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To slow renal elimination, a C18 di-acid fatty chain is covalently attached to Lys26 through a spacer composed of two 8-amino-3,6-dioxaoctanoic acid units and a glutamic acid moiety

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Aside from that, B12 shots also have higher absorption rates than oral supplements, most of which are lost to urine

How Gastric Banding Affects Vitamin B12 Absorption Gastric banding leaves the B12 absorption pathway anatomically intact, so deficiency is driven by dietary restriction and PPI use rather than surgical bypass

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If its due to altitude, rest, drink water, and drink coca tea