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Its similar to an anaphylactic reaction, but instead of affecting the entire body, this hypersensitivity is contained around the injection site only

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Dinh Tran, MD about a personalized B12 treatment plan

Absorption problems Even with adequate intake, absorption can be reduced by: Certain gastrointestinal conditions affecting the stomach or small intestine Some medications Age-related reduction in stomach acid (which can affect absorption) Autoimmune gastritis (often historically referred to as pernicious anaemia) This is a well-recognised cause of B12 deficiency and may require ongoing management

1b, Supplementary Table S2)

[10] Many older adults benefit from supplementation or consumption of fortified foods, as crystalline B12 in supplements and fortified products doesn't require stomach acid for absorption