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What high B12 means If your B12 is elevated because of supplements or injections, its usually harmless

B12 is water soluble and excreted in the urine, any excess would not build up in the body but be removed via urine

8 Where results are unclear, serum MMA and homocysteine levels (both of which accumulate with B12 deficiency as discussed above) can also be used to confirm a diagnosis, although homocysteine is not specific to B12 deficiency, as it may also be caused by deficiencies in other B vitamins

see Vitamin B12 Health Professional Fact Sheet

The semaglutide component matters less than the baseline deficiency risk