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Always follow the instructions given by your healthcare team

(2018) Surplus vitamin B(12) use does not reduce fatigue in patients with irritable bowel syndrome or inflammatory bowel disease: A randomized double-blind placebo-controlled trial

This is why the rule is so strict: after reconstitution, immediate and constant refrigeration is required

[DOI] [PubMed] [Google Scholar] 106.Rofstad E.K., Halsr E.F

The appropriate response to that uncertainty is not to abandon the compound but to use it within a structured clinical framework: defined goals, evidence-appropriate dosing, quality-assured sources, systematic monitoring, and ongoing reassessment as the science matures