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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

The researchers own conclusion was that it was well absorbed. Why that number is the whole ballgame: ~38% of an oral dose reaching circulation is a genuinely good absorption fraction for an oral compound plenty of approved oral products sit at or below that

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Taking vitamin B-12 with vitamin C might reduce the available amount of vitamin B-12 in your body