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As it develops, not only do B12 levels decrease, but other metabolites or biomarkers of B12 such as holotranscobalamin, methylmalonic acid (MMA), and homocysteine are affected as well

NMDA receptors trigger long-term synaptic changes essential for learning and memory

Similarly, long-term travelers or individuals with underlying health conditions may require extra precautions

So the practical takeaway is not oral is better or SC is better. It is: pick one route, follow the documented per-dose figure for the vial you have, and keep the route constant so that whatever you observe is not confounded by a mid-stream route change