Marty, Injections are cyano form, and not active in the body. Many people have a genetic error called MTHFR which cannot activate synthetic B12, and some B12 in food to the methyl form.

It would be best if you took 5mg of methylcobalamin a day orally, on an empty stomach, to raise yourself that way. Your levels are low still even with the infrequent injection (which is really not working well for you).

Sleeping is difficult because MethylB12 is a cofactor for your brain to make melatonin from serotonin. So if you don't have it you cannot sleep.

There are many studies out now showing oral works. But you have to take it correctly--- on an empty stomach. I have the links to medical papers on the first page of this thread for you to read.

You can buy methylcobalamin on line just about anywhere now, including Puritan's Pride at a savings. It is also in some local stores now, Walgreens' and Costco carry it now.

The longer you remain below 400pg/ml the more damage you sustain. This is inexpensive to do yourself. Doctors remain clueless about this topic so I have this information here for patients to take control of this therapy themselves.