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If it were me I would write to the Practise Manager to complain, stating that you have PA and therefore are unable to absorb B12 any other way than through injections

By reducing oxidative stress, ALA may help protect nerve cells from damage, improve nerve blood flow, and enhance overall nerve function

Santos CXC, Raza S, Shah AM

One day after seeding, the cells were treated with either 50 nM MitoQ, 100 nM MitoQ, 10 M retinoic acid or vehicle, and incubated 37C for 7 days

Step 3: Draw the appropriate amount of bacteriostatic water into a syringe

This risk was 1.5 times higher in patients receiving a daily metformin dose between 1 g and 2 g and 4.3 times higher in patients receiving daily metformin doses exceeding 2 g