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Dear Jim, It's been a while since your message, so hopefully your symptoms have subsided with the B12 injections. I have PA, too, and it took at least 4 months before I noticed feeling better. Your doctor may call 200 "a bit low", but I can point you to research articles that debate whether 200 is a proper cutoff level and indicate that there are great individual differences in when symptoms appear compared to b12 level. Mine was just over 200, but I'm sure I would have died without treatment. I had nerve damage in my neck, legs, left arm and hand that is much better now. I lost over a third of my body weight and did not have the strength to lift the covers with my legs in the winter. It was difficult to hold my head up, and I had numbness from the knees down, in my arm, neck and left side of my face. My balance was so bad that I fell a lot, especially at night or with my eyes closed. The doctor thought I was just a hypochondriac. I developed macrocytic anemia or I would not have been diagnosed, even with a B12 level that was at the bottom of the scale. I feel great now as long as I remember my shot. I hope you have improved, and tell others that a "normal" B12 level does not tell the whole story.