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In summary, the reasons a GP surgery may refuse an early B12 injection are often rooted in a strict interpretation of established, but imperfect, guidelines, a misunderstanding of the actual science of B12 storage and metabolism, and a desire to maintain administrative consistency

Intact vials remain stable until the documented expiration date

Both openings could provide access to the catalytic triad, as they have negative electrostatic potential and would attract the positively-charged N-terminus of the short bioactive peptide substrate (Rasmussen et al., 2002)

Neurodegenerative and neurodevelopmental diseases and the gut-brain axis: the potential of therapeutic targeting of the microbiome