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Slow IV injection is an option when immediate availability of the vitamins is desired or if the patient is already receiving IV fluids

Vitamin B12 injections are also used by people with impaired vitamin B12 absorption or deficiency called Pernicious anaemia caused by: Inadequate dietary intake of B12 Loss of gastric parietal cells in chronic atrophic gastritis Structural damage or surgical resection of the small intestine or stomach Long-term use of acid regulating medication Alcoholism Gastric banding surgery Celiacs disease Pernicious anaemia Crohns disease Until now, injection of methyl-B12 has required a needle

Mild side effects can include redness or swelling at the injection site, lightheadedness, or an upset stomach

For malabsorption (e.g., pernicious anemia), injections are often preferred, though some clinicians still use very high-dose oral regimens (NIH ODS)