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That is the lyophilized (freeze-dried) peptide

Symptoms often include fatigue, weakness, and neurological problems

Taking birth control, antacids, or chronic medications that interfere with absorption

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Symptoms of vitamin B12 deficiency may include any or all of the following: Chronic fatigue (4) or low energy (despite getting enough sleep) Shortness of Breath Macrocytic anemia (5) High MCV (mean corpuscular volume on CBC analysis) Neurological changes that can mimic dementia (6) Depression (7), anxiety, and other mood disorders Difficulty with concentration (8) Brain fog Skin changes like hyperpigmentation (9), vitiligo, or angular stomatitis Hair changes (including hair loss (10)) Perhaps you can relate to one or more of these symptoms noted above