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B12 shots are far superior to oral forms of B12 due to the fact that they have superior absorption and quickly get into your target tissues (where B12 has its action)

Kidney disease can affect the ability to metabolize vitamin B12

This may include arthroscopic surgery to repair damaged tissue or a full joint replacement in extreme cases

Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 mcg/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity

Vitamin B12 injections in the management of deficiency: Current practices and future perspectives

Shelf life 2436 months when stored correctly in sealed format