Inadequate digestion: I should start by saying that it is possible to be deficient in vitamin B12 even with an elevated blood test. Common causes of an elevated MCV are inadequate absorption of vitamins in your gastrointestinal tract, excess alcohol intake and other medications. If you have a normal diet it may be advisable to have additional blood work performed to ensure that you are adequately digesting nutrients.
Answered 11/23/2017
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