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Key Takeaway: Topical application alone faces bioavailability limitations

Pathological causes of elevated B12 warrant careful consideration: Haematological disorders : Myeloproliferative neoplasms (polycythaemia vera, chronic myeloid leukaemia), acute leukaemia, and lymphoproliferative disorders can increase B12-binding proteins (transcobalamin and haptocorrin), elevating total serum B12 [3] Liver disease : Hepatocellular damage releases stored B12 into circulation

A commenter expressed concern regarding CMS adjusting the ranges to increase the penalties for low scores without adequately assessing the impact of those changes

The Wrong Water: Using tap water, bottled water, or even unpreserved sterile water for a multi-use vial is asking for trouble

Przemeck SM, Varro A, Berry D, et al