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The same discussion also raised a broader supply chain point: if a small number of upstream manufacturers supply most downstream labs and vendors, then a single finishing-stage issue could propagate across multiple brands

Many cyanocobalamin injection products are stored at room temperature and protected from light, but the dispensed label is the controlling source

Wang JY, Wu YH, Liu SJ, et al

Constipation or bloating can also happen as digestion becomes slower
