Vitamin B12, long promoted as a straightforward nutritional supplement, may have a more nuanced relationship with cancer than previously understood. Scientists have discovered that both abnormally high and abnormally low blood levels of this essential vitamin appear in patients with various cancers, including lung, breast, esophageal, and colon malignancies. The findings have prompted researchers to reconsider whether B12 itself contributes to cancer development or whether elevated levels are merely a consequence of the disease.
Recent research suggests the latter explanation may be correct. A major study examining over 37,000 colon cancer patients revealed that those with elevated B12 levels had significantly worse survival outcomes, but closer examination of tumor genetics indicated that aggressive cancers may simply consume and hoard B12 more efficiently to fuel their rapid growth. Rather than causing cancer, high B12 readings could be symptoms of tumors disrupting the body’s normal vitamin storage and transportation systems.
The situation regarding low B12 levels remains less clear, with conflicting evidence from different populations. While some research suggests both extremely high and low dietary intake may increase cancer risk, these observational studies cannot definitively prove causation. Experts now emphasize that the relationship between B12 and cancer remains unresolved and likely more complex than initially assumed.

Here's the evidence.