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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
Essential facts about Vitamin B12 : Vitamin B12 helps in controlling the level of amino acid found in blood plasma
Subcutaneous may offer slightly more consistent plasma levels, but the practical difference is marginal given the compounds short half-life requiring daily dosing either way
Keep the solution at room temperature (typically below 25 C or 30 C), unless otherwise instructed by the pharmacist
