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when b12 injections don't work Not Working? Your Cofactors Might Be the Problem : r/B12_Deficiency How Often Should You Get
Description
Switch to IM injection if sublingual isnt maintaining 400+ pg/mL

Neither is a reason to avoid B12, just a reason to be aware

Plus, the body very quickly urinates any excess of B12

The patient has been advised of dietary modifications and is currently on Vitamin B12 tablets (1500 mcg)
Clean the injection site with alcohol, pinch the skin to create a fold of tissue, insert the needle at a 45-90 degree angle, inject slowly, and withdraw the needle