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It also explains the treatment for pernicious anemia and how to get enough vitamin B12

You will need to boost your B12 supply to address this situation

Injections, on the other hand, skip the digestive system for a more direct and effective delivery of vitamin B12

Here's the TL;DR on vitamin timing: while there is no official medical advice dictating that you should take vitamin supplements at a specific time of day to improve their efficiency, there is quite a lot of research showing that avoiding some vitamin supplements at particular times (or more accurately, with particular meals) can improve absorption, or that taking some vitamins alongside food can reduce the risk of adverse side effects

For patients with pernicious anaemia or severe malabsorption , oral supplementation with either form is usually insufficient