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Stomach acid A lack of stomach acid, whether due to medications, health issues, or age, can interfere with absorbing B12 since stomach acid is necessary for the nutrients to enter the bloodstream

Heres my game plan: Test for intrinsic factor antibodies if my doctor offers this Try high-dose sublingual B12 (5000mcg daily) for 8 weeks as a test If my B12 stays below 400 pg/mL, go straight to injections Calculate the cost difference to justify the investment The 10% Rule If youre absorbing less than 10% of your oral B12 (you can estimate this by comparing your supplement dose to your blood response), weekly shots often cost less than daily high-dose pills

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At once-weekly dosing, that is 20 to 40 weeks from a single vial