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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

Finally, the biggest risk is for people who have pernicious anemia, a rare condition in which a person is unable to absorb any B12 through their stomach or intestines people with this condition are the ones who actually need B12 injections

Let it dry completely