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Description
Kuzminski AM, del Giacco EJ, Allen RH et al (1998) Effective treatment of cobalamin deficiency with oral cobalamin

Gastrointestinal Symptoms : nausea, vomiting, diarrhea, constipation, abdominal pain, reflux, heartburn, and impaired motility Secretomotor Symptoms : difficulty sweating, tearing, and other fluid production (dry eyes, dry mouth, difficulty swallowing, dry skin)

Let them come to room temperature (10-15 minutes)

PMID 25945462

Then, they get weekly injections until they start to get better
The preservative supports repeated entry for up to 28 days