conditions such as tumors or other abnormalities 4
- Laboratory tests such as complete blood counts, liver function tests, and renal function tests may also be necessary to evaluate for underlying conditions 3, 1
- In some cases, a bone marrow biopsy or other invasive procedures may be necessary to diagnose underlying conditions such as hematological malignancies 3