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Jun 2023;165:104308.doi:10.1016/j.brat.2023.104308

When should methylmalonic acid, homocysteine, or holotranscobalamin be ordered despite a high total B12

People with Digestive Disorders Conditions like celiac disease or Crohns disease can block vitamin B6 and B12 absorption

(Green R, et al., Nature Reviews Disease Primers, 2017 PubMed: 28660890 ) Because B12 is water-soluble, excess amounts that the body cannot use are excreted in urine rather than stored