Yes Lee Ann, keeping the B12 deficiency level at 200 pg/mL is very strange. That is the level you see one of the most severe manifestations of a B12 deficiency, which is pernicious anemia. That is like a car manufacturer deciding to have the engine light come on in a car just as the engine explodes. Very strange indeed. Even at 500-550 pg/ mL (which is the level Japan sets its B12 deficiency) you will see dementia. I believe that your low B12 is linked to your symptoms. However there is more to it than that. The question to answer is -Why are you deficient? Are you a vegetarian? If not, then you most likely are eating foods that contain B12, but you are not properly metabolizing it. The country with the most vegetarians in the world, also leads the world in heart disease. That country is India. India is responsible for 60% of the world's heart disease. And they know why. Their doctors, their newspapers and even their studies confirm it is due to a lack of B12. The following abstract shows how prevalent low B12 and high homocysteine is in India. Even with an extremely low limit tested for B12 (150 pg/mL), it was found that 81% of the urban middle class group had low B12, and 79% had hyperhomocysteinemia. Homocysteine is 40 times more predictive of heart disease than cholesterol. http://www.ncbi.nlm.nih.gov/pubmed/17214273 Another surprising fact, is India also leads the world in diabetes and other autoimmune diseases as well. They are literally called, "the diabetes capital of the world" by the International Journal of Diabetes in Developing Countries. Their diabetes is also linked in studies to their lack of B12. B12 is found in dietary animal proteins. Just like the prisoners of war that developed myathenia gravis from lack of B12, Indians are developing autoimmune and heart disease from not eating animal proteins. Americans, however, are a different story. We have the same lack of B12, but we eat plenty of animal proteins. Tufts University found that 40% of Americans are deficient in B12. The study used 258 pg/mL as their criterion. If you find the reason you are unable to metabolize B12, I believe you will have found the true source of your symptoms. Taking B12 in supplement form may not solve your problems. In fact, it may actually increase them. If you are unable to metabolize B12, no matter how much you take either in supplement or natural form, you will be unable to properly utilize it. This is like taking a bunch of suitcases with you to the bus stop. If the bus doesn't come, no matter how many suitcases you bring, you aren't going anywhere.