The donor responsible for the decyanation seems to be glutathione, which PA patients need for lowering their increasing levels of homocysteine
Reduced secretion of gastric acid and pepsin, from the use of H 2 blocker or proton-pump inhibitor (PPI) drugs, can reduce the absorption of protein-bound (dietary) vitamin B 12 , although not of supplemental vitamin B 12
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Following these steps helps ensure safe and effective results from your vitamin B12 injection therapy
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But taking daily oral B12 means you get a steady level of B12 at all times, and your levels will be much more consistent and you should not get a return of your symptoms when your next injection is due