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Reported intake or a recent injection is the likely cause, since oral supplements, fortified products, and injected B12 are the most common reasons for a high value

Oral Vitamin B12 Replacement for the Treatment of Pernicious Anemia

Another group thats at-risk for low B12 levels are those who have had gastric bypass surgery or have other stomach issues, such as ulcers

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The reported adverse reactions following parenteral administration of vitamin B12 include: Generalized : Anaphylaxis and death Cardiovascular : Pulmonary edema and congestive cardiac/heart failure during early treatment