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So, we recommend using SL vitamin B12 rather than oral and IM, especially in patients who do not tolerate IM injection and patients who need prolonged vitamin B12 supplementation, such as patients with long-term metformin use and patients with pernicious anemia or with gastro-duodenal resection [5154]

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Generally speaking, both regular B12 injections and lipotropic injections are safe for all patients

doi: 10.1111/j.1742-4658.2010.07754.x 421 AngajalaALimSPhillipsJBKimJHYatesCYouZet al

The main challenge isnt the trail but the altitude, cold, and wind