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There are a few reasons why it might be a better idea to avoid OTC supplements

Patients following such a diet, should be advised to take oral vitamin B 12 regularly

According to an article about cobalamin deficiency in Tufts Universitys catnip newsletter, people with cobalamin deficiency also experience changes with intestinal permeability and absorptive function

Cobalamin (vitamin B 12 ) Deficiency Investigation & Management Early treatment of cobalamin deficiency is particularly important because neurologic symptoms may be irreversible

Once a vial has been accessed, it should be refrigerated and used within 28 days