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Praet SFE, Ong JH, Purdam C, Welvaert M, Lovell G, Dixon L, et al

Your body does not make vitamin B12 on its own, so you must consume food and drinks that have vitamin B12 to receive it

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Last reviewed: May 14, 2026 Last updated: May 14, 2026 Written by: Jay Hastings, CEO of PlexusDx Jay Hastings is the CEO of PlexusDx, a precision health company focused on genetic testing, blood biomarker insights, and personalized wellness recommendations

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