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The variability in total IGF-I may be due, in part, to major changes in selective IGFBPs during the post-bariatric surgery period, i.e

10.1016/j.immuni.2018.04.026 40

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Mustoe TA, Pierce GF, Thomason A, Gramates P, Sporn MB, Duel TF
They participate in metabolic processes such as fat digestion and absorption, cholesterol metabolism, and immune regulation (Wahlstrm et al., 2016

It's pretty rare to overdose on B12 since it's water-soluble, but super high doses can cause side effects
