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Vegetarians and vegans: As B12 is primarily found in animal products, strict plant-based diets can increase the risk of deficiency
Gastrointestinal Issues: Some people might experience digestive issues like nausea, diarrhea, or upset stomach
As a general rule, IM is favored when the goal is rapid correction of a clinical deficiency, when the patient has difficulty absorbing B12 through oral or sublingual routes, or when a provider wants predictable peak serum levels
It is important to note that all current evidence derives from in vitro cellular models and in vivo animal studies, and no human clinical trials have been conducted as of February 2026