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In addition, factors unrelated to vitamin B12 status, and noted earlier, may have contributed to the seemingly normal or sometimes high levels of serum B12

In the left you can see the B12 tucked into the structure, such that it is buried within the protein (right) The major cause of Paradoxical Vitamin B12 Deficiency appears to lack of functional vitamin B2, which may occur due to overt vitamin B2 deficiency in a person's diet, Hypothyrodism (Habbar etal, 2008), or due to lack of adequate intake of Iodine, Selenium and/or Molybdenum, which in turn leads to insufficient production of the two active forms of vitamin B2, namely FMN and FAD