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People who cannot digest B12 can take a supplement that is placed and absorbed under the tongue (sublingual), inhaled through the nose, or given as a shot injected into muscle

Signs of infection Monitor your injection site for 48 to 72 hours after each injection

Older adults Depending on the definition used, between 3% and 43% of community-dwelling older adults, especially those with atrophic gastritis, have vitamin B12 deficiency based on serum vitamin B12 levels [43,44]

Methylmalonic Acid Homocysteine Notes on Clinical Trials of B12 Supplementation Although not addressed in the graphs, younger people who start out deficient tend to have more drastic, initial drops in MMA and homocysteine