Oral dissolvable B12 (No need for shots)
Kirkland Signature Sublingual B-12 5000 mcg
Quick Dissolve B‑12 5000 mcg. Highly bioavailable methylcobalamin. Get it from Costco or on Amazon.
Put under the tongue, don’t swallow, don’t suck, don’t dissolve in a drink.
Bypasses the stomach so you don’t have to worry about pernicious anemia or lack of intrinsic factor.
***You can treat Vitamin B12 Deficiency either with shots or orally.
Sources: http://www.aafp.org/afp/2011/0615/p1425.html and
https://www.health.harvard.edu/staying-healthy/ask-the-doctor-b12-shots-vs-pills
Neurologic symptoms may develop in low-normal vitamin B12 levels in serum. In true Vitamin B12 deficiency, methylmalonic acid and homocysteine levels are typically quite elevated, and these return to normal with treatment. Elevated levels of Homocysteine and methylmalonic acid (MMA) are usually diagnostic of Vit B12 (Cobalamin) deficiency.
“Folate (vitamin B9) deficiency usually presents with a sore tongue (ie, glossitis), weakness, fatigue, and anemia. Even though megaloblastic anemia is also seen in folate deficiency, there are no associated neurologic symptoms, unlike with vitamin B12 deficiency.”RR
Medications that cause Low vitamin B12
“Prolonged use of Metformin, H2-blockers, and proton pump inhibitors. The mechanism is unclear, and it is not known whether prophylactic supplementation prevents deficiency.
Metformin reduces absorption of vitamin B12 in 30% of patients and reduces vitamin B12 concentrations in 5%–10% of those taking it. The dosage and duration of metformin therapy is correlated with the risk of vitamin B12 deficiency. Given this risk, it seems prudent to monitor vitamin B12 levels periodically in patients taking metformin.” ABFM
References
Am Fam Physician 2011;83(12):1425-1430.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4853879/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3019388/
http://www.aafp.org/afp/2011/0615/p1425.html
https://www.health.harvard.edu/staying-healthy/ask-the-doctor-b12-shots-vs-pills