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Key points about elevated B12: Water-soluble vitamin with significant hepatic storage capacity Elevated levels defined as exceeding laboratory upper reference limit Often discovered incidentally during routine blood tests May reflect underlying pathology rather than toxicity Persistent elevation should be confirmed with repeat testing It is important to note that high B12 levels are generally not considered toxic in the same way as fat-soluble vitamins

doi: 10.3389/fendo.2026.1822475 Received 03 March 2026 Revised 05 May 2026 Accepted 02 June 2026 Published 18 June 2026 Volume 17 - 2026 Edited by Carmine Bruno, Link Campus University, Italy Reviewed by Matej Rakusa, University Medical Centre Ljubljana, Slovenia Fredrik Tiberg, Camurus AB, Sweden Updates Copyright 2026 Dominikowski, Rko, Olejarz, Szczepanek-Parulska, Domin and Ruchaa

In fact, according to the National Institutes of Health, nearly 1 in 5 adults over 60 and up to 15% of the general population are estimated to be deficient in vitamin B12

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