I do not know how many patients realize that being in the middle range B12 levels does not mean the patient does not need B12 injections esp when you have thyroid nodules/disease, Narcolespy,pain and on and on. The middle range can cause patients to have neuropsychriatric symptoms, which I was having due to all my meddical issues not being addressed, asessed, misdiagnosed . If your doctor will not listen to your complaints and at least offer you a trial of B12 injections NOT SUBLINGUAL tablets ... they do not work.
I found a caring Palliative care doctor who started me on 1000mcg/day IM for 2 weeks then weekly for 1 month then once a month . I started to feel better after the second week and was able to get out of bed abd it helped with my pain, mood etc... I am seeing a Oncologist thta tells me I am not anemic but she said "i want to keep you on B12 injections for your severe fatique. It has been a long painful journey but I should of nt stuck with doctors too long when I knew they had no care in taking care of patients and alot of negligence in the medical community in the USA