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Meaning, if you're swallowing folic acid, your doc might miss the obvious signs of low B12 until more serious neurological symptoms like difficulty walking or memory issues pop up, says Zhaoping Li, M.D., director of UCLA's Center for Human Nutrition

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2)]

The lyophilized form is stable at room temperature for brief periods during shipping and handling

Symptoms of Low Levels of Cobalamin Include: anemia, nerve damage (burning, tingling, weakness or numbness in hands and feet), difficulty in sensing vibration, unsteadiness and psychological side effects