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In these situations, I recommend B12 shots as first-line therapy over oral forms
The sublingual oral spray is a non-injection alternative its absorbed through tissues under the tongue and bypasses digestive breakdown
Bibcode:2016PNAS..113E.884W
Storage and Handling Requirements To safeguard the complex molecular structures and prevent premature chemical degradation of the encapsulated matrix, bottles must be stored long-term in a cool, dry environment, completely shielded from direct light, excessive heat, and ambient moisture
Mechanisms of ischemic neuroprotection by acetyl-L-carnitine [PMID: 16179519] Laboratory literature summary: Mechanisms of ischemic neuroprotection by acetyl-L-carnitine
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