The GP will take a detailed history including: Current medications and supplements (particularly B12 injections or high-dose oral preparations) Alcohol consumption and risk factors for liver disease Personal or family history of haematological disorders or cancer Symptoms suggesting underlying pathology Recommended investigations: Patients with unexplained elevated B12 should undergo: Repeat B12 measurement to confirm persistence, ideally timed away from recent injections or high-dose supplements Full blood count (FBC): To identify polycythaemia, leucocytosis, or other haematological abnormalities Liver function tests (LFTs): Including ALT, AST, ALP, bilirubin, and albumin to assess hepatic function Renal function tests: Urea, creatinine, and estimated glomerular filtration rate (eGFR) Lactate dehydrogenase (LDH): Elevated in haemolysis, liver disease, and some malignancies Further investigations may include: Abdominal ultrasound or CT scanning if liver disease or malignancy suspected Haematology referral for bone marrow examination if myeloproliferative disorder considered Liaison with the laboratory if results conflict with the clinical picture, as immunoassay interference (e.g., macro-B12) may occur In specialist settings, measurement of holo-transcobalamin or B12-binding proteins may be considered The urgency of investigation depends on clinical features and suspected underlying conditions
If it works for you, the expected effect is more along the lines of: modest shifts in fat loss over weeks to months, not dramatic weekly scale drops
Osteoarthritis is the commonest form of arthritis and is a common cause of hip pain, especially amongst older people
The injections quickly replenish the body's stores and provide rapid relief from your symptoms
Following the advice in this article helps doctors create a treatment plan that works for you
[1] However, whilst acute toxicity is rare, elevated serum B12 levels can occasionally occur and may warrant investigation, particularly when they arise unexpectedly or in the context of certain medical conditions
