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This reaction is accelerated by heat and by acidic or basic pH extremes

The Nobel Prize in Physiology or Medicine 1934, Nobelprize.org , Nobel Media AB 2014

On-Label vs Off-Label and Compounded Products Vitamin B12 injections are an established medical treatment for confirmed B12 deficiency and related conditions (for example, pernicious anemia and certain malabsorption states), as summarized by the NIH Office of Dietary Supplements in its Vitamin B12 fact sheet for health professionals

While some patients tolerate treatment well when appropriately evaluated, safety depends on individual health status, medications, and clinical judgment