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Other signs may include shortness of breath, pale skin, stomach problems, such as constipation, diarrhea or gas, or nerve problems, like muscle weakness or tingling in fingers or toes. Over time, a deficiency of B12 can cause problems with balance, confusion, depression, poor memory and possibly dementia, and it can even cause permanent damage to the nervous system, Somers says

The dorsogluteal muscle may seem the preferred choice because it is so large, but IM injections pose risks as there are major blood vessels and nerves located there, including the sciatic nerve

"Processing of alkylcobalamins in mammalian cells: A role for the MMACHC (cblC) gene product"

PMID 14527323