vit b12 injection route Shots at Home: How, Where & How Often to Inject Yourself Vitamin B12 Injection For Cats:

If your B12 stays below 400 pg/mL after high-dose oral supplements, injections become the obvious choice

doi:10.1111/1471-0528.17973

Where around 200 is accepted here as a low normal not needing intervention, other countries, like Japan and England, have updated their low normal values to be around 500-550, and consider anything less than this to be dangerous, even life threatening The only way I know to easily assess ones methyl b12 status is to measure ones homocysteine levels, which, contrary again to US accepted normal high values, needs to be around 7 (rather than around 10-15)

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Lastly, SAR442085 is being considered as a therapeutic option for Cold agglutinin disease (NCT04802057)