Hi, thanks for posting your concern in the HCM. Your Vit B12 level is definitely low. A low Vit B12 level may manifest as diarrhoea, loss of apetite, confusion, tingling abd numbness of the hands and feet, loss of balance and many other symptoms. The treatment you are on for this condition is correct. What I want to add is that there are numerous reasons of Vit B12 deficiency including vegetarian diet, heavy alcohol consumption, Coeliac disease, sprue, enteric diseases, previous surgery of the GIT, pernicious anaemia etc . These need to be ruled out by history, clinical examination and relevant investigations. Furthermore, I don t feel an MRI will be urgently needed now. The symptoms are most probably due to B12 deficiency. However, if there is pain in the neck and upper back along with vertigo you can have a Xray C- Spine (AP & Lat) done. The findings of polyp and DNS suggest that you are prone to recurrent sinusitis. Get an ENT consultation done to correct these underlying problems that can cause recurrent sinusitis. Finally to prevent Vit B12 deficiency, diet rich in animal proteins are required. Fortified soy products, cheese, fortified cereals also contain Vit B12. So, be watchful of your diet too. For any further question, please write back to HCM. Regards.Dr. Kaushik