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If it remains clear, colorless, and free of particles, it is likely still viable

B 12 deficiency in such a situation can lead to progressive accumulation of otherwise metabolically inactive methyl-THF (figure 2)

At 250 mcg twice daily, one 10 mg vial covers roughly 20 days

Given 40-60% nasal bioavailability compared to 80-95% for injection, equivalent nasal doses would be approximately 400-1000mcg to achieve similar systemic levels

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