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Pathological causes of elevated B12 warrant careful consideration: Haematological disorders : Myeloproliferative neoplasms (polycythaemia vera, chronic myeloid leukaemia), acute leukaemia, and lymphoproliferative disorders can increase B12-binding proteins (transcobalamin and haptocorrin), elevating total serum B12 [3] Liver disease : Hepatocellular damage releases stored B12 into circulation

A Realistic Starting Point If low energy, fatigue, or stalled progress toward a healthy weight has you considering B12 injections, the most useful first step is confirming whether a deficiency is actually present rather than guessing

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