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A physician investigating unexplained hypercobalaminemia will typically order some combination of the following: Complete blood count (CBC) with differential to check for abnormal red blood cell, white blood cell, or platelet counts Liver function tests (ALT, AST, ALP, bilirubin, albumin) to assess liver health Kidney function tests (creatinine, BUN, estimated GFR) to evaluate renal clearance Peripheral blood smear if a myeloproliferative disorder is suspected Abdominal imaging (ultrasound or CT) if liver or abdominal pathology is a concern Cancer-specific markers or screenings if clinical suspicion warrants them The NIH Office of Dietary Supplements fact sheet notes that observational data from a Danish registry analysis of 757,185 people found the adjusted 1-year cancer risk was 1.74 to 4.72 times higher among those with B12 above 813 pg/mL compared to those in the normal range of 203 to 813 pg/mL

[13] Potential Risks and Side Effects of B12 Injections Whilst B12 injections are generally considered safe due to the vitamin's water-soluble nature (excess is excreted renally), several adverse effects and risks warrant consideration
Effective Absorption : Vitamin B12 injections are 100% absorbed, as theyre given directly into the muscle or under the skin
Even though vitamin deficiency can go undetected, there are adverse effects if your body is not getting enough of the nutrition it needs to function at its best