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Irritation or adverse reactions Skin irritation from topical application usually responds to reducing frequency or concentration

Pathological causes of elevated B12 warrant careful consideration: Haematological disorders : Myeloproliferative neoplasms (polycythaemia vera, chronic myeloid leukaemia), acute leukaemia, and lymphoproliferative disorders can increase B12-binding proteins (transcobalamin and haptocorrin), elevating total serum B12 [3] Liver disease : Hepatocellular damage releases stored B12 into circulation

Supporting evidence excerpts were retained with each extracted record to facilitate manual review and downstream quality assurance

24 HeL.WeiQ.LiuJ.YiM.LiuY.LiuH.et al (2017)