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A variety of stressors can also influence its release, and the role of ACTH in the stress response is discussed later in this chapter

Sealed lyophilized vials are stable at room temperature for transit and short-term storage

Long-term safety data The most compelling safety evidence comes from a 15-year follow-up study on long-term epithalamin treatment

The combination is significantly more effective than either modality alone

J., & Papadopoulos, V

[2] Patients should contact their GP if they experience: Side effects from B12 injections (though these are rare and usually mild) Difficulty attending scheduled injection appointments, as missed doses may lead to symptom recurrence New symptoms developing during treatment Concerns about treatment effectiveness or duration Changes in other medications that might affect B12 absorption Suspected adverse reactions to B12 treatment can be reported through the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk)