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When given by intramuscular injection, the dose bypasses the digestive tract and is absorbed reliably, which matters because dietary B12 absorption depends on stomach acid and a protein called intrinsic factor, both of which decline with age, medication and certain gut conditions

There is minor discomfort

Metformin-Induced Vitamin B12 Deficiency Can Cause or Worsen Distal Symmetrical, Autonomic and Cardiac Neuropathy in the Patient With Diabetes

On average one in ten people are believed to be deficient in Vitamin B12, that is an astonishing six million suffering from the consequences of having less than the optimum amount of B12 in their system

Methylation and nicotinamide pathways investigated in preclinical biochemical frameworks