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Two patterns I see clinically: The form of B12 matters

Progressive Symptoms: Anemia, causing shortness of breath, dizziness, and increased heart rate: All of these symptoms may be brought on by a deficit that lowers the synthesis of red blood cells

Oral GLP-1 formulations continue development despite bioavailability challenges

Patients with Normal Intestinal Absorption: Where the oral route is not deemed adequate, initial treatment similar to that for patients with pernicious anemia may be indicated depending on the severity of the deficiency

If you have one of those conditions, getting B12 injections can prevent a deficiency before it starts

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