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Avoid vigorous shaking, which can denature peptides and introduce aggregation

In an online survey, almost one third of 683 participants reported cancellation of B 12 injections during the covid-19 lockdowns, with subsequent worsening of symptoms and often with negative emotions and feelings including anger, fear, disappointment, feeling let down, and feeling undervalued.66 In contrast, those who were self-administering B 12 injections or who were rapidly taught to do so reported a noticeable improvement in their symptoms and quality of life, with some benefiting from increasing the frequency of injections to suit their personal need.6566 What are the harms

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Hydroxocobalamin: Adverse reactions (IV use)