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There are studies that show that higher dose sublingual administration of B12 is as effective as injections in some cases

Mechanistically, we establish a connection between the mitochondrial oxidative stress induced by SLC25A39 and the progression of HCC

The table below shows possible dosage changes for severe cases: Vitamin B12 Injection Dosage for Adults with Malabsorption Adults with malabsorption issues, like those with celiac disease or Crohns disease, might need more B12 injections

Pasupathy S, Tavella R, Grover S, Raman B, Procter NEK, Du YT, et al

doi:10.1177/1535370218758275 Iftikhar A, Azam H, Ahmed M, et al