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See a doctor if you have high B12 and High B12 on a blood test doesn’t always require action, but certain combinations warrant prompt evaluation: B12 above 1,000 pg/mL without supplementation or injections Unexplained fatigue, weight loss, abdominal pain, or night sweats alongside elevated B12 Abnormal liver function tests (ALT, AST, bilirubin) or kidney markers (creatinine, GFR) on the same panel Abnormal complete blood count (CBC), especially elevated white blood cells, red blood cells, or platelets B12 levels that are rising over serial measurements without a clear dietary or supplement explanation What to do about high B12 levels There is no specific “treatment” for high vitamin B12 because the B12 level itself is almost never the problem