Once a month shots may not be enough.

That is a really old protocol.

In nursing homes in US when patients (and there are many) are initially diagnosed, they are given shots once a week until their levels
become above normal. In US that is 400pg/ml.

Your test results in pmol has to be converted:
http://www.unc.edu/~rowlett/units/sc...ical_data.html

Which puts you at about 161 US pg/ml. That is really low.
The ranges have been changed and raised, in the past decade, but many doctors are still using the old one, lower ones.

Here is my B12 thread:
http://neurotalk.psychcentral.com/thread85103.html

When serum levels get very low like yours, then the B12 cannot move well into the brain and spinal cord. Damage then occurs there and can be permanent.
Here is a B12 video that is very recent. Please watch it completely. Here in the US testing is poor, and then interpretation is also poor on this subject.

http://www.youtube.com/watch?v=BvEiz...ature=youtu.be

There are recent studies today showing that oral works as well or better than shots. Even for patients with pernicious anemia.
Because you lack intrinsic factor, you need to take a high oral dose daily preferably of the active B12 called methylcobalamin, and only on an empty stomach. B12 in high dose will passively be absorbed enough in the intestine (which is rather new understanding), for even pernicious anemia patients.

This is all explained on the B12 thread.