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do not refreeze after reconstitution

This includes confirmed low serum vitamin B12 levels, pernicious anaemia, malabsorption states such as coeliac disease, inflammatory bowel disease, or post-gastric or bariatric surgery, unexplained anaemia, neuropathy or neurological symptoms consistent with vitamin B12 deficiency, a long-term vegan diet with symptoms or low levels, or failure of oral vitamin B12 supplementation

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[16] [121] Investigations into the intestinal absorption of B 12 confirm that the upper limit of absorption per single oral dose is about 1.5 g, with 50% efficiency

For healthy individuals who desire a super-fast pick me up, Methylcobalamin injections are slightly more fast-acting than their synthetic counterpart, although both are highly effective