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Efficacy should be hedged accordingly the trials tell us what the drug does in a controlled trial population, not what any individual using research material will experience

The diagnosis of vitamin B12 deficiency typically relies on low total B12 levels and elevated concentrations of homocysteine (Hcy), as well as levels of transcobalamin-bound B12 (holoTC) and methylmalonic acid (MMA), which serve as functional indicators of cobalamin insufficiency (Carmel and Sarrai, 2006)

Regarding the hemoglobin level, the pooled effect sizes showed no difference between all routes of administration that could reach statistical significance