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Importantly, folate supplementation should not be started before excluding B12 deficiency

Common causes of B12 deficiency include: vegan or vegetarian diet, age 50+, acid reflux medication (PPIs), digestive disorders, birth control use, heavy alcohol intake, and celiac disease

They can do a blood test to check the level of vitamins in your blood

Injections may be preferred when absorption is poor, symptoms are significant, or a clinician wants a more direct replacement route

National Institute of Diabetes and Digestive and Kidney Diseases

How to use sublingual B12 supplements If youre a first time sublingual B12 user (thats a mouthful), heres what you should know