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In severe cases, the body may struggle to absorb enough of the vitamin from oral sources leading to continued symptoms of deficiency

However, B12 shots are less likely to increase energy or performance when B12 levels are already normal

Wilsons disease in patients presenting with liver disease: a diagnostic challenge

M.EmperadorS.PinedaM.Lopez-GallardoE.MonteroR.YuberoD.et al

If you take methotrexate orally, it's worth noting that GLP-1 receptor agonists slow gastric emptying, which could potentially affect the absorption of oral medications