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Injections are particularly appropriate for those with: Pernicious anaemia, an autoimmune condition affecting B12 absorption Conditions affecting the stomach or small intestine, such as Crohns disease or coeliac disease Those who have had gastric surgery or bariatric procedures Strict vegans and vegetarians not meeting their B12 needs through food or oral supplements For those who can absorb B12 normally, oral supplements are generally an effective and well-evidenced alternative to injections

Injections are delivered into a muscle that contains a rich blood supply

Will the shot hurt

These can be a little more painful than subcutaneous injections because the needle has to reach into muscle tissue

Brain 145:e77e78 [DOI] [PubMed] [Google Scholar] Loens S, Chorbadzhieva E, Kleimann A, Dressler D, Schrader C (2017) Effects of levodopa/carbidopa intestinal gel versus oral levodopa/carbidopa on B vitamin levels and neuropathy