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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

10.1016/j.redox.2018.08.001 46 WuQ.ChengZ.ZhuJ.XuW.PengX.ChenC.et al (2015)

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10.1016/j.cell.2021.01.004 28 SamantaL.ParidaR.DiasT