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Methylcobalamin B12 is also indicated in those with pernicious anemia, diabetes, neuropathy, heart disease, circadian rhythm sleep disorders, memory loss, depression, fatigue, AIDS, inflammatory bowel disease (IBD), Lyme disease, osteoporosis, tendonitis, psychiatric disorders, Alzheimers disease, liver and kidney disease, and asthma

Oral B12 supplements have to pass through the gut, and absorption can be limited especially if you have digestive issues, take certain medications like metformin or antacids, or simply have low stomach acid

Like other vitamins, the goal is to balance vitamin B12

With SIBO, B12 made by the bacteria in the large intestine can migrate to the small intestine and get picked up by B12 transporters