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chronic liver disease and hepatitis may present with elevated levels Renal impairment : Reduced clearance can contribute to accumulation, though this is rarely clinically significant Solid tumours : Certain malignancies, particularly hepatocellular carcinoma and metastatic disease, may elevate B12 levels [3] Evidence suggests that unexplained markedly elevated B12 levels without supplementation may sometimes be associated with underlying disease

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these treatments are not universally available to all patients

Yet in practice, they produce completely different outcomes for completely different purposes, and choosing the wrong one means months of wasted effort targeting the wrong mechanism entirely

We discuss hair loss treatment and safety at consultation