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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
NoHRT isnt a direct weight loss treatment
Fasting insulin, HOMA-IR as an insulin resistance index, HbA1c, and C-reactive protein as an inflammation marker
For patients seeking personalized optimization, the PlexusDx Precision Peptide Genetic Test ($298) analyzes 14 metabolic pathways and 49 peptides to identify genetic variations affecting medication response and weight regain risk
