*This article is not medical advice. Before starting on any health related regimen, seek the advice of your Primary Care Physician or an M.D.

High serum B12 in chronic illness might reflect a deficiency caused by oxidative stress, deficiencies in B2, Glutathione, Molybdenum, Iodine, sulfur, or Selenium. Aberrant excess nitric oxide from nNOS (NOS1) and iNOS (NOS2) degrades B12 rendering it useless. Hydroxocobalamin inhibits nNOS (NOS1) and iNOS (NOS2). nNOS and iNOS are often upregulated from bacterial and viral infections, and a cascade of inflammation starting in the microbiome. Lowering oxidative stress with a diet rich in anti oxidants can be helpful too.