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Finally, I would advise against injecting the sheath of the long head of biceps blind in the clinic environment

The push rate also influences the potential for tissue damage, so its good to take your time (a count of five) when pushing the plunger of your syringe to deliver your vitamin B12

People with Certain Medications Long-term use of certain medications, like proton pump inhibitors, H2 receptor antagonists, or metformin, can interfere with B12 absorption

Generally, the effects of Vitamin B12 injections start waning after a week

Structure and function of NAD kinase and NADP phosphatase: key enzymes that regulate [PMID: 18391451] Laboratory literature summary: Structure and function of NAD kinase and NADP phosphatase: key enzymes that regulate the intracellular balance of NAD(H) and NADP(H)

If your B12 deficiency is not diet-related, you'll need to take B12 injections