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As a general rule, IM is favored when the goal is rapid correction of a clinical deficiency, when the patient has difficulty absorbing B12 through oral or sublingual routes, or when a provider wants predictable peak serum levels

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Keep in mind that oral B is not well absorbed in people who truly lack intrinsic factor or have certain GI issues, which is why B is usually injected or given as a high-dose sublingual in those cases

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