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I think it has got to be something that is spoken about openly." More:

Maintain a Balanced Diet A balanced diet rich in B12-rich foods can help maintain optimal B12 levels

Initial treatment may involve more frequent injections, followed by maintenance doses

4 How is pernicious anemia diagnosed

Inadequate secretion of intrinsic factor, resulting from lesions that destroy the gastric mucosa (ingestion of corrosives, extensive neoplasia), and a number of conditions associated with a variable degree of gastric atrophy (such as multiple sclerosis, certain endocrine disorders, iron deficiency, and subtotal gastrectomy)

Unlike oral supplements, which must pass through the digestive system and may not be well absorbed, injections deliver the vitamin directly into the bloodstream, allowing for quicker and more efficient absorption