B12 is not absorbed in the stomach (gastric). It is absorbed in the ileum, and true pernicious anemia is lack of intrinsic factor. When intrinsic factor is not present to escort the B12 to the ileum, a very large dose must be taken, and in that case a small percentage is absorbed by default.

That is why at least 1000 mcg must be taken for people with severe malabsorption (lack of intrinsic factor or no stomach) to get about 10 mcg. Sublingual B12 was not used during the decades this dose has been used medically by those doctors who are not ignorant of it. 1000 - 2000 mcg is the textbook oral dose for severe malabsorption.

Most people do improve somewhat. Some who are treated early enough get their lives back entirely. When severe damage is done, the body can continue to repair for years. The fact that weird symptoms occur during those repairs does not mean people are getting worse. That is just part of the process for many.

The fact that you could got get continued treatment was due to ignorance, not lack of studies. Even most mediocre doctors would want a higher level than 200. The better lab ranges don't even have an upper limit to the "normal" range for B12. And even most of those are far too high on the lower end.

I'm all for people taking lots of B12. But I think it is extremely important that they realize the results they are seeing are not necessarily dose dependent. It takes time to repair, and the process is not linear.

rose