My symptoms definitely waxed and waned early on. I would think B12 deficiency first as the reason for your symptoms, although celiac disease, MS, lyme disease... all have similar symptoms. I've been reading forums for almost a decade now, and many, many people have had symptoms caused by B12 deficiency with levels in the 200-400's. You absolutely want a level above mid-range, preferably in the top quarter to over the top.
Do not worry about too much B12, but you should take it with a B-complex because B's need each other. 2000mcg daily of B12 would be a good amount, until you can determine you are top of range, and then you can probably cut back to 1000mcg daily as a maintenance dose. A multivitamin with a "B-50" level of B's would be a good idea.
While your low ferritin might be caused by heavy monthly bleeding, that is an assummption. Since you are low in both iron and B12, I'd consider looking for a malabsorption problem, as well.
Quote:
The clinical diagnosis was celiac sprue in 21 patients (32%), aclorhydria in 7 (10.5%), bacterial overgrowth in 1 (1.5%), intestinal giardiasis in 1 (1.5%), menstrual blood loss in 1 (1.5%) and 35(53%) patients remained without a definitive diagnosis.
Iron deficiency: not always blood losses PMID: 12831295
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You might find a doctor willing to look for other deficiencies, especially vitamin D, another one people are commonly deficient in... and associated with autoimmune diseases, cancers, bone disease, etc.
Do you have any other symptoms? Any GI symptoms? (You can have celiac disease without GI symptoms, but having any would be meaningful) Is there any family history of autoimmune disease? thyroid disease? RA? diabetes? MS?
Some 250 symptoms are associated with gluten sensitivity/celiac disease, most atypical (not GI). Symptoms can vary greatly... constipation or diarrhea or no GI problems whatsover. Here are two good overview articles on celiac disease:
Detecting Celiac Disease in Your Patients by Harold T. Pruessner, MD (AAFP)
http://www.aafp.org/afp/980301ap/pruessn.html
Gluten-Sensitive Enteropathy (Celiac Disease): More Common Than You Think by David A. Nelson, JR, MD, MS (AAFP)
http://www.aafp.org/afp/20021215/2259.html
btw... NONE of the eight different doctors I saw recognized any of my symptoms to be related to B12 deficiency... yet turns out they were all relatively common symptoms. The neurologist finally identified with the "buzzing" feeling I had in my legs, as he had remembered another patient with B12 deficiency complain of that sensation. That was an afterthought on my 3rd and final visit with him. so..I don't know why are doctors don't know to recognize symptoms, and don't know that low normal levels are a problem. In some other countries, lab lows are set at 500.
You need to pursue this all further, one way or another. There is much you can pursue on your own, but it would be best to find a doctor who took this all more seriously. You want to fix this now.... not later when things are even worse.