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Sublingual administration, which bypasses the gastrointestinal tract, appears to be equally effective as IM injections while being less invasive and more cost-efficientparticularly in patients with atrophic gastritis, post-gastrectomy status, or conditions that impair intrinsic factor-mediated absorption, where long-term intervention is often required

doi: 10.1038/s41392-020-00349-7

Oral supplementation (50150 micrograms daily) is appropriate for dietary deficiency in vegans and vegetarians with intact absorption, with MHRA guidance recommending monitoring in at-risk groups