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For adults 60+, and especially anyone with reduced stomach acid, atrophic gastritis, post-bariatric surgery, or on metformin/PPIs, sublingual is the lower-risk default because at least some of the dose absorbs through the oral mucosa directly, bypassing the stomach

If someone else is giving the injection, it may also be administered into the deltoid muscle (upper arm) or the gluteal muscle

Vitamin B 12 deficiency can develop with heavy regular use of nitrous oxide N 2 O, also known as "laughing gas", used for anaesthesia in a clinical setting or as a propellant gas, commonly abused as a recreational drug