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With respect to dosage, the average reductions were: 2000 mcg: 71.5% (single data point) 1,000 mcg: 31.8% Although limited data are available for higher dosages, the findings support the efficacy of both oral and non-oral B12 formulations in modulating homocysteine levels

Endocrinology , 142(2), 626632

What this implies: if the vial remains sealed, in a cool, dry, dark place (ideally under refrigeration or freezing, with minimal humidity), you can reasonably expect 2-3 years of viability in the lyophilized state

Severe deficiency cases may result in pernicious anemia, typified by the development of abnormally large red blood cells

The blood level of methylmalonic acid increases when a person has B 12 deficiency