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Research suggests it may work through different mechanisms, potentially involving direct interaction with adipocyte membranes or intracellular signaling pathways distinct from classical GH receptor activation

Goodman & Gilman's The pharmacological basis of therapeutics (10th ed.)

Many labs use controlled-temperature storage and minimize repeated temperature cycling

B vitamins support energy pathways in the body to ward off depression, anxiety and fatigue

doi: 10.1001/jama.2016.0048

The COVID-19 pandemic caused major disruptions and rapid changes in primary care services with an increase in remote consultations.16 UK healthcare providers issued interim guidelines which advocated postponing or replacing injections of vitamin B 12 with tablets to minimise in-person appointments and reduce COVID-19 transmission.17 18 In this study, we assess the impact of these guidelines on prescribing in England