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Intramuscular administration allows B12 to bypass hepatic metabolism and enter systemic circulation directly, which is why this route differs from oral supplementation

This rapid elimination means frequent supplementation is essential to maintain therapeutic levels

Medicare Benefit Policy Manual, Chapter 1, Section 30 Drugs and Biologicals Chapter 6, 20.5.3 Coverage of Outpatient Therapeutic Services Incident to a Physician's Service Furnished on or After January 1, 2020 Changes to Supervision Requirements Chapter 15, Section 50 Drugs and Biologicals and Section 60 Services and Supplies What is the effect of Vitamin B12

Depending on your condition, after your first round of shots, your doctor may keep you on a regular regimen of shots or shift you to other delivery systems like pills or liquids