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Bariatric surgery causes changes to your digestive system that make it difficult to maintain a healthy level of vitamin B12

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Although cyanocobalamin is more readily absorbed, much of it is excreted through the urine before it can reach the cells Cyanocobalamin vs Hydroxocobalamin In comparison to hydroxocobalamin, cyanocobalamin has a significantly worse absorption rate and storability, which is why today mostly hydroxocobalamin is used in B12 injections

As we get older, our ability to absorb B12 from food naturally decreases, making injections a great option for many older adults