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The consequences of B12 deficiency on the lipid metabolism however remains under-researched better understood are the effects on the nerves

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4 Cantuti-CastelvetriL.FitznerD.Bosch-QueraltM.WeilM.-T.SuM.SenP.et al (2018)

When symptoms or risk factors suggest deficiency despite a reassuring serum B12 number, functional markers help clarify cellular B12 status

Injectable routes typically provide more consistent systemic exposure and may be preferred for non-gastrointestinal applications requiring tissue delivery beyond the digestive tract