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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
Neumann SN, Li JJ, Yuan XD, Chen SH, Ma CR, Murray-Kolb LE, et al
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Personalized treatment plans often improve energy, mood, and cognition, with severe cases requiring a series of injections for significant progress
Selective and membrane-permeable small molecule inhibitors of nicotinamide N-methyltransferase reverse high-fat-diet-induced obesity in mice
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