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If switching the route of administration and dosage don't help, you may also have like a substrate issue

doi: 10.1111/jvim.15638

My 30 day mortality is 0%, readmission rate is less than 1% and leak rate is 0%

[16] The European Food Safety Authority (EFSA) refers to the collective set of information as "dietary reference values", with population reference intake (PRI) instead of RDA, and average requirement instead of EAR

Endocrinologa y Nutricin (English Edition) 59(8):487490 Reinstatler L et al (2012) Association of biochemical B 12 deficiency with metformin therapy and vitamin B 12 supplements: the National Health and Nutrition Examination Survey, 19992006

How to Treat Vitamin B12 Deficiency