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Loss of Sterility Over Time: Every puncture is a new potential entry point

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Limitations of Use: DDAVP Nasal Spray is not indicated for: Treatment of nephrogenic diabetes insipidus, Treatment of primary nocturnal enuresis [see Warnings and Precautions (5.1)], Use in patients with conditions that compromise the intranasal route of administration (e.g., severe nasal congestion and blockage, nasal mucosa atrophy, severe atrophic rhinitis, recent nasal surgery such as transsphenoidal hypophysectomy) [see Warnings and Precautions (5.2)]

This is because a standard serum test measures the total amount of B12 in your blood, not the amount that is actively available for your cells to use