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In fact, any chronic GI disorder can result in low cobalamin levels

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Hydroxy B12 is considered one of the most well-tolerated forms of vitamin B12, offering sustained release and potentially longer-lasting benefits compared to other forms like cyanocobalamin

Proper refrigerator storage gives you time to assess the situation without further compromising the medication

Cyanocobalamin Pharmacokinetics European Journal of Cardiovascular Medicine: Vitamin B12 Deficiency in Long-Term Metformin Users USFDA Adverse Event Reporting System: Vitamin B12 Deficiency Associated with Metformin and PPIs MedRxiv (PNAS Preprint): Patient-Reported Treatment Outcomes in ME/CFS and Long COVID Journal of Neurological Sciences / Nutrients: Cognitive Function and Neuropathy