High Levels of Vitamin B12 and Ferritin: Any pointers?

Per MayoClinicLabs
Vitamin B12 Assay, Serum
Many other conditions are known to cause an increase in the serum vitamin B12 concentration and should be considered in the interpretation of the assay results, including:
Increased serum vitamin B12
Ingestion of vitamin C
Ingestion of estrogens
Ingestion of vitamin A
Hepatocellular injury
Myeloproliferative disorder
Uremia

Per UCSFHealth
Vitamin B12 level
An increased vitamin B12 level is uncommon. Usually, excess vitamin B12 is removed in the urine.
Conditions that can increase B12 level include:

Liver disease (such as cirrhosis or hepatitis)
Myeloproliferative disorders (for example, polycythemia vera and chronic myelogenous leukemia)

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- Vitamin B12 Assay, Serum https://www.mayocliniclabs.com/test-catalog/Overview/9154#Clinical-and-Interpretive

Do you have experience with abnormal vitamin B12 levels?

Yes

Hi Sherry, welcome. What is your experience with abnormal vitamin b12 levels? What is being done about it?

I posted about this a month or so ago but have had no luck getting any information. My B12 has been elevated for a couple of years (no, I don't take any supplements). Last October it was a little over 4000, now it is a little over 6000. All other blood work is good. The development that has me worried is excruciating lower back pain. I thought it was muscular or maybe I had irritated my arthritis but this feels more like an organ than bone or muscle. So far, doctors have dismissed the B12 numbers as "nothing to be worried about" help!

Hi @rubyjag3 As you can see you’re not alone in your concern over the very high Vitamin B-12 level in your blood tests and wondering what can be done. There is no indicated toxic level if someone is taking the vitamin in a supplement.
However, from my understanding, if there’s a significant excess of B-12 in the blood with no supplements it can be a sign of
low B-12 with what’s actually being used by the body. This can sometimes be caused by underlying conditions which interfere with how well it can be processed and absorbed. Anything in excess is waste and not being used, so it floats freely in the blood and is indicated by that high level.
There are some specific tests that can be done to see how well your body breaks down/absorbs and transport/bonds to Vitamin B-12.
Did any of this increase with your higher protein diet?
You said all of your other bloodwork came back normal. Did this include a kidney and liver panel?

Thank you......yes, (from 4000-6000 in the last 11 months) I have been focusing on increasing protein since January. How does that relate to the increase in B12?
This blood work was 8/5/22
ALT:12
AST:17
ALP:63
Albumin:4.4
Total protein: 7.8
Total bilirubin: .3
GFR: >90

Looking at your lab numbers, they are nicely all in the normal range, even the GFR. I only asked about the protein in case there was any correlation with your kidney function but your numbers don’t reflect that. And I know you’re concerned that this high B-12 number is related to your back pain. If there was kidney involvement that might also be shown in blood work but again that’s all normalcy An ultrasound of your kidneys would show possible kidney stones.
Have you specifically asked about the back pain? Have you had MRI or CT scan of your back to rule out any disc involvement?

Thank you for your response. It is true that I do not take any supplements or any medication at all. All my other blood work was "normal". However, I had an appointment last Friday and asked that it be checked again. I received the results over the weekend and my B12 has increased from 6066 on 8/5/22 to 7345 on 9/30/22. I have been feeling awful for about 3 weeks. Fatigue, dizziness, blurred vision late in the day, very dry eyes, headaches, confusion, and back pain (upper mid) I had an EKG on Friday as well to rule out a heart attack (all good). I don't know where to go from here.

I’m happy that you saw this discussion and hopped on board. You, @rubyjag3 and several others in the forum have higher than the ‘stated normal’ ranges for Blood serum B-12 levels. As we age there are changes in our chemistry where we may not be absorbing as much Vitamin B 12 as needed for optimism health. Taken as a supplement, Vitamin B-12 has no toxic limits as whatever isn’t used by the body is simply flushed away. It enters the blood stream and shows up as a high serum level.
The question is, why is it so high in some people when they’re not taking supplements? Finding the cause isn’t always easy. When it’s high, it can also mean the vitamin isn’t being utilized in the body and people with high serum levels can actually be experiencing very low B-12 levels on an essential level.
Low B-12 can cause strange sensations, numbness, or tingling in the hands, legs, or feet
difficulty walking (staggering, balance problems)
anemia
a swollen, inflamed tongue
difficulty thinking and reasoning (cognitive difficulties), or memory loss
weakness
fatigue
vision changes
hair loss
mental problems like depression or behavioral changes

Doing some research today I found some sites worth reading. This one gives a description of tests used in determining how well the body is using V-B12 besides the regular V-B 12 serum test. The article gets the point across and helps give a pretty good understanding on what’s happening with a high V-B 12 level and what it can mean.

-https://www.restartmed.com/how-to-test-for-vitamin-b12-deficiency/

I’m not advocating this site but this particular integrative medicine article has some interesting information on the importance of pursuing the cause of extremely elevated B-12 when someone is not actively taking supplements. https://www.swintegrativemedicine.com/blog/causes-of-high-b12-without-supplementation

This can also be caused by underlying health issues such as liver, kidney or blood diseases. So it’s important to get to the root of the problem. It seems there is a lot of dismissal from doctors that this isn’t anything to be concerned about. But from simple research it looks as though there can be some definite concern for potential health issues.

Have either you or @rubyjag3 thought about a second opinion with an Integrative Medical Professional?