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However, sometimes it gets stuck when your sinuses are swollen and that leads to congestion

In the duodenum, pancreatic enzymes cleave B12 from R-proteins, allowing binding to intrinsic factor produced by gastric parietal cells

In summary, the available data about the effect of buffers on the sensation of pain suggest that, in some cases, it is a consequence of the particular drugbuffer combination, as occurs in the case of bicarbonate and local anesthetics in which the buffering capacity of bicarbonate at pH 7 increases the activity of the anesthetics, thus reducing pain associated with the SC injection [51]

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An abstract of the study is online

In these cases, B12 injections are crucial for maintaining adequate nutrition and preventing deficiencies that could arise from altered digestive capabilities