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The major difference between a B12 shot and an oral supplement is that the B12 shots or injectables are directly put into the bloodstream while the oral ones take time to ingest through the bodys digestive system

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Thus, in my clinical practice, given the uncertainty about B12 blood levels, if a patient has symptoms suggestive of B12 levels affecting cellular function, unless he/she wishes to undertake further testing with homocysteine and MMA, a trial of sublingual B12 in the active form at 1-2000 mcg daily (to avoid malabsorption issues) is a reasonable course of action

This creates both a marker and cause of oxidative damage