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In these individuals it would appear that whilst they were able to exist as relatively healthy individuals, often not knowing that they had methylation associated mutations, some initiating factor such as a prolonged infection, combined with low vitamin D levels resulted in gradual loss of their vitamin B12 supplies leading to the CFS symptomatology being apparent, and the subsequent discovery of their methylation status

Should I get B12 injections instead of pills

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For Hereditary B12 Malabsorption If you suffer from Imerslund-Grasbeck disease, your vitamin B12 malabsorption will be treated with hydroxocobalamin injected into the muscle at a dose of 10 mg per day for 10 days followed by monthly injections for life