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A 2024 critical review noted that unexpectedly high B12 levels can be further investigated by a clinician if needed, preferably by directly measuring the carrier proteins haptocorrin and transcobalamin rather than relying on the commonly ordered PEG precipitation test, which the authors found nonspecific and potentially misleading (Fedosov, 2024)

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The reservoir sponges were placed in 50 mL conical tubes, centrifuged for 3 min at 3,000 RPM, and the e-liquid was diluted in isopropyl alcohol (1:20 or 1:100) in glass tubes and shipped to Portland State University (Portland, Oregon) for gas chromatography/mass spectrometry (GC/MS) analysis of WS-3 and WS-23 concentrations