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Conditions associated with elevated B12 levels include: Liver disease : Hepatocellular damage releases stored B12 into circulation, with levels correlating with disease severity in conditions such as cirrhosis, hepatitis, and hepatocellular carcinoma Renal impairment : Reduced kidney function decreases B12 clearance, leading to accumulation Haematological malignancies : Myeloproliferative disorders, acute leukaemia, and polycythaemia vera can elevate B12 through increased production of B12-binding proteins (transcobalamins) Solid tumours : Certain cancers, particularly those affecting the liver or gastrointestinal tract, may elevate B12 levels A specific concern relates to cyanocobalamin in patients with Leber's hereditary optic neuropathy , a rare mitochondrial disorder

Hong Kong Med J 2015 Apr;21(2):15564 | Epub 10 Mar 2015 DOI: 10.12809/hkmj144383 Hong Kong Academy of Medicine

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[4] Enhanced athletic performance: For fitness enthusiasts and athletes, decreasing body fat can lead to improved athletic performance

[DOI] [PubMed] [Google Scholar] 131.Werner J, Laposata M, Fernandez-Del Castillo C, Saghir M, Iozzo RV., Lewandrowski KB, Warshaw AL

Improves Insulin Sensitivity Promotes better glucose metabolism and weight management