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But if your B12 is high without supplementation , it can be a marker for underlying conditions that require medical evaluation, including liver disease, kidney dysfunction, and certain cancers

However, oral supplements are appropriate for many individuals

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Some research from Germany has shown that an even higher threshold (over 500 pg/mL) is necessary in early-to-mid pregnancy to maintain vitamin B12 levels throughout pregnancy, lactation, and to support an infants vitamin B12 status (via breast milk) through 6 months of age