Originally Posted by mrsD

I suggest you start at 5mg a day of active methylcobalamin type B12 oral. Take this only on an empty stomach.

In 3 months get another test if you can to see how much you have changed. You should be above 400 and perhaps as high as 1000 or more.

When you reach 1000, you can then reduce to 5mg twice a WEEK or take 1mg a day instead.

Somehow you got so low, so you will probably have to take B12 for life.