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Some fortified foods contain B12, such as plant-based milk drinks, yeast extract (Marmite) but the NHS says sources for vegans are limited and a vitamin B12 supplement may be needed. The British Dietetic Association (BDA) recommends the following advice: Long-term vegetarians and vegans should have their vitamin B12 status checked, especially as high folate levels can mask vitamin B12 deficiency, encouraged to consume B12 fortified foods and if required, recommended supplements of around 10 mcg per day to ensure adequate status. Always check in with your doctor if you are vegan and are concerned about your B12 levels, says Dr Michael

Key points about elevated B12: Water-soluble vitamin with significant hepatic storage capacity Elevated levels defined as exceeding laboratory upper reference limit Often discovered incidentally during routine blood tests May reflect underlying pathology rather than toxicity Persistent elevation should be confirmed with repeat testing It is important to note that high B12 levels are generally not considered toxic in the same way as fat-soluble vitamins

Having a diet deficient in B6 results in vitamin B12 levels lowering

It can be taken as oral medication or as an injection if necessary