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While oral supplements work for some, injections provide several distinct advantages: Immediate Absorption Directly enters the bloodstream, bypassing digestive barriers

Peripherally, pancytopenia is most often observed, but only 1-2 of the major cell types (erythrocytes, leukocytes, platelets) may be depressed in some cases

Serious side effects are rare but may include allergic reactions, shortness of breath, and severe dizziness

Patients with Normal Intestinal Absorption: Where the oral route is not deemed adequate, initial treatment similar to that for patients with pernicious anemia may be indicated depending on the severity of the deficiency

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