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Other than patients who have had their stomachs bypassed, there is also an autoimmune condition known as pernicious anemia that leads to a deficiency of intrinsic factor, lack of ability to absorb vitamin B12 and therefore poor availability of cobalamin (vitamin B12)

doi: 10.1016/j.ceca.2016.04.007 45 DiszhaziGMagyarZELisztesEToth-MolnarENanasiPPVennekensRet al

4) Pharmacokinetics & Safety (Preclinical) In animals, intravenous and intramuscular dosing provide systemic exposure with a relatively short elimination half-life

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Oral formulations may require longer durations given the bioavailability uncertainty