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Several autoimmune diseases can make it harder for your body to absorb B12, including pernicious anemia

in Cell Metabolism note that SIRT1 activation improves mitochondrial efficiency and promotes a shift toward lipid utilization for energy, which can be especially beneficial in endurance and fat-loss settings (Price et al., Cell Metabolism )

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According to Mayo Clinics drug and supplement reference, intramuscular B12 (the form used in MIXTs B12 injection protocols) is well-established for restoring B12 status quickly in clinically deficient patients and is often used when oral supplementation is poorly absorbed

If your B12 deficiency is because of your diet, you can start eating more meat, fish, and dairy products