refrigeration at 4 C (39 F) is acceptable for short-term storage (days to weeks)
Those with Neurological Symptoms: B12 deficiency can cause nerve damage, leading to symptoms like numbness, tingling, balance issues, or memory problems
Hydroxocobalamin 1mg intramuscular injections are prescription-only medicines in the UK, indicated for confirmed B12 deficiency or malabsorption conditions such as pernicious anaemia
Methylation burden & metabolic dysfunction research: Laboratory applications in cellular methylation stress, SAM-cycle imbalance and NAD+ salvage engineering

Haematological symptoms often appear first and include: Fatigue and weakness due to anaemia Pallor (pale skin) Shortness of breath, particularly on exertion Heart palpitations Glossitis (sore, red tongue) Mouth ulcers Neurological manifestations can be particularly concerning and may include: Paraesthesia (pins and needles) in hands and feet Peripheral neuropathy causing numbness or altered sensation Difficulty walking or balance problems (ataxia) Memory problems and cognitive difficulties Mood changes, including depression or irritability Rare optic neuropathy in severe cases Other symptoms that may occur include: Digestive disturbances Loss of appetite and weight loss Generalised weakness It is crucial to note that neurological symptoms can occur even in the absence of anaemia, and you should contact your GP urgently if you experience persistent paraesthesia, balance problems, memory difficulties, or unexplained neurological symptoms