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There is no specific treatment to lower B12 levels in isolation, as the vitamin is non-toxic and excess is naturally excreted

CASE PRESENTATION A 76-year-old female with a past history of hypertension, chronic anemia and coronary artery disease presented to outpatient clinic complaining presyncopal episode and head lightheadedness

Martin et al

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However, two other forms hydroxocobalamin and cyanocobalamin become biologically active after they are converted to methylcobalamin or 5-deoxy adenosylcobalamin, said Dr Aravinda G M, consultant, internal medicine, Manipal Hospital, Jayanagar, Bangalore