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Thats because vitamin B12 is bound to protein and can only be released by digestive substances in the stomach (hydrochloric acid and gastric protease) to be absorbed

Expert Opinion on Drug Metabolism and Toxicology vol

However, for those with inactive disease it may be reasonable to stop at the start of the third trimester, in line with peak foetal development[1]

These side effects often go away if you stop taking the drug temporarily (which should only be done under a doctors supervision)

After youve filled the syringe with the correct dose, youll safely remove the drawing needle and replace it with the smaller, sterile needle intended for the injection