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and Tosti, A., 2021

Vitamin B-12 can be found in a variety of foods like fish, meat, and eggs

For more severe deficiencies due to malabsorption or other underlying conditions, injections of vitamin B12 may be necessary

Early diagnosis and treatment give the best long-term outcomes

Although there are some secondary biomarkers such as the measurement of certain enzyme activities in the leukocytes or the excretion of 3-hydroxy-3-methylbutyric acid in the urine, these are ambiguous indications and only a few doctors are familiar with the corresponding tests (8, 9)