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Determination of cyanocobalamin by isotope dilution LC-MS/MS
A physician investigating unexplained hypercobalaminemia will typically order some combination of the following: Complete blood count (CBC) with differential to check for abnormal red blood cell, white blood cell, or platelet counts Liver function tests (ALT, AST, ALP, bilirubin, albumin) to assess liver health Kidney function tests (creatinine, BUN, estimated GFR) to evaluate renal clearance Peripheral blood smear if a myeloproliferative disorder is suspected Abdominal imaging (ultrasound or CT) if liver or abdominal pathology is a concern Cancer-specific markers or screenings if clinical suspicion warrants them The NIH Office of Dietary Supplements fact sheet notes that observational data from a Danish registry analysis of 757,185 people found the adjusted 1-year cancer risk was 1.74 to 4.72 times higher among those with B12 above 813 pg/mL compared to those in the normal range of 203 to 813 pg/mL
This makes sense on paper, but there are no large human studies proving the combo works better than using just one
I think they are promising but Im not sold just yet for me personally because of the lack of data and regulation
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Potential long-term health consequences
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