How can you remove excess B12 from the body to reduce B12 levels?
If your blood test shows high B12 levels, it often points to an underlying condition that causes the B12 to be released from its stores into the blood. In other words, high B12 levels are a symptom, not the cause, of an issue worth investigating:
The aetiological profile of high serum cobalamin predominantly encompasses severe disease entities for which early diagnosis is critical for prognosis. These entities are essentially comprised of solid neoplasms, haematological malignancies and liver and kidney diseases. This review reflects the potential importance of the vitamin B12 assay as an early diagnostic marker of these diseases. A codified approach is needed to determine the potential indications of a search for high serum cobalamin and the practical clinical strategy to adopt upon discovery of elevated cobalamin levels. While low serum cobalamin levels do not necessarily imply deficiency, an abnormally high serum cobalamin level forms a warning sign requiring exclusion of a number of serious underlying pathologies.
The pathophysiology of elevated vitamin B12 in clinical practice
Treatment of High B12 Levels
So, how to flush out vitamin B12 excess?
In the presence of an underlying illness, the best treatment for high vitamin B12 levels is to treat the illness. Once you resolve the condition, B12 levels should normalize. Don’t worry, excess B12 is harmless and naturally flushes out of your system.
Possible Underlying Conditions
- Cancer destroying healthy cells, releasing B12 into the blood
- A malfunctioning liver that can no longer store B12
- Kidney issues
- Higher production of the transport protein haptocorrin, which binds to B12
Elevated levels of serum cobalamin may be a sign of a serious, even life-threatening, disease. Hematologic disorders like chronic myelogeneous leukemia, promyelocytic leukemia, polycythemia vera and also the hypereosinophilic syndrome can result in elevated levels of cobalamin. Not surprisingly, a rise of the cobalamin concentration in serum is one of the diagnostic criteria for the latter two diseases. The increase in circulating cobalamin levels is predominantly caused by enhanced production of haptocorrin. Several liver diseases like acute hepatitis, cirrhosis, hepatocellular carcinoma and metastatic liver disease can also be accompanied by an increase in circulating cobalamin. This phenomenon is predominantly caused by cobalamin release during hepatic cytolysis and/or decreased cobalamin clearance by the affected liver. Altogether it can be concluded that an observed elevation of cobalamin in blood merits the a full diagnostic work up to assess the presence of disease.
SIGNIFICANCE OF ELEVATED COBALAMIN (VITAMIN B12) LEVELS IN BLOOD
If your B12 levels are abnormally high, go and have the necessary tests done.
One Exception: Supplementing
Taking a B12 supplement regularly? Then high B12 blood levels are expected. If you’re still thinking how to flush B12 out of your system, know that even if you managed to do so, your levels will quickly become high again. For this reason, doctors advise stopping supplements for at least two weeks before a B12 blood test. It could skew results.
Should You Decrease B12 Levels Anyway?
As explained, unless you supplement on a regular basis, your number one priority should be to find out what underlying condition causes your B12 levels to be so high. Address that underlying illness, and your levels should return to normal soon after.
Now, if you’re still concerned about lowering B12 levels, remember that B12 is water-soluble. It dissolves in water and isn’t easy to store. The body absorbs what it needs and can absorb, and excretes the rest through urine. Exactly how long does it take for B12 to leave your system? The body releases most excess B12 in the blood within hours.
For this reason, there’s no toxicity threshold for B12. In life-threatening cyanide toxicity, doctors inject 5,000,000 µg of B12, causing blood levels to rise to 560,000,000 pmol/L. If needed, they repeat it for a total of 10,000,000 µg, 4.17 million times the recommended daily intake. B12 is not only non-toxic in such doses but also helps clear the cyanide toxicity from the body. B12 levels return to normal once the excess is urinated out.
What about those with kidney issues? There’s a study from Japan, where kidney dialysis patients with polyneuropathy received 5,000 µg of B12 three times a week for half a year. Because of poor renal clearance, the B12 remained in the blood, and levels rose from an average of 422 pmol/L to 54,000 pmol/L. No side effects were recorded.
Our Point
If you supplement, you’re going to have high levels of B12 around the clock. There is no need to worry about it. It is harmless. Drink enough water, and most of the excess B12 will flush out of your system through the urine within a matter of hours.
However, if you don’t supplement and still show high B12 levels, then do the necessary tests to see what underlying disease is causing the high levels. Treat the disease, and you’ll naturally treat the elevated B12. In other words, focus on treating the underlying disease rather than on how to reduce B12 levels, which are just a symptom.
All the best.