Buttons,
Sorry if you've already answered this, but has the thyroid angle been thoroughly explored?
Your case is certainly complicated. Any one of three or four conditions could cause your problems, and except for the spider bite

, they often occur in the same person.
Regardless, what the heck. More methylcobalamin can't hurt. And make sure you are getting the other nutrients. They're all necessary, and some work very closely together.
I wouldn't take anything else with my B12, not food, not supplements, not meds.
A small minority find themselves wired by their B12. Those often decide to take it in the morning.
rose