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Causes include: Pernicious anemia Gastrointestinal or autoimmune disorders Alcoholism Bariatric surgery Strict vegetarian diet Prolonged use of antacids or proton pump inhibitors Advanced age Conditions B12 May Help Prevent or Improve Memory loss, Alzheimers disease, or dementia Fatigue and lack of concentration Weakened immune system Heart, kidney, and liver disease Infertility Osteoporosis Allergies or asthma Tinnitus Skin disorders Lyme disease While oral supplements or nasal gels are alternatives, injections are often necessary when absorption through the digestive tract is impaired

Patients who already have exceptionally high pyridoxine levels or signs of pyridoxine toxicity (such as sensory neuropathy) should not continue to receive high-dose supplementation until those symptoms resolve

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03 Stability, Storage & Multi-Dose Handling The 28-Day Rule for Punctured Multi-Dose Vials Unopened vials should be stored at controlled room temperature, 20C to 25C (68F to 77F)