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For residents near Troy, MI , the answer might lie in something simpler: a Vitamin B12 deficiency

Injections avoid delays from poor oral absorption Pharmacists assess suitability, check medicines, and monitor response to protect your health We provide safe, professional B12 injections using licensed products in a clean, private setting

Food labelling Food manufacturers are required to label allergens, including gluten, on ingredients lists in bold

What this implies: if the vial remains sealed, in a cool, dry, dark place (ideally under refrigeration or freezing, with minimal humidity), you can reasonably expect 2-3 years of viability in the lyophilized state