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a patients were taught to self inject b we could buy injectable B12 OTC This paper from 1983 focuses on pernicious anaemia rather than the many other causes of B12 deficiency, much like today, patients who do not have a definitive diagnosis of PA are considered to be in need of less treatment (or none at all) despite the severity of symptoms being exactly the same

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Lyophilized peptide vials require reconstitution, and the process of drawing a measured dose from a vial that may have been stored incorrectly, shipped across international borders without cold chain maintenance, and manufactured in a facility with no pharmaceutical-grade quality control is not as straightforward as forum guides make it appear

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Heat accelerates degradation chemistry and can increase contamination risk if handling is careless