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People taking high-dose B12 supplements (1,000 to 5,000 mcg daily), receiving B12 injections (cyanocobalamin or methylcobalamin), or consuming heavily fortified foods can easily push their serum levels above 900 pg/mL

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Women who have had a previous NTD-affected pregnancy may be advised to consume up to 5 mg/day (5,000 g/day) of folic acid if they are planning a pregnancy, but this level of supplementation should be prescribed by their medical provider (see the CDC recommendations and the World Health Organization [WHO] guidelines)

The theoretical mechanism involves reduced stomach acid, but clinical significance remains unclear

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