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This matters because digestion and absorption can affect how much of a nutrient your body actually uses from oral supplements

[19] Cyanocobalamin vials should be stored at controlled room temperature (15 - 25 C), protected from excessive light and humidity, and kept in their original packaging to preserve potency

The answer depends on what you are trying to fix

In this case, expect elevated B12 blood levels

If there are changes occurring in your body, we can be alert to that. Doctors should also try to educate themselves on the science that exists, including any safety data, says Kumar