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A body might react adversely to B12 shots for a variety of reasons

There is a large indeterminate zone between normal and abnormal levels (see Figure1: B 12 Test Result Review and Process Algorithm for Patients with Risk Factor for B 12 Deficiency* and/or Non- Specific** or Specific Symptom of B 12 Deficiency below)

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In contrast, there is some evidence of an enhancement of the maximum absorption via intrinsic factor, by up to a factor of 2, when the vitamin B12 is accompanied by food, but this is not consistently observed and probably only applies when the food quantity and vitamin B12 dose are sufficient to slow the passage of the vitamin B12 through the small intestine enough (about three hours or more) to allow each intrinsic factor receptor to absorb two molecules of vitamin B12 from the oral dose rather than one