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In the primary healthcare setting, the most commonly seen causes of vitamin B12 deficiency are related to abnormalities of digestion (atrophic gastritis, achlorhydria or the consequences of gastrectomy) or absorption (autoimmune pernicious anaemia, chronic pancreatitis, Crohns disease, the effect of medications that alter the mucosa of the ileum, or the consequences of surgical resection), and, to a lesser extent, a lack of exogenous supply

will be capitalized and amortized, which may have an adverse effect on our cash flow

Shelf Life : When properly stored and unopened, nasal sprays have a shelf life of up to 12 months from the date of manufacture

However, its important to note that compounded medications are not FDA-approved, and quality can vary depending on the pharmacy