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Myeloproliferative Disorders: Conditions like polycythaemia vera could be associated with increased B12 binding proteins, leading to higher circulating B12 levels 3 , 10 , 11

Clinical indications include deficiency due to inadequate diet or malabsorption, drug-induced deficiency (for example, from long-term isoniazid or oral contraceptives), and certain inborn errors of metabolism (such as pyridoxine-dependent seizures or sideroblastic anemia)

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We suggest that vegetarians and vegans take b12 supplements with cyanocobalamin daily