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A consultation with a Primary Care Provider is still a good idea if: Your B12 levels are persistently low or high without explanation You have a family history of autoimmune conditions or GI cancers You are vegan, over age 60, or on long-term medications that may interfere with B12 If symptoms persist, especially if they worsen, seeking medical attention is important to determine the cause and start appropriate treatment, says ter Keurs

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In such cases, someone with the MTHFR gene variation may seem to have elevated levels of B12 (as well as elevated levels of homocysteine), but will actually have low levels of B12 in the form that their body can utilize