That the human body has an innate ability to adjust to low levels of available B12. Un-discovered to date.
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If this happened to be true it should be a consideration when self treating.
The increase in symptoms that some but not all have when first injecting is assumed to be the neurological system coming back online.
If the symptoms eventually improve it is attributed to healing when it could be the body is able to adjust to the new level of healing. If they do not improve that is accepted as just the way it is.
If that happened to be true the body would not be healed from the damage caused by being B12 deficient rather healed enough to be able to adjust.
This could explain the topping off/up. That the body has used up enough B12 that it can no longer adjust, yet is not healed.
I came to this in part by going back on the timeline of my life prior to when my symptoms were severe and I assume damage was not yet occuring. I kinda sorta felt like I do now sometimes.