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For ongoing care, especially if you have a chronic condition causing the deficiency, you might need maintenance shots, maybe every two months or even monthly

Annals of the New York Academy of Sciences , 1194, 179-189

The success rate decreases remarkably if patients have symptoms refractory to PPI therapy, patients have atypical symptoms other than heartburn or acid regurgitation, there is poor documentation of objective evidence of reflux disease, or the procedure is performed by less experienced surgeons

The body is undergoing metabolic shifts as fat oxidation increases

severe thiamine deficiency, while rare, can cause Wernickes encephalopathy in hyperemesis gravidarum, and inadequate B is associated with anemia and neurologic issues in the newborn