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When B12 levels become problematic: High-dose supplementation (particularly doses exceeding 1,000 micrograms daily) Frequent B12 injections without medical supervision Underlying conditions affecting B12 metabolism Concurrent use of multiple B12-containing supplements The NHS does not set an upper safe limit for vitamin B12 because harmful effects from excessive intake have not been definitively established

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Moreover, elevated plasma Hcy levels have been significantly associated with hypertension (Van Guldener et al., 2003), particularly with systolic blood pressure (SBP) (Shi et al., 2019)