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Here are the realworld risk gaps: No standard dose or formulation Humans in papers got 20 mg IV in a pilot, but many online vendors sell subcutaneous vials without clear dosing guidance

Unopened vials should be kept at room temperature, as freeze thawing, could result in the stability being damaged or reconstitution failure

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Digestive issues such as Crohn's or celiac disease can lead to impaired absorption of nutrients in the gut which may result in the need for B12 supplementation