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483,484 It is worth mentioning that many investigations have reported aberrant melatonin secretion in autistic patients, particularly decreased melatonin and metabolite secretion at night, and altered circadian rhythms of melatonin

chronic liver disease and hepatitis may present with elevated levels Renal impairment : Reduced clearance can contribute to accumulation, though this is rarely clinically significant Solid tumours : Certain malignancies, particularly hepatocellular carcinoma and metastatic disease, may elevate B12 levels [3] Evidence suggests that unexplained markedly elevated B12 levels without supplementation may sometimes be associated with underlying disease

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