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Individuals with certain genetic variations affecting methylation (such as MTHFR-related variations) may prefer to avoid cyanocobalamin since additional conversion is required

10.1111/j.1600-0838.2009.01070.x Scand

If you are concerned about acne whilst taking B12 supplements, it is advisable to discuss this with your GP rather than discontinuing treatment without medical guidance, particularly if the B12 has been prescribed to address a documented deficiency

It should be kept at room temperature Store at 20 to 25C (68 to 77F), according to Pfizer Medical Information , away from direct sunlight or any other source of heat and moisture

This method is less precise because it does not deposit the medication near the target nerve root, and the steroid solution is free to spread within the epidural space