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Since your body only absorbs a small amount at once, excess B12 just gets flushed out

At OmniSpine Pain Management, vitamin B12 injections are used to help support patients experiencing fatigue, low energy, or nerve-related symptoms by delivering the vitamin directly into the bloodstream for better absorption than oral supplements

Microbiology 144 , 425?432 (1998)

(2) Patients with major heart, liver, kidney, and other organ disorders, including co-infection with hepatitis C virus (HCV), hepatitis D virus (HDV), or other chronic liver diseases such as alcoholic liver disease, non-alcoholic fatty liver disease (NAFLD), and autoimmune hepatitis