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
Plasma levels drop from approximately 200 ng/ml at age 20 to around 80 ng/ml by age 60
The compound's interaction with multiple pathways (hormonal, vascular, and neural) introduces unresolved concerns about long-term effects
B., Gulkarov, S., Lau, R., Klek, S
Dutasteride is stronger but has a different safety profile and is often used off-label