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chronic liver disease and hepatitis may present with elevated levels Renal impairment : Reduced clearance can contribute to accumulation, though this is rarely clinically significant Solid tumours : Certain malignancies, particularly hepatocellular carcinoma and metastatic disease, may elevate B12 levels [3] Evidence suggests that unexplained markedly elevated B12 levels without supplementation may sometimes be associated with underlying disease

Further context As the global health community continues to grapple with the obesity epidemic, interest has grown in glucagon-like peptide-1 (GLP-1) receptor agonists

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( B ) Larger magnification of two DNs

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