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131 (3), 317.e1-317.e10 (2018)

Treatment with intranasal cyanocobalamin should be delayed until symptoms resolve in patients with nasal congestion, allergic rhinitis, and upper respiratory infection

Keep it upright when possible, and do not freeze the solution unless your protocol specifically validates that approach

It is an intracellular metabolic-enzyme modulator, which is why its research read-outs are things like NAD+ levels and adipocyte gene expression, not how full you feel. That mechanistic distinction is the single most important thing to understand before looking at any dose number

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