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I have no daytime fatigue anymore and my sleep at night is regular for the first time in a decade

As long as the vial seal remains intact, refrigeration offers no additional benefit and may even introduce risk

The benzyl alcohol acts as a preservative that inhibits bacterial growth, so a single vial can be accessed for multiple withdrawals across a 28-day period rather than being discarded after one use

Antioxidants 10 (1), 71

While low serum cobalamin levels do not necessarily imply deficiency, an abnormally high serum cobalamin level forms a warning sign requiring exclusion of a number of serious underlying pathologies

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