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can b12 injections cause heavy periods Anemia in Women B12 Injection Therapy in Shoreline
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(PubMed) Almeida OP, McCaul K, Hankey GJ, Norman P, Jamrozik K, Flicker L

Curr Med Sci

In practice a GP or nurse may administer off-licence by giving a sub-cutaneous (under the skin, SC) injection but it is important to remember that the GP makes their own decision and takes their own accountability and reliability if they go off-licence

Soares MO, Dumville JC, Ades AE, Welton NJ (2014) Treatment comparisons for decision making: facing the problems of sparse and few data
CMS requires modifier JW or JZ on applicable Part B drug claims

Beyond 6 months , ongoing maintenance therapy prevents recurrence of deficiency