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Conditions like pernicious anaemia (an autoimmune condition affecting a protein called intrinsic factor vital for B12 absorption), stomach issues (such as from reduced stomach acid or certain medications like proton pump inhibitors), intestinal disorders (like Crohns disease or coeliac disease), or even surgical removal of parts of the small intestine (e.g., gastric bypass surgery) can prevent proper absorption

B12 shots can help restore healthy B12 levels more quickly than oral supplements because they bypass the digestive tract and absorption process

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[Google Scholar] Boddy 1968 Boddy K, King P, Mervyn L, Macleod A, Adams JF