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I think that they are hoping that giving large doses of oral B12 will give some passive absorbtion, which will keep levels up

The British National Formulary (BNF), for example, differentiates the prescription of hydroxocobalamin according to presenting symptoms, eg, For neurological involvement, it is advised to administer hydroxocobalamin by intramuscular injection, initially 1 mg once daily on alternate days until no further improvement, then 1 mg every 2 months. In the Netherlands, pharmacotherapeutic guidelines 51 recommend (for the same neurological symptoms or abnormalities) administration of 1000 mcg once or twice weekly for up to two years

Here, you will gradually add complex carbohydrates, fruits, and starchy foods into your diet

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