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In several neurodegenerative diseases, including Parkinson's disease (PD), there are disruptions of the blood-brain barrier

High residual moisture (above roughly 5 to 7%) shortens shelf life of the lyophilized product

People at higher risk of running low include: Those with HIV Those with eating disorders Those with diabetes (especially those taking metformin) Vegans and vegetarians (natural B12 is found in animal products) Those with Crohn's Disease or pancreatic disease Anyone else with trouble absorbing nutrients A B12 deficiency can slow you down in many ways, because your body is not producing red blood cells or supporting the nervous system the way it should

[1] However, whilst acute toxicity is rare, elevated serum B12 levels can occasionally occur and may warrant investigation, particularly when they arise unexpectedly or in the context of certain medical conditions

This helps peripheral tissues to uptake and utilize glucose [48]