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Certain congenital conditions, such as hereditary intrinsic factor defects and congenital vitamin B12 malabsorption (Imerslund-Grsbeck disease), can also cause severe vitamin B12 deficiency

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Level of Evidence: 5 (Diagnostic) The use of botulinum toxin has been increasing, with new indications and applications continually emerging, along with reports of adverse reactions

The intracellular concentrations of vitamin B12 can be inferred through the total plasma concentration of homocysteine, which can be converted to methionine through an enzymatic reaction that uses 5-methyltetrahydrofolate as the methyl donor group