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If you notice any of these issues, your best bet is to discard the vial

S., Lee, M

Vitamin B12 Deficiency and Diabetic Neuropathy Risk in Patients with T2D on Metformin Therapy Vitamin B12 is essential in axonal myelination by producing methionine in the central and peripheral nervous systems [54]

Both paracellular hyperpermeability [demonstrated by abnormal TJ expression and upregulation of myosin light chain kinase (MLCK) activity (86, 322324)] and transcellular hyperpermeability [represented by bacterial internalization to epithelia (325)] were documented in mucosal biopsies of patients with Crohn's disease and UC