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Sprue, Fish bandwurmfall or Blind-loop syndrome (change in the intestinal course after stomach operation)

Concordant clinical presentation, suggestive neuroimaging findings, and/or biochemical evidence raise suspicion for the correct diagnosis, but acute neurologic conditions consistent with vitamin B12 deficiency should be treated without waiting for definitive biochemical confirmation (69)

Creative Peptides , for example, describes reconstituted peptide storage as ranging from days to weeks and notes that bacteriostatic-water preparations may remain active for up to four weeks under refrigeration

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Its also really important to understand that HOW you take vitamin B12 can make a huge difference

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