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Deficiency is common in those with fatigue, brain fog, or nutrient absorption issues, especially individuals with gastrointestinal conditions, vegans and vegetarians, or those taking medications like metformin or proton-pump inhibitors

Some research suggests that low vitamin B12 combined with high folic acid intake may be associated with elevated homocysteine and methylmalonic acid levels

The deltoid muscle in the upper arm is the preferred injection site for adults

for example, after insertion of the needle and just before injection, the plunger rod can be withdrawn slightly to aspirate and verify the needle is not intravascular, inject the product slowly, and apply the least amount of pressure necessary

In general, B12 is available in a high concentration, so most injections are a low volume, and they are administered every one to two weeks as needed