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Oral B12 supplements have to pass through the gut, and absorption can be limited especially if you have digestive issues, take certain medications like metformin or antacids, or simply have low stomach acid

Some residual damage to the nervous system may remain in people who sought treatment late in the illness

With SIBO, B12 made by the bacteria in the large intestine can migrate to the small intestine and get picked up by B12 transporters

Aging, chronic stress, poor diet, alcohol, and illness all deplete NAD level The Process: Some slight discomfort may be experienced after the shot, but this goes away quickly