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I don't think you are being treated correctly for pernicious anemia. If you look up medical guidelines for pernicious anemia they call for life-long B12 therapy with B12 shots or maybe high-dose daily tablets in the long run. The fact that your B12 level has never been much above 200 seems to suggest that you have never been properly treated for pernicious anemia (your B12 would be high and even that should not be a reason to stop treatment). If your level is 257 and you are having symptoms that is not fine. It has been well-established that you can have (serious) symptoms with a B12 level above the low end of the range. If all else fails try to find a doctor that will treat you correctly. You could start high dose (at least 1000/2000 micrograms) B12 tablets/sublinguals yourself but B12 shots of the proper dosage are the recommended treatment.

Good luck!

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