Arnika Apotheke say their ampoulles don't need to be chilled?

[AgeOfCapricorn83]

They sell methylcobalamin and adenosylcobalamin, and say they should not be refrigerated. I asked them about this and they said they autoclave them - heat them up to 121 degrees for 20 minutes to kill germs anyway, but people on this site say that the companies who don't refrigerate them are cowboys. Who should I believe?

[Pickle500]

Most pharmaceutical companies provide guidelines with their products. This is the information you need.

During heatwaves, it may be wise to avoid certain brands reaching high temperatures. But that is an individual choice.

[AgeOfCapricorn83 in reply to Pickle500]

So do you think I should trust arnika apotheke and not the random people online who says it always needs to be refrigerated?

[Pickle500 in reply to AgeOfCapricorn83]

You should always follow guidelines from manufacturers.

But since none of us can trust our Doctors to get anything right concerning B12, since they have little to no training in it, we also have to find our way with self-treatment, including storage of B12.

[Gambit62 Administrator]

AgeOfCapricorn83 The comments from Arnika relate to contamination. Recommendations to refrigerate in hot weather - or to maintain some form of temperature control are to do with degredation of the contents as forms of cobolamin that are bio-accessible are sensitive to heat. However, how sensitive depends on the form of cobolamin and also the materials used to suspend the contents.

Did you specifically ask Arnika about degredation of contents of their vials given that B12 is heat sensitive? It may be that the respondent misunderstood why you were asking and thought the concern was safety of contents rather than degradation.

[AgeOfCapricorn83 in reply to Gambit62]

I specifically asked if they're sure they shouldn't be refrigerated, even during the heatwave. I said I'd heard methyl can turn to hydroxy otherwise. They said "please do not refrigerate our ampoulles" although they didn't say why, they said they autoclave the ampoulles at 121 c anyway, and said even if the heat changes the methyl to hydroxy it doesn't matter? So I just don't know if I should trust them or not. I'm wondering about trying oxford biosciences instead but you have to mix that up yourself and they only do methyl, not adenosyl like arnika do.

[Gambit62 Administrator in reply to AgeOfCapricorn83]

a) the degradation of methyl results in forms of B12 that are not necessarily bio-accessible. It doesn't mean it gets converted to hydroxocobolamin. There are many forms of cobolamin that are not bio-accessible.

b) you should never freeze ampoules.

I can't possibly say what was understood and what wasn't understood in the conversation but all I can say is that the response doesn't say to me that the question posed was really understood because it addresses contamination, not about degradation of the contents.

[AgeOfCapricorn83 in reply to Gambit62]

How does it address contamination? Why would avoiding refrigeration prevent contamination and why would they speak about methyl degrading to hydroxy if they were talking about contamination?

[Gambit62 Administrator in reply to AgeOfCapricorn83]

"they said they autoclave them - heat them up to 121 degrees for 20 minutes to kill germs anyway". Refrigeration has long been used as a way of reducing the growth of potential contaminants.

I don't remember any posts advocating "that the companies who don't refrigerate them are cowboys." If this has been said then please report the post.

B12 can generally be stored at room temperature but in general needs to be kept below 20/25C. Over the summer there were many occasions in the UK where temperatures were well above this - hence the advice to refrigerate. People do have genuine concerns about transportation by couriers during periods like these, particularly if packages have been left outside.

General advice on the forum is that ampoules don't actually need to be refrigerated.

As above - it isn't correct to state that methyl B12 will become hydroxycobolamin. It will decay into other forms of B12 that are not necessarily bio-accessible.

[helvella]

Bear in mind that 20 minutes at 121 C might have a very different effect to weeks at a much lower temperature. Just because it is a higher temperature doesn't automatically imply its impact on the substance will be greater.

[Davy28]

I have always believed and read that storing them room temperature and out of heat and sunlight is what is prefered, I don't remember hearing they should be refrigerated so i have doubts on that, I have pernicious anemia and inject every week or so and I have been fine this way for years.

[Lurcher-lady in reply to Davy28]

Agree, I’ve never refrigerated mine, just kept in a dark cupboard at room temp.

[Haveitall]

they come in dark bottles to keep out the light so it remains stable. As long as it’s not being subjected to extreme hit it’s fine to not refrigerate. Ive done both and they worked equally.

[Pasjc]

i have never been told to refrigerate i also get them from GP and told no to

[Calise]

I bought a supply of cyanocobalamin when I was on holiday in the Canary islands. As the weather was very hot, I asked the pharmacist if I should refrigerate them and they said no.