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In many patients with severe primary IGF-I deficiency (SPIGFD) defined by low IGF-I (less than 3 SDS or the 2.5 th percentile), severe short stature (Height SDS less than 3), normal GH secretion and absence of acquired insensitivity to GH (discussed below) genetic defects may be absent

It is reported as orally active in rodents [1]

Ornellas, T., & Chavez, B

However, individuals with absorption disorders may require significantly higher doses to achieve therapeutic levels

B12 can be injected just under the skin (often in the abdomen) or into the muscle (usually the thigh)