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and Rarely, kidney problems

Altered B12 handling and reduced clearance in kidney disease, and both cellular release and reduced clearance in liver disease, can raise B12, so supportive renal or hepatic findings make those causes plausible

Increased serum vitamin B12 levels are associated with adult-onset Stills disease with reactive macrophage activation syndrome

2017 Feb;13(1):75-80

Increased Energy Levels: Vitamin B12 plays a crucial role in energy production within the body

WADA specifies in its S0 clause that any pharmacological substance without regulatory approval for human use is banned at all times in sport (World Anti-Doping Agency)