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Some fortified foods, dietary supplements, and medications contain a synthetic version of vitamin B12

Bottom line Existing evidence comparing oral with IM vitamin B12 is suboptimal

Some practitioners implement cycling to theoretically prevent receptor desensitization, provide physiological breaks, or manage costs, though evidence supporting these approaches is limited

[2] Patients should contact their GP if they experience: Side effects from B12 injections (though these are rare and usually mild) Difficulty attending scheduled injection appointments, as missed doses may lead to symptom recurrence New symptoms developing during treatment Concerns about treatment effectiveness or duration Changes in other medications that might affect B12 absorption Suspected adverse reactions to B12 treatment can be reported through the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk)