Elevated Serum B 12 levels and its relevance

Two questions -
* were the lab draws part of an ordinary set of labs or was there some clinical exploration?
* if the latter, what are your symptoms or diagnosis to confirm or rule out (if you want to share)?

High or Low results ?

kaida75, I'm sure you would have reduced supplementation of B12. The % of RDA in those supplements is commonly 5,000+
There are other conditions that cause elevated B12, so it's very good that you are pursuing cause. Are your labs for the liver and the kidneys normal. Some autoimmune diseases (SLE. RA and Stills) cause high serum B12 and some cancers (blood cancers and tumors).
High B12 doesn't cause these conditions and high B12 isn't harmful. But it can be an early clue for a condition that is best treated early.
It is difficult to get too much B12 from foods. The only one I can remember is clams.
I'm curious what you will find out, and hope there is an easy remedy

@pb50 &@gently Thanks so much for the responses. Labs were drawn as first time visit to a new Concierge Internal Medicine/Functional visit in August 28,2025. B12 was elevated at 1707 (range for Lab Corp 232-1245), SGOT 58, elevated SGOT at 55 (0-40 range) Renal panel WNL - Abdominal ultrasound was negative. Repeat lab for f/u on 11/19/2025 Vitamin B12 was 1836.
I stopped the multivitamin, did some deep-dive research and feel that further testing needs to be done to evaluate the elevation of B12. Most of the NIH articles and others I have read from reputable sources have mentioned hard tumor in liver, pancreas, colon along with blood disorders of the malignant type. Cannot seem to get the physician interested in evaluating further. Wondering What specialty I should pursue....hematology perhaps. The 45 years of nursing in me tells me yes - 2nd evaluation. 20 years of the 45 were spent as a Director of Nursing so I am used to investigating abnormal labs and working with the physicians for answers. All opinions welcome

Hi. I'm well outside my 'wheelhouse' on this topic, but maybe some of this will help to twig something in that 45 year career in nursing and bring it to the fore for you. Congrats on that career, BTW, and thanks for your service:

Basic start:
https://my.clevelandclinic.org/health/diseases/high-b12-levels
Middlin' level:
https://www.rupahealth.com/post/high-vitamin-b12-levels-causes-symptoms-and-what-to-do-next
Advanced (more comprehensive):
https://scifusions.com/articles/effects-high-vitamin-b12-levels/
Latest research:
https://pmc.ncbi.nlm.nih.gov/articles/PMC10935444/
https://ashpublications.org/bloodneoplasia/article/2/3/100136/546160/Elevated-B12-serum-levels-are-associated-with-the
Good luck with this. I think it's solvable, but it might not be quick, either in decision or in resolution.

@kndaustin71, I suggest (without opinion) asking the "concierge" physician to order Anti Nuclear Antibody testing (ANA) to rule out specific autoimmune systems. You should be able to obtain this order without seeing another physician.

@kndaustin71
Fascinating. I spent a dozen years in neurophysiology and diagnostics before transitioning to the risk management side of service delivery. But once you develop a diagnostic brain, you’re stuck with it 🙂
I have had a few opportunities to observe concierge medicine that were treating friends and family. I’m curious - were you pleased/impressed with thebone you saw? My impression is that they see their key value proposition as availability and affability and assume that is what you are willing to pay up for - but I wouldn’t care if they were mean as hell if they were brilliant diagnosticians.

I absolutely agree you need to run this to ground. In this case I am less useful than Google I’m afraid. But I would figure out who the Ace internist in town is and get your primary to pull strings to get you a referral.

Once you get the "but for differential diagnostics and cause and effect it doesn't leave you. This is my first time interacting with a Concierge model of practice so I will have to let you know how it goes. Unfortunately, there are no Ace physicians from where I am........most have done all there education/practice within the State and don't even have a referral base. I have made several self referrals based on my needs and traveled as far as Duke (I live in central South East) for pulmonary intervention for my COPD. Interesting tho several private practice physicians have gone the concierge route as I believe they too are tired of corporate medicine with interest in money and not patient care!