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A patient with unexplained fatigue should be worked up, not injected masking a B12 deficiency of unclear cause, or an unexamined thyroid problem, with a monthly shot is a real clinical risk

Its key for doctors to know these differences to choose the best treatment for their patients

To absorb B12 from food or from a pill, your body needs three things working together: Stomach acid , which releases B12 from the protein it is bound to Intrinsic factor , a protein your stomach lining makes that escorts B12 through your gut A healthy small intestine , specifically the last section, where B12 is finally taken in Should even one of these three steps break down, absorbing B12 from a tablet becomes difficult

You may notice mild redness at the injection site for a day or two, and some patients experience slight fatigue or nausea during the first few days as the peptides begin working

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