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According to a news release from Sesame, that buys Costco members three months of low pricing on high-quality individualized clinical consultations, as well as: Ability to select which clinician they want to consult by video
Once a depleted system gets the B12 it needs it may start using that B12 in processes that require other vitamins and minerals, in this way the B12 injection can leave you depleted in other vitamins and minerals
Intraclass differences and variations in pharmacokinetics are also possible explanations
Hynes R.O
Sep 2001;158(1):195-198
They switched from 30-day to 90-day refills
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