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"I received six B12 injections from a nurse at my surgery (and scheduled for three monthly for further injections)." That's a UK treatment pattern for B12 deficiency without neurological symptoms

This adaptation is augmented by activation of the transcription factor hypoxia-inducible factor (HIF-1) which supports rapid ATP generation under hypoxic conditions ( Figure 2 )

Cardiovascular Issues: Changes in metabolic functions may increase the risk of hypertension and heart disease

This is part of why researchers are curious whether peptides, some of which appear to have anti-inflammatory and neuroprotective properties, might influence these same pathways