Subcutaneous B12 shots are injections of Vitamin B12 given just beneath the skin layer
Furthermore, sprays allow for the vitamin to enter into the systemic circulation, bypassing the intestinal vessels
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Long term prescription of medications such as the following are likely to increase the cause of, or exacerbate the risk of B12 deficiency - the proton pump inhibitors (esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole), famotidine, ranitidine, metformin, glibenclamide, gliclazide, glimepiride, glipizide, sodium valproate, gabapentin, doxycycline, some oral contraceptives
adding a second dose in the early afternoon extends cognitive benefits through the workday
Optimal dosages may vary