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Vitamin B12 injections are also used by people with impaired vitamin B12 absorption or deficiency called Pernicious anaemia caused by: Inadequate dietary intake of B12 Loss of gastric parietal cells in chronic atrophic gastritis Structural damage or surgical resection of the small intestine or stomach Long-term use of acid regulating medication Alcoholism Gastric banding surgery Celiacs disease Pernicious anaemia Crohns disease Until now, injection of methyl-B12 has required a needle

Abenavoli L, Izzo AA, Mili N, Cicala C, Santini A, Capasso R

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American Journal of Physiology-Cell Physiology 315(3):C343C356 Bo L, Guojun T, Li G (2018) An expanded neuroimmunomodulation axis: sCD83-indoleamine 2,3-dioxygenasekynurenine pathway and updates of kynurenine pathway in neurologic diseases