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Our diet consists of real foods

Most vegans and vegetarians can maintain adequate B12 levels through consistent oral or sublingual supplementation and B12-fortified foods such as plant milks, nutritional yeast, and fortified cereals

For patients in South Florida, the heat outside the refrigerator is an especially important factor: a peptide vial left on a counter in a Doral kitchen during summer is exposed to ambient temperatures that can reach the mid-80s Fahrenheit or higher, which meaningfully accelerates degradation for any reconstituted solution left out during injection preparation

Regulatory warnings in several countries 3