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Conditions include alcoholic liver disease, viral hepatitis, cirrhosis, and primary or metastatic liver cancer Renal dysfunction : Impaired kidney function reduces B12 elimination, causing accumulation even with normal intake Haematological conditions : Myeloproliferative neoplasms, chronic myeloid leukaemia, polycythaemia vera, and hypereosinophilic syndrome increase transcobalamin production, elevating total serum B12 Laboratory interference : Macro-B12 (immunoglobulin-bound B12) and assay interference can cause spuriously elevated results without true excess In clinical practice, unexplained hypercobalaminaemia should prompt investigation for underlying disease, particularly in patients without obvious supplementation history

Our Podiatrists will be able to confidently assess your feet and analyse exactly what is causing your presenting lower limb complaint and how to treat/manage it

10.9734/ARRB/2016/31711

The improvement in energy levels following B12 supplementation in deficient individuals reflects restoration of normal physiological function rather than a stimulant effect

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