Elevated Serum B 12 levels and its relevance

Thank you all for your input. I have shared some with my current PCP, but can't seem to get him interested in further investigation. In the meantime, I have stopped all my supplement especially the multivit with B12. I will have to trace back in my labs to see what my prior levels were. May be a bit difficult because B12 levels are not routine draws. My plan is to chill over the holidays then look into a "good" hematologist. The article/comments were fantastic and obviously authored by individuals who know what they are talking about. Always a Plus!

Can't seem to get my PCP interested into looking further into the reason that I have a highly elevated B12 level, so will just do a self referral to a hematologist!

I am also a retired RN who just received my lab results with a B12 level of 1894. I have an appointment with my primary tomorrow. I am anxious to see what he says. In doing my research I came upon your letter and the replies you have received. They were very enlightening.

I wonder how you are doing and if you have received any information you are comfortable with.

I cannot get a rise from any physician that reviews my labs, which for the most part are WNL except for the elevated B12......no one seems concerned. Also, cannot find much literature/research/medical articles etc. addressing it either. Even the Consierge Functional Physician I go to is not concerned. I quiet taking Multivitamins and am supplementing the B's minus B12. So there must be something about it because why would a company even make a Vitamin B supplement minus B12? Niacin flush not to much fun! So I have quit fretting about it....Interesting that no one is able to give me an answer.....may have to start inquiring RDs. Please let me know if you find anything!

Mother and I were also taking daily B12 supplements 1000 mg of methylcobalamin. The blood work showed high elevation of B12 for both of us. The doctor said it not harmful. There are benefits to taking B12. We reduced the dose. Now we take it a few days a week and not daily. We had no headaches or other symptoms.

@kndaustin71
Kdalda 75
Please clarify, was the B12 level greater than 1200, or greater than one might expect from taking B12 oral, or supplemental injection?
Did physicians ignore the extraordinary high B12 level because no other lab was abnormal? (In other words do you have normal results for WBC and CBC (neutrophil counts, etc), hepatic enzymes ALT/AST OR SGPT/SGOT normal, kidney function estimates OK (estimate of GFR or CrCl) normal? No unexplained weight loss, or other symptoms? I suppose if you are feeling great and the only lab abnormality is markedly elevated B12, they might monitor, for now?

Please let us know if anything develops or changes.
Certainly if you have other lab abnormalities, weight loss, or other illness were applicable, work up might by a specialist might be pursued, agreed?

Best wishes

@tailbackhip B 12 trending upward from 2021 for 989 to current 1900. Other labs WNL with some variance but unremarkable. No weight loss. Have researched thru reputable sites, NIH, John Hopkins etc and found nothing. Not sure I want to pursue it further and end up doing the physicians research for them. I tend to be rather cynical re the medical arena in the good ole Southern States Where everyone stays in on place to do their med school, resident studies and fellowships......blind leading the blind

@kndaustin71 I’m going to tell you a secret; most clinicians are horrible at diagnosis. Even with labs and other diagnostic tests they often fail to put the puzzle pieces together adequately. I am an RN who has MANY chronic conditions (neurological & connective tissue) and my recent labs also had elevated levels of b12. Without having them in front of me idk the levels but I also had a low iron and my first through was possibly pernicious anemia but idk if that’s accurate as I don’t think I have a beefy red tongue (supposedly a hallmark of the disease). So I kept digging and I noticed one of the other autoimmune conditions that I suspected called Sjögrens Syndrome. I already suspected this because I have other conditions that are related to it. I want you to ask them to check for Sjögrens Syndrome. The next thing is a MTHFR gene mutation. That’s what I will be asking my primary care provider at my next visit. I already suspected I had Sjögrens along with a connective tissue disorder called Ehlers Danlos Syndrome & a bunch of other ones because I already have Chiari Malformation type 1, Syringomyelia, Scoliosis, Kyphosis. I also suspect Neuro EDS since I already have several conditions in that group.

Tell your provider you want them to look for Sjögrens and MTHFR gene mutations, or anything related to that. Another person posted an even more comprehensive list of a differential, & as an RN it’s outside of my scope of practice (currently) to make a medical dx. So you may want to consult that more comprehensive list. I wouldn’t just ignore this as b12 vitamins are water soluble. Meaning we pee them out. We should not have excess. I stopped taking my vitamins a week before my labs at least so something doesn’t add up. I had my detective hat on earlier and this is the most reasonable explanation for me personally. If you don’t have any of those conditions you need to see a hematologist or oncologist. This isn’t something to sit on. It could be from over-supplementation, but that doesn’t make much sense, we should be removing them. So it could also be a liver or kidney issue. Fatty liver disease. It could be inflammation. So here’s what I would do. Ask your primary to draw labs for inflammation & redraw the B12 as well. If the B12 is still high ask them about Sjögrens (don’t be surprised if they know nothing about it or haven’t heard of it). Ask about the MTHFR gene mutations & if they don’t want to do it tell them you want it documented in your chart that they don’t want to order necessary tests. I wouldn’t not anticipate your PCP will know anything about most of these things. Even among neurologists they don’t know what to do with me. lol it’s automatically you go to neurosurgery. I hope this gives you some answers. ⚕️