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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
iron deficiency and anaemia is often considered a problem for women, particularly those of child-bearing age
Metformin (for diabetes), proton pump inhibitors (such as omeprazole or esomeprazole), and H2 blockers (such as famotidine) can all reduce B12 absorption over time
Lotiglipron The development of lotiglipron for obesity and T2DM was prematurely stopped in early-phase clinical trials due to its association with elevated transaminases and potential liver toxicity
BPC 157 (acetate) (02 g/mL
Extended room-temperature storage accelerates degradation
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