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A rat study reported 38.4% oral bioavailability, while human oral and subcutaneous exposure remain unknown

Both matter for choosing between oral and injectable forms

This happens for several reasons that are all completely normal

Cobalamin C defect should be considered in the differential diagnosis in adult patients with atypical hemolytic uremic syndromes, slow unexplained decline in renal function, idiopathic neuropathies, spinal cord degenerations, ataxias, unexplained or recurrent thrombosis, visual field defects, maculopathy, and optic disc atrophy (120)

Exploring the realm of B12 Shots & B12 Injections: The Good, Bad, and Alternative