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Conditions include alcoholic liver disease, viral hepatitis, cirrhosis, and primary or metastatic liver cancer Renal dysfunction : Impaired kidney function reduces B12 elimination, causing accumulation even with normal intake Haematological conditions : Myeloproliferative neoplasms, chronic myeloid leukaemia, polycythaemia vera, and hypereosinophilic syndrome increase transcobalamin production, elevating total serum B12 Laboratory interference : Macro-B12 (immunoglobulin-bound B12) and assay interference can cause spuriously elevated results without true excess In clinical practice, unexplained hypercobalaminaemia should prompt investigation for underlying disease, particularly in patients without obvious supplementation history

It appears that maintaining adequate blood levels of the vitamin, like through supplementation, does improve birth outcomes ( SUMMARY A vitamin B12 deficiency can cause a range of mild to severe side effects, including anemia, weakness and fatigue, and birth defects in infants

Monitoring by a healthcare provider is key

Here is a primer on B12 (a.k.a