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Yet, the etiology appears to be multifactorial, as a number of other causative factors have been suggested for KBD, including fungal toxins in grain, iodine deficiency, and contaminated drinking water (52)

Genetic and metabolic mapping studies have clearly delineated the absolute dependence of the Aldehyde Dehydrogenase (ALDH) and Monoamine Oxidase (MAO) enzymes on specific vitamins and minerals

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PubMed PMID: 820366

(4) If the exact value would change management, the clinician may need to ask whether dilution or another confirmatory step is available, since "greater than 1,000 ng/L" can hide a B12 level that is markedly elevated

Total = 2 mL of water for 20 mg powder