Hello dear I understand your concern Normal Vitamin B12 level is 200-500 pg/ml. You have low level of B12. Following are symptoms of vitamin B12 level: Weakness, tiredness, or lightheadedness, Heart palpitations and shortness of breath, Pale skin, smooth tongue, Constipation, diarrhea, a loss of appetite, or gas, Nerve problems like numbness or tingling, muscle weakness, and problems walking. You should take treatment under advise of internal medicine specialist: You can take Nerurokind plus injection: one injection per week of 10 week and then for long term management: once injection per month. You can also take tablet mbson SL for 1-2 months Eat healthy diet, drink plenty of water and do regular exercise Hope this may help you Contact further if follow up needed Best regards Dr. Sagar