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2 There is insufficient data to recommend other formulations of vitamin B 12 replacement (e.g., nasal, sublingual, subcutaneous)

Risk factors that should prompt consideration of B12 deficiency include advancing age (reduced stomach acid production), strict vegan or vegetarian diets, pernicious anaemia, gastrointestinal surgery (particularly gastric bypass or ileal resection), long-term use of certain medications (metformin, proton pump inhibitors, H2-receptor antagonists), nitrous oxide exposure (including recreational use), and conditions affecting the gut such as Crohn's disease or coeliac disease

guidance from healthcare professionals improves safety and ensures injections target appropriate muscle or subcutaneous tissue

Workout results improve because your body is using fat more efficiently as fuel