We're one of the few nation left that actually uses ranges that allow for normal to be that low; Europe and Japan generally set the low end of the normal range in the 400s or even 500s, and there have certainly been people who have experienced deficiency related symptoms even at those levels.

It would seem some supplementation is in order, along with investigation into why the levels are there. Reduced B12 absorption from food is common with increasing age, most often due to reduced ability to produce stomach acid and/or intrinsic factor, but there can be many reasons for low B12 levels.

Fortunately, it's usually not hard to raise them with an inexpensive regimen of supplementation. We usually recommend anywhere from 1000mcg to 5000mcg daily, which can be taken in sublingual lozenges or tablets, though we also usually recommend the already methylated methylcobalamin form (as opposed to the cyanocobalamin form), just in case part of the problem is reduced ability to methylate the cobalamin molecule. (You can read all about this in the B12 thread among the Useful Websites section here.)

I also personally tell people to make sure that whatever they take they take alone, at least one hour before or two hours after eating, as it's very easy to interfere with cobalamin absorption (it's the largest nutritive molecule our bodies regularly utilize and it can be complexed very easily if you take it with food or drugs).