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Conditions that may lead to anemia include: Heavy periods Pregnancy Ulcers Colon polyps or colon cancer Inherited disorders A diet that does not have enough iron, folic acid or vitamin B12 Blood disorders such as sickle cell anemia and thalassemia, or cancer Aplastic anemia, a condition that can be inherited or acquired G6PD deficiency, a metabolic disorder Anemia can make you feel tired, cold, dizzy, and irritable

Medical necessity narrative (if requested): For payers that require prior authorization or post-service review, a brief clinical summary explaining why oral supplementation is not appropriate may be required

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This is actually one of the more common causes of high vitamin B12 levels