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[3] The British Society for Haematology guidelines emphasise that the response to treatment should be monitored through clinical assessment and blood count testing, rather than routine measurement of B12 levels after treatment has started

It's estimated that between 10 percent and 30 percent of people older than 50 produce too little stomach acid to release B12 from its carrier protein in foods

This gives people who prefer to avoid needles a legitimate alternative, though dosing schedules can differ from injectable versions

Exploring B12 Shots & Injections: Evaluating the Definite Availability and Options for B12 Injections Houston, Alongside Alternatives