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Vitamin B12 deficiency results in megaloblastic anemia, GI lesions, and neurologic damage (which begins with an inability to produce myelin and is followed by gradual degeneration of the axon and nerve head)

In addition, hydroxocobalamin may be used as part of the treatment for cyanide poisoning (as an antidote), although in such emergency cases very high doses are administered under hospital care

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This could be monthly injections for those with absorption issues, or less frequently if you're just topping up levels

Vitamin B12 is not present in foods of plant origin, but is abundant in foods of animal origin