Red blood cells carry oxygen around the body. An association between elevated B12 and solid cancers has been demonstrated by two population-based cohort studies16,17 and persists after adjustment for the other elevated-B12-related causes1. B-12 uses three different carrier proteins to do this TCN 1, TCN 2, and TCN 3. Inflammation. Epub 2012 Nov 25. van der Wal HH, Comin-Colet J, Klip IT, Enjuanes C, Grote Beverborg N, Voors AA, Banasiak W, van Veldhuisen DJ, Bruguera J, Ponikowski P, Jankowska EA, van der Meer P. Heart. One Cause of Vitamin B12 Deficiency. 2. IUBMB Life 68, 303310 (2016). 5, 232640981769235 (2017). . LiveWell Labs Nutrition 100% Methylcobalamin Vegan B12 Drops. ADS This does not necessarily mean you have these things but problems that could be going on to cause elevated B-12. Irregular heartbeats. We compared the cancer-free survival during 60months between the groups after adjustment for the other elevated-B12-related causes in a survival competing risk model. Therefore the B-12 just, Role of Inflammation in High B12 Without Supplementation, What To Do With High B12 Without Supplementation. There were 256/688 men (37.2%), and the median time from T1 to the last hospitalization or consultation was 3.2 [1.55.2] years. The antibodies also block a critical protein called intrinsic (in-TRIN-sic) factor. An official website of the United States government. National Library of Medicine Autoimmune thyroid disease, also called Hashimoto's disease, is an autoimmune disease that causes hypothyroidism, or an underactive thyroid gland. With inflammation, there is damage to the cell membranes. Serum Vitamin B12 was increased in 1186 (81.2%) patients, mainly middle-aged males, with sepsis, multiorgan failure, and higher 30-day mortality (all p < 0.01). Drink more water to help flush your body of water-soluble elements in the blood, which includes vitamin B12. Blood 2008; 112 (11): 4898. doi: https://doi.org/10.1182/blood.V112.11.4898.4898. Vitamin B 12 in serum is bound to two proteins, haptocorrin (HC) and transcobalamin (TC). Intrinsic factor is a protein made in the stomach. The information in the article is based a research paper that can be found here ( Causes of High B12 Without Supplementation in Clinical Practice ). Wang, Z. et al. Among these 344, 144 (41.9%) patients had a B121000ng/L at T2 (EE group) and 200 (58.1%) patients had a B12<1000ng/L at T2 (EN group). Google Scholar. We collected the incident elevated-B12-related causes, including solid cancers, which appeared within 60months following T1, and their date of occurrence. By using this Site you agree to the following, By using this Site you agree to the following, Need relief - not sure what is going on - std or autoimmune, Had IV Infusion for possible MS, test results unclear, The Best IOL for 2022 RXSight Light Adjusted Lens, Will refractive surgery such as LASIK keep me out of glasses all my life. What does it mean if your B12 is too high? The second hypothesis is that of the release of haptocorrins by the granulocytic cells involved in the anti-tumor response. Article We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Level was 33 (27-32). Gimsing, P. Cobalamin forms and analogues in plasma and myeloid cells during chronic myelogenous leukaemia related to clinical condition. Chem. In patients with repeatedly high B12 levels, ICs were detected in approximately 25% of samples. What does it mean if your B12 is too high? F.C. Incident solid cancer was diagnosed in 30/144 (20.8%) patients in the EE group, 12/200 (6.0%) in the EN group and 13/344 (3.8%) in the NN group (p<0.001). As a result, there is more binding of the B-12 but less of it is getting taken up into the cells because it's all bound by non-functional transport proteins. 2020 Oct 9;18(1):307. doi: 10.1186/s12916-020-01771-y. The main autoimmune issues in ALPS are related to reactions against components of blood. The serum vitamin B12 level: its assay and significance. This supports the presence of undiagnosed subclinical cancer rather than a hypothetical role of the elevated B12 in the development of cancer. This site needs JavaScript to work properly. 8600 Rockville Pike 2023 Cryptoguiding. HC is a glycosylated serum protein of ~68kDa that is produced mainly by . Arendt, J. F. H., Srensen, H. T., Horsfall, L. J. Nat. (Video) Diet That Tackles Symptoms of Autoimmune Diseases. Patients gave informed consent. Measuring holotranscobalamin II, an early indicator of negative vitamin B12 balance, by radioimmunoassay in patients with ischemic cerebrovascular disease. The authors declare no competing interests. Google Scholar. Oncol. We are not able to exclude loss of information due to the fact that follow-up was carried out in several centers. hope this video was helpful in giving you a deeper understanding of the causes of elevated B-12 level without supplementation. We cannot exclude that the elevated B12 level may have prompted some physicians to look for underlying cancer in patients of the EE and EN groups, but this limitation is imbalanced by the prolonged follow-up (3.2 [1.55.2] years in the whole population, with a longer follow-up in the NN group), which could have enabled detection of cancers that have not been actively searched initially. So how does B-12 get into the cell? This still can be the cause of high B-12 without supplementation but there could be other, more serious, reasons for this as well. In any case of persistently elevated B-12 levels, you should be explored the other things noted above with preliminary labs to make sure you don't have problems with your white blood cells, kidneys, liver, etc. Inflammation in the tail-end of your small intestine, called Ileitis, can have numerous causes. Arendt, J. F. B., Pedersen, L., Nexo, E. & Srensen, H. T. Elevated plasma vitamin B12 levels as a marker for cancer: A population-based cohort study. Therefore, malabsorption of vitamin B-12 is quite likely to occur in patients with CD. Zhao, L., Wei, Y., Song, A. Podzolkov VI, Dragomiretskaya NA, Dambaeva OT, Auvinen ST, Medvedev ID. Increased vitamin B12 serum may be due to: Didn't find the answer you were looking for? 2006 Nov;52(11):2107-14. doi: 10.1373/clinchem.2006.073882. https://www.westonaprice.org/soy-alert . We assessed the prevalence of vitamin B12 deficiency in patients with AITD and whether their evaluation may be simplified by measuring fasting gastrin levels. Previous studies have chosen a variety of levels to represent high or very high B12 (pmol/l) levels. Haematologica 91, 394396 (2006). FOIA contracts here. Moreover, a prospective study was carried out during three consecutive months. Pernicious anemia is an autoimmune condition that happens when your immune system produces antibodies that attack cells in the mucosal lining of your stomach and nerve cells. Cases of Gaucher disease, systemic lupus, rheumatoid arthritis and Still's disease with high serum cobalamin have also been reported. The two major types of lymphocytes are B cells and T cells, which are derived from pluripotent hematopoietic stem cells in the bone marrow. Google Scholar. J. - Randomly woke up one day last week with excessive swelling under ja Hi forum In studies evaluating the association between solid cancer and elevated B12, a single measurement was sufficient to define an elevated B12 level1,16,17. [Hypervitaminosis B12 - a new marker and predictor of prognostically unfavorable diseases]. Pernicious anemia is an autoimmune condition in which the body can't absorb vitamin B12 correctly. For the first time, we demonstrate that the risk of incident solid cancer in the case of transiently elevated B12 is similar to that of patients without elevated B12, whereas this risk is strongly increased in the case of persistent elevated B12. Initially thought I had a yeast infection redness, swelling, itching. It also is normal for lymph nodes to change somewhat in size, shape, or feel over time. What autoimmune diseases cause high B12 levels? Read on to learn more about testing B-12 levels and what the test results mean. I'm assuming these 2 abnormal tests will be linked, as in both being caused for potentially the same reason? Symptoms may develop over time and include: 5. Berg, R. L. & Shaw, G. R. Laboratory evaluation for vitamin B12 deficiency: The case for cascade testing. Department of Internal Medicine and Clinical Immunology, Angers University Hospital, Angers, France, Valentin Lacombe,Carole Lacout,Alaa Ghali,Christian Lavigne&Geoffrey Urbanski, Department of Biochemistry and Genetics, Angers University Hospital, Angers, France, Ouest Institute of Cancerology, Angers, France, Department of Internal Medicine and Clinical Immunology, Angers University Hospital, 4 rue Larrey, 49000, Angers, France, You can also search for this author in The plasma vitamin B12 (B12) measurement is mainly conducted to detect vitamin B12 deficiency, but the incidental finding of elevated B12 is not uncommon1,2. Solid cancers represent one of the main diagnoses found in patients with unexplained and persistent elevated B12. B12 is stored in the body. Clipboard, Search History, and several other advanced features are temporarily unavailable. Bookshelf In this article we will explore this topic in a little bit more detail. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Patients with pernicious anemia or those supplemented with vitamin B12 were also excluded. The mechanism of elevated B12 in case of solid cancer is poorly understood5,6,20. People with severely low levels of B12 may need more shots in the beginning. The https:// ensures that you are connecting to the This one will focus on steps to take, labs to do etc. A. M., Vlasveld, L. T. & Lindemans, J. Patient organizations can help patients and families connect. Patients in whom active screening should be discussed need to be better targeted to allow early diagnosis and limit unnecessary investigations. Symptoms tend to be most severe in children, andmany people with ALPS experience a lessening or complete resolution of their autoimmune and lymphoproliferative symptoms in adulthood. The elution profile from size-exclusion chromatography of vitamin B12-binding proteins did not reveal any abnormal vitamin B12-binding proteins in ALPS. Lymphoproliferative disorders are a set of disorders characterized by the abnormal proliferation of lymphocytes into a monoclonal lymphocytosis. Thank you for visiting nature.com. Res. Epub 2021 Jul 2. At least one cause of elevated B12 was diagnosed in the follow-up of 75/144 (52.1%) patients in the EE group, 34/200 (17.0%) in the EN group, and 38/448 (11.0%) in the NN group (p<0.001, Table 1). Gimsing, P. Cobalamin metabolism in chronic myelogenous leukemia. Nutrients. Time-to-event curves for incident solid cancer were presented as KaplanMeier curves and were compared with a log-rank test. Andres, E., Serraj, K., Zhu, J. However, ICs were detected in 10 frozen samples and in seven cases (25%) of the prospective study, respectively. Total and holo-HC levels were 36- and 32-fold higher than the upper limit of the reference interval (Total HC: 250840 pmol/L; Holo-HC: 240680 pmol/L), respectively, in ALPS patients. Consequently, if elevated B12 levels are caused by some cancers, elevated B12 should persist as long as the cancer persists. Elevated B12 has been associated with various diseases1,5,6: liver diseases7,8,9,10, myeloid blood malignancies10,11,12,13, chronic renal failure3,14, autoimmune or inflammatory diseases3, Gaucher disease15. . Br. An official website of the United States government. Clin. If you are having persistently elevated B-12 levels, this information will be helpful. Conclusions: If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. PrEP is used by people with high risk to prevent HIV infection. However, it can have more to do with the transportation of B-12 rather than the cell membrane. The elevated-B12-related causes were: acute liver disease (acute elevation of transaminases to more than 2 times normal) or chronic liver disease (dysmorphic ultrasound appearance, persistent biological signs of hepatocellular insufficiency, and/or histology suggestive of cirrhosis), severe chronic renal failure (MDRD clearance30mL/min/1.73m2), autoimmune or inflammatory disease, Gaucher disease, myeloid blood malignancy, active solid cancer, and cancer treated over the last 5years1,2,6. Implications cliniques de la dcouverte dune hypervitaminmie B12 en mdecine interne. Condoms are the most effective way to prevent HIV and STDs. 5, 2 (2016). Experts have also found high levels of homocysteine in people with coronary heart disease and stroke. Both of which would be elevated in the presence of B-12 deficiency. & Thachil, J. Vitamin B12 deficiency: A 21st century perspective. Neutropenia occurs when the body destroys infection-fighting cells called neutrophils. J. Haematol. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. With liver cancer some of the liver cells are damaged as a result the liver cell are are not expressing as many B-12 receptors. The information in the article is based a research paper that can be found here (, The causes of high B-12 levels without supplementation are numerous. Symptoms. In the case that you've ruled out excess consumption of B-12, it makes sense to explore some of these other things. A. M., Bakker, J. Lab tests also can confirm defects in apoptosis of lymphocytes, which is highly suggestive of ALPS. The diagnosis of ALPS is based on clinical findings, laboratory findings, and identification of mutations in genes, such as FAS, that affect the programmed destruction of cells (apoptosis). Significance of elevated cobalamin (vitamin B12) levels in blood. Hepatitis and Hepatocellular Carcinoma can also lead to increase release of B-12 from the cells being damaged. We therefore hypothesized that acute conditions could have temporarily raised the B12 level. Vitamin B12 is an essential micronutrient that plays a fundamental role in cell division and one-carbon metabolism. Med. We also observed a higher mortality in the EE group, which could possibly bias the incidence of solid cancers. In contrast, people with ALPS often have abnormally low levels of HDL (high density lipoprotein) and total cholesterol. Vitamin B 12 is an essential micronutrient that plays a fundamental role in cell division and one-carbon metabolism. What is the biggest northern pike ever caught in the United States? Between January 2007 and May 2015, 9,198 patients underwent at least 2 measurements of B12 in our center, excluding the intensive care and maternity units. Now this doesn't necessarily explain the elevated B-12 levels but it does explain how one can be deficient in B-12 in the presence of higher serum B-12 levels. 26. Chiche, L. et al. So taking all those causes of elevated B-12 level into consideration, the first thing you want to do is find out if you're actually deficient in B-12. Be sure to check out the next article in a few weeks, what to do about elevated B-12 levels. What level of B12 is dangerously high? Shipton, M. J. You may still have the condition even if your vitamin B12 levels are normal. Events only referred to solid cancers and not to blood malignancies. Vlasveld, L. T., Bos, G. M. J., Ermens, A. Among the causes of elevated B12, incident myeloid blood malignancies and chronic liver diseases were more frequent in the EE group (p<0.001 and p<0.001, respectively). & Baker, E. R. Cobalamin (vitamin B12) and holotranscobalamin changes in plasma and liver tissue in alcoholics with liver disease. PMC . To avoid this, we included the sex of patients as a variable of adjustment in the survival model and, finally, sex did not significantly influence the occurrence of cancer at 60months. Frenkel, E. P., White, J. D., Reisch, J. S. & Sheehan, R. G. Comparison of two methods for radioassay of vitamin B12 in serum. Reviews: 88% of readers found this page helpful, Address: Suite 835 34136 Adrian Mountains, Floydton, UT 81036, Hobby: Skimboarding, Photography, Roller skating, Knife making, Paintball, Embroidery, Gunsmithing. People with ALPS have an increased risk of developing lymphoma. We set the period of at least 1month between the 2 measurements to allow normalization of B12 in case of acute transient elevation. Association study between genome-wide significant variants of vitamin B12 metabolism and gastric cancer in a han Chinese population: Unexpected Role of Vitamin B12 Metabolism Genes. Google Scholar. Loss of follow-up was censored. Let's look at that next. Clin. J. Clin. See, in many autoimmune conditions, there is the risk of malabsorption which can result in nutrient deficiencies as well, it is best to get the blood test done in a fasted state and have abstained from vitamin B12 supplementation for three days, a serum vitamin B12 test does not differentiate between active and inactive forms, vegetarians and vegans may be at increased risk of developing a vitamin B12 deficiency, autoimmune patients often have a defect in how their bodies break down and utilize certain nutrients, Tips for Navigating the Holidays with Hashimotos, 25 Healthy Recipes for Thanksgiving Dinner, Thanksgiving Blessings: How I Learned to be Grateful for My Autoimmune Disease, Five Cold Weather Tips for Arthritis Sufferers, How to Make Household Cleaner Non Toxic and Safe. Vitamin B 12 and its binding proteins in hepatocellular carcinoma and chronic liver diseases. 2014 Southwest Integrative Medicine. In this study, we limited the analyses to cancers occurring within 60months following B12 measurement, because it appeared to be difficult to establish the causal link between a subclinical solid cancer and an elevated plasma B12 beyond a period of 5years32,33,34,35. 76, 521525 (2006). The site of primary cancer (according to the International Classification of Diseases for Oncology classification), presence of metastasis and site of metastasis were collected. So double-check you are not getting B-12 from various sources that you are not aware. Introduction: A doctor may use the results of a vitamin B-12 test to help form their diagnosis. The quantitative data were presented in medians and quartiles and compared using a Student t test or an ANOVA. High levels of these substances in your body are a sign of pernicious anemia. Serraj, K., Mecili, M., Housni, I. An abnormally high vitamin B-12 status can be an early sign of liver disease, diabetes, or certain types of leukemia. Essentially if you remain having persistently elevated B-12 levels in the absence of supplementation you should explore this further with more testing. BMC Nephrol. Serum vitamin B12 decreased to normal values after precipitation with PEG, and size exclusion chromatography confirmed ICs. Hannibal, L. et al. BMC Health Serv. Clin. Assessment of the serum levels of hemoglobin, ferritin, and vitamin B12 in a sample of Iranian population with morbid obesity. [Hypervitaminemia B12 (high level of cobalamin): physiopathology, role and interest in clinical practice]. The patients with elevated plasma B12 at first measurement were split into 2 groups, according to the presence (EE group, n=144) or the absence (EN group, n=200) of persistent elevated plasma B12 at second measurement. Increased vitamin B12 levels are associated with mortality in critically ill medical patients. Primers 3, 1 (2017). Epub 2014 Oct 16. Why vitamin B12 deficiency should be managed aggressively. and JavaScript. 8. What is it called when a prisoner goes back to jail? As a pilot study, 26 frozen samples with high B12 were evaluated for changes in vitamin B12 after PEG. Among these patients, plasma B121000ng/L at T1 were found in 344 patients without any known elevated-B12-related causes. The word "pernicious" means gradually harmful and damaging. Greibe, E. et al. PubMed An association with autoimmune or hematological disorders was observed. The risk of solid cancer seems insufficient to systematically perform these invasive and expansive investigations in case of incidental discovery of elevated B12. (Video) What Causes Autoimmune Conditions? It's also rich in protein, which is good for cellular repair. Autoimmune hepatitis is when the body attacks the liver, an important organ that has many functions. ALPS is a rare autoimmune disease in children resulting from defective lymphocyte apoptosis and is characterized by lymphoproliferation, peripheral accumulation of DNT cells (double-negative T cells; TCR alpha/beta +, CD3+ CD4 CD8), often leading to autoimmune multilineage cytopenias. Res. Results: Unauthorized use of these marks is strictly prohibited. PubMed Vitamin B 12 is an essential micronutrient that plays a fundamental role in cell division and one-carbon metabolism. In other words, about 1 in 5 patients will develop ALPS lymphoma by the time they are 40. Most commonly it would be liver tumors, hepatocellular carcinoma in particular. Patients with elevated plasma B12 (1000ng/L) at first measurement (n=344) were matched for age and sex with patients having 2 normal B12 measurements (<1000ng/L) (NN group, n=344). 1, 37 In the aformentionned study from Arendt, high serum cobalamin levels were significantly associated with alcoholism (odds ratio (OR) = 5.74 [2.76-11.96], liver disease (OR = 8.53 [3.59-20.23]) and cancer (OR = 5.48 [2.85 . What stocks should I buy in a bear market? One of the main causes of increased vitamin B12 with liver disease is release . Pregnant and breastfeeding women may also need to be especially mindful of B12 levels. Remacha AF, Sard MP, Canals C, Queralt JM, Zapico E, Remacha J, Carrascosa C. Ann Hematol. Zibold J, von Livonius B, Kolarova H, Rudolph G, Priglinger CS, Klopstock T, Catarino CB. In this article we will discuss the causes of high B-12without supplementation. Serum B12 level in patients with rheumatoid arthritis was significantly higher than that in patients with osteoarthritis and normal subjects. Additionally, an increase in serum vitamin B12 can indicate lymphoproliferation in the form of ALPS caused by mutations in the FAS gene (ALPS-FAS). Geoffrey Urbanski. Causes Of High B12 Without Supplementation, In this article we will discuss the causes of high B-12without supplementation. This raises the question of the potential interest in repeating investigations 1year later. 2022 Aug 9;17(1):310. doi: 10.1186/s13023-022-02453-z. Vollbracht C, Gndling PW, Kraft K, Friesecke I. J Int Med Res. SDS-PAGE and western blot analysis revealed the presence of HC in lymphocyte lysates of ALPS but not apparently healthy controls. 2019 Aug 15;91(8):160-167. doi: 10.26442/00403660.2019.08.000378. HHS Vulnerability Disclosure, Help Explaining time elapsed prior to cancer diagnosis: patients perspectives. Inflammation is very nonspecific but various cases of autoimmune disease, like lupus etc have been described as causing elevated B-12 levels. Vitamin B 12 in serum is bound to two proteins, haptocorrin (HC) and transcobalamin (TC). J. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. Rev. Interne 29, 187194 (2008). Autoimmune disease, especially against blood cells; . Signs and symptoms may be subtle at first but usually increase as the deficiency worsens. J. People who have low levels of vitamin D often have joint pain. Bethesda, MD 20894, Web Policies Diagnosis is by . J. Is high vitamin B12 status a cause of lung cancer?. Correspondence to ---Significance of elevated cobalamin (vitamin B12) levels in blood--- Abstract "Elevated levels of serum cobalamin may be a sign of a serious, even life-threatening, disease. The influence of covariate (including age, sex, and all the elevated-B12-related causes) on the occurrence of solid cancer was evaluated with a survival competing risk model (package cmprsk from R) with the death as the competing risk. . The first hypothesis consists in the secretion of a tumor mediator increasing the bioavailability of vitamin B12, promoting the synthesis of nucleic acids by cancer cells. C.L., A.G., O.C., A.P. Even though the title is "cause of high B-12 without supplementation," my experience helping people figure this out, they are taking B-12. Patients were required to have undergone two B12 measurements at 2 different times (T1 and T2) at 1 to 48months intervals. 21. High Levels vs. Dis. The first thing to consider and rule out is solid tumors as they can cause elevated B-12 levels. A. Ter Arkh. The association between elevated B12 and solid cancers was demonstrated by two population-based studies: a B12>800pmol/L (1084ng/L) was associated with a diagnosis of cancer in the following year with a Standardized Incidence Ratio of 6.3 [95% CI 5.76.9] in a Danish cohort16, and a B12 between 800 and 1000pmol/L (10841355ng/L) was associated with an Incidence Rate Ratio of 2.9 [95% CI 2.43.5] in a British cohort17. Cancer 116, 14991504 (2017). Our study has some limitations. T2 was the test immediately following T1 with at least 1month between T1 and T2. Shortness of breath. High B-12 levels could be an epiphenomenon or related to a deeper issue with B-12 transportation. Slider with three articles shown per slide. The .gov means its official. So if you are finding high B-12 levels and elevated methylmalonic acid, you would want to supplement with B-12 until that methylmalonic acid goes down. 24. Anything over 950 (pg/mL) is considered high. Ermens, A. QJM 106, 505515 (2013). 1. Biomarkers in lung cancer screening: achievements, promises, and challenges. As you will see below look at some of the problems that can come up with the transcobalamin transport proteins and various diseases that can cause elevated B-12 when you're not supplementing with B-12. Persistent elevation of plasma vitamin B12 is strongly associated with solid cancer, https://doi.org/10.1038/s41598-021-92945-y. This review reflects the potential importance of the vitamin B12 assay as an early diagnostic marker of these diseases. A . Clin. 25. Elevated B12 has been associated with various diseases 1,5,6: liver diseases 7,8,9,10, myeloid blood malignancies 10,11,12,13, chronic renal failure 3,14, autoimmune or inflammatory diseases 3 . the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Most often, with elevated B-12 levels, it has nothing to do with alterations in these transport proteins called transcobalamin. Careers. Bowen RA, Drake SK, Vanjani R, Huey ED, Grafman J, Horne MK 3rd. Sviri, S. et al. Separate from kidney disease, inflammation can be another cause for elevated B-12 levels. How is vitamin B12-deficiency anemia treated? Milman, N., Byg, K.-E., Bergholt, T., Eriksen, L. & Hvas, A.-M. Cobalamin status during normal pregnancy and postpartum: A longitudinal study comprising 406 Danish women. The persistence of elevated B12 was associated with a high incidence of solid cancer at 60months, in contrast to a transient B12 elevation. Epub 2019 Sep 23. The occurrence of solid cancers in 20.8% of patients in the EE group could justify careful clinical surveillance and raises the question of carrying out complementary investigations. government site. Is high vitamin B12 status a cause of lung cancer? Patients in our study were hospitalized, so the results need to be confirmed in an outpatient population. An unexplained elevated B12 level should be confirmed later by a second measurement, which could help to identify patients in whom the screening for solid cancers would be of interest.
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