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A.BoyerL.AignerS.et al (2011)

How Cobalt Allergy is Diagnosed Diagnosing cobalt allergy involves a combination of medical history, physical examination, and specific tests

There is no evidence that doses above 500mcg produce proportionally better results, and clinical trials using 1mg daily did not dramatically outperform lower doses

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So if you took B12 and felt worse, and your blood B12 is elevated, and you have a constellation of symptoms across multiple systems that's three signals pointing toward MCAS as worth ruling out

Available options include: B12 Shots : Intramuscular injections (IM) are the most commonly used treatment because they bypass absorption barriers and deliver the vitamin directly into the bloodstream[21]