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If you have tried oral B12 before and felt no change, this may be part of the reason, and it is worth mentioning to your provider

Yu Z, Guo R, Ge Y et al (2003) Gene expression profiles in different stages of mouse spermatogenic cells during spermatogenesis1

Damaged intestinal barrier can facilitate the development of local diseases such as irritable bowel disease, inflammatory bowel disease or celiac disease, but also the development of systemic inflammatory diseases such as rheumatoid arthritis, ankylosing spondylitis, hepatitis, and lupus erythematosus, neurodegenerative or psychiatric conditions, or metabolic diseases such as diabetes or obesity

AlphaLipoic Acid (ALA) is used for different health concerns