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Because B12 is primarily found in animal products (meat, fish, dairy, eggs), people following vegetarian or vegan diets may be at higher risk of deficiency

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chronic liver disease and hepatitis may present with elevated levels Renal impairment : Reduced clearance can contribute to accumulation, though this is rarely clinically significant Solid tumours : Certain malignancies, particularly hepatocellular carcinoma and metastatic disease, may elevate B12 levels [3] Evidence suggests that unexplained markedly elevated B12 levels without supplementation may sometimes be associated with underlying disease

Self-administering researchers need to budget $20-50 monthly for quality supplies