High Vitamin B12 Levels: Causes and Implications for Your Health - Cardiology

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What happens if the concentration of B12 in the serum is too high?


Due to a recent episode of gastroenteritis, I unexpectedly discovered anemia through blood tests in the emergency department.
Upon follow-up blood tests, the results are as follows: the low iron index indicates iron deficiency anemia, but I also found that my vitamin B12 level is five to six times higher than the normal range.
I recall receiving a B12 injection nine days prior in orthopedics due to hand numbness, and I have not supplemented further.
However, the B12 level is significantly elevated.
Does this indicate any underlying disease that could cause such a dramatic increase in B12? Could it be related to the injection I received nine days ago?
WBC: 9000/μL (4500-11000)
RBC: 4.22 million/μL (4.2-5.4)
HGB: 9.8 g/dL (12-16)
HCT: 30.7% (37-47)
MCV: 72.8 fL (80-96)
MCH: 23.2 pg (27.5-33.2)
MCHC: 31.8 g/dL (33.4-35.5)
RDW: 19% (11.5-14.5)
PLT: 222,000/μL (150,000-350,000)
RET: 0.94% (0.6-2.1)
RET#: 0.0410 million/μL
CHR: 25.4 pg (29-33)
TIBC: 422 (200-400)
Iron: 32 (35-200)
Ferritin: 6.1 (30-204)
DC - White blood cell differential is within normal limits
IgG: 1673 mg/dL (751-1560)
IgA: 299 (82-453)
IgM: 208 (79-152)
Vitamin B12: 3039 (187-883 pg/mL)
Folate: 8.5 (3.1-20.5 ng/mL)
eGFR: 84 mL/min/1.73 (normal > 60 mL/min/1.73)
BAND: 0.0 (0-5)
GOT, GPT, albumin, and globulin are all normal.
An abdominal ultrasound showed one or two small calcifications in the kidneys and a 1 cm hepatic hemangioma.

Vivian, 30~39 year old female. Ask Date: 2017/08/19

Dr. He Dongjin reply Cardiology


Hello, after receiving a B12 injection, it is possible for levels to increase, which is not harmful.
It is advisable to monitor the situation.
Having a bit more of it is also not an issue.
Changhua Hospital cares about you.

Reply Date: 2017/08/19

More Info


High levels of Vitamin B12 in the blood can raise concerns, particularly when they are significantly above the normal range, as you have indicated with a level of 3039 pg/ml compared to the normal range of 187-883 pg/ml. It's important to understand the potential causes and implications of elevated Vitamin B12 levels, especially in the context of your recent health issues, including iron deficiency anemia and a history of gastrointestinal problems.

Vitamin B12, also known as cobalamin, plays a crucial role in red blood cell formation, neurological function, and DNA synthesis. While deficiencies in Vitamin B12 can lead to serious health issues, including anemia and neurological disorders, elevated levels can also warrant investigation.
In your case, the high B12 levels could be attributed to several factors:
1. Recent Supplementation: You mentioned receiving a B12 injection nine days prior to your blood test. This is likely the most significant contributor to your elevated levels. B12 injections can lead to a rapid increase in serum B12 levels, and this is generally considered a normal response to supplementation.

2. Underlying Health Conditions: While your recent injection is a likely cause, elevated B12 levels can sometimes indicate underlying health issues, such as liver disease, certain types of leukemia, or other hematological disorders. However, your blood work shows that your white blood cell counts and other parameters are within normal ranges, which makes these conditions less likely.

3. Dietary Intake: If you consume a diet rich in animal products, this could also contribute to higher B12 levels, but given your recent injection, this is less likely to be a significant factor in your case.

4. Functional B12 Deficiency: In some cases, individuals may have high serum B12 levels but still experience symptoms of deficiency due to issues with absorption or transport. This is less common but worth considering if you have symptoms related to B12 deficiency.

Given your low iron levels and the diagnosis of iron deficiency anemia, it is essential to address this condition as well. Iron deficiency can lead to fatigue and other symptoms, which may overlap with those of B12 deficiency. It is crucial to manage both conditions effectively.

In terms of follow-up, it would be prudent to monitor your B12 levels after a period of time to see if they normalize, especially if you are not continuing with B12 supplementation. Additionally, addressing your iron deficiency through dietary changes or supplementation, as advised by your healthcare provider, is important.

If you continue to experience symptoms such as fatigue, weakness, or neurological issues, further investigation may be warranted. This could include additional blood tests, imaging studies, or referrals to specialists, depending on your healthcare provider's assessment.

In summary, while your elevated Vitamin B12 levels are likely a result of the recent injection, it is essential to continue monitoring your health, particularly your iron levels and any symptoms you may experience. Always consult with your healthcare provider for personalized advice and treatment options tailored to your specific health needs.

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