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The AAFP’s evidence-based clinical review states directly: “Oral administration of high-dose vitamin B12 (1 to 2 mg daily) is as effective as intramuscular administration for correcting anemia and neurologic symptoms in patients with B12 deficiency” (Langan RC, Goodbred AJ, American Family Physician, 2017)

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In people whose vitamin B 12 deficiency is related to overgrowth of intestinal bacteria, treatment with oral antibiotics such as tetracycline (sold under several brand names) may stop bacterial overgrowth and allow the absorption of vitamin B 12 to return to normal