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The core mechanism of osteoporosis (imbalance of bone metabolism) Osteoporosis is essentially a negative balance between bone formation and bone resorption, resulting in continuous loss of bone mass, destruction of bone microstructure, increased bone fragility, and increased risk of fractures

Intramuscular hydroxocobalamin is the preferred treatment for most patients with confirmed deficiency, particularly when malabsorption is present or neurological symptoms exist

Cyanocobalamin clears faster and requires more frequent dosing, so it has largely fallen out of routine use here

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Without blood testing, you cant confirm oral supplements are effectively raising your B12 levels