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However, human clinical trials are limited, and long-term safety data is sparse — a 2025 systematic review of 36 studies found 35 were preclinical and only one clinical , with no clinical safety data identified (Vasireddi et al., 2025)

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Causes of Excessive B12 Levels Elevated serum vitamin B12 levels (hypercobalaminaemia) can arise from various mechanisms, both iatrogenic and pathological