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B12 injections may be the better choice if you: Have severe, diagnosed B12 deficiency with neurological symptoms Have pernicious anemia requiring medical supervision Have had gastric bypass surgery affecting all absorption Prefer less frequent dosing and don't mind needles Have a medical condition requiring injectable B12 specifically Who Should Choose Oral Spray

Human studies are very limited

doi: 10.1111/1753-0407.13310 White ND

doi:10.1111/acem.12420 Purrucker JC, Herrmann O, Lutsch JK, et al

The nurse practitioner provides counseling and coordinates referrals to additional services, such as behavioral health services or other forms of ongoing support