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Frequently Asked Questions Can Low B12 Cause Symptoms Even If My Blood Test Looks Normal

Reviews show mixed results for timing expectations
Vitamin B12 deficiency and cognitive impairment: A comprehensive review of neurological impact

The first is a 2014 Nature paper in which researchers knocked down NNMT in the fat and liver of mice
The same applies if your elevated B12 is accompanied by abnormal results on other labs (liver enzymes, kidney markers, CBC), or by symptoms like unexplained weight loss, persistent fatigue, abdominal pain, or easy bruising

Its also possible that a crash follows the initial boost of energy as the body adjusts to the sudden influx of B12
