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Those drugs are required to meet the highest standards for purity, because they bypass the body’s natural immune defenses and carry greater health risk than non-sterile products such as oral tablets

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Injections are particularly appropriate for those with: Pernicious anaemia, an autoimmune condition affecting B12 absorption Conditions affecting the stomach or small intestine, such as Crohn’s disease or coeliac disease Those who have had gastric surgery or bariatric procedures Strict vegans and vegetarians not meeting their B12 needs through food or oral supplements For those who can absorb B12 normally, oral supplements are generally an effective and well-evidenced alternative to injections