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If you're pregnant or nursing, check with your provider first so your plan matches your situation

According to the National Heart, Lung, and Blood Institute, this absorption failure makes B12 injections the primary and most effective treatment, as they deliver the nutrient directly where your body can use it, bypassing the digestive system entirely

We also recommend keeping the injection site clean and avoiding scratching or rubbing it to prevent irritation or infection

The absence of FDA approval means that use represents an off-label application requiring informed consent and medical judgment

Whilst many symptoms improve with appropriate B12 treatment, not all resolve completely, especially if neurological damage was severe or prolonged before treatment commenced