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A sluggish liver could be due to a liver disease, an infection like Hep C, a toxic body, nutrient deficiencies, methylation, and glutathione problems, etc (7, 8)

DHODH-Mediated ferroptosis defence is a targetable vulnerability in cancer

If they respond to oral supplements, I would re-test after 1 year: if levels higher, continue supplements for life at which point, there is the debate between expensive tablets or risky injections

The Dutch Vegan society has a very informative blog (Dutch only!) about the things you should consider when taking a B12 supplement

This form has been studied for decades and is known to stimulate wound healing, boost antioxidant defenses, and promote collagen/elastin synthesis