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If it does not dissolve after 5 minutes of gentle swirling, possible causes include: degraded peptide (check storage history and expiration status ), contaminated water (use a fresh vial of bacteriostatic water), or water temperature (cold water from the refrigerator dissolves peptides more slowly than room temperature water)

[125] The ability to absorb vitamin B 12 declines with age, particularly in individuals over 60

2017 Jun;64(6):673-674 Koratala A, Chamarthi G, Segal MS

There are many treatments for the disease, which is progressive, but there is no cure

Nasal absorption of hydroxocobalamin in healthy elderly adults