What do significantly high levels of vitamin B12 indicate?

Hello,

Welcome to icliniq.com.

Based on your query, my opinion is as follows.

Increased vitamin B12 is worrisome. It is a water-soluble vitamin. It never increases unless there is some amount of hepatic damage or certain cancers. I strongly urge you to get a liver function test. Both Cymbalta (Duloxetine) and Citalopram are excreted partially or fully through the liver, and whether they have caused any liver injury needs to be looked into.

Alcohol or other hepatotoxic drugs need to be considered. ALT (alanine transaminase) and AST (aspartate transaminase) enzyme levels can confirm if there is any liver injury. Because of your age, I suspect liver injury. Otherwise, numerous cancers can cause it, like chronic myeloid leukemia, promyelocytic leukemia, polycythemia vera, and hypereosinophilic syndrome. Certain solid tumors of the liver and pancreas are also known to be associated.

I hope there is no family history of cancer. Get a complete hemogram and a peripheral smear done. It will help in identifying blood cancer. Even in an autoimmune disorder, it can be increased. There are too many of them. I do not have your complete history, so I cannot comment much on that.

At present, I am only worried about liver damage or cancer. Get the ALT and AST enzyme levels with a complete hemogram with peripheral smear. If normal, then keep checking for once in three to four months for at least a year to make sure you do not have it. A single test alone would not mean much. Discuss with your doctor regarding the tests.

I hope this helps.

Thank you.

Hi,

Welcome back to icliniq.com.

You had excess vitamin B12. Studies have shown that even taking 1000 mcg per day delivers only 5 to 40 mcg of vitamin B12 when taken orally. Anything in excess is always excreted through urine. Injectable vitamins can cause excessive levels as they are absorbed directly. But, orally, it is very rare. The possibilities of malignancies are low at this age. Alcohol or drug-induced hepatitis may be the cause.

I would recommend that you repeat the vitamin B12 assay after stopping vitamin B12 supplements for 10 to 15 days. The gut bacteria and diet contain vitamin B12. So, you need not worry about it. Presently, stopping vitamin B12 is a good option. If the vitamin B12 level does not reduce, then you will have to get the tests of the liver and a complete hemogram with a peripheral smear.

Keep monitoring your vitamin B12 levels for a year at intervals of every two to three months.

I hope this helps.

Thank you.