Sally Pacholok has autoimmune pernicious anaemia actually. Her book is entitled "Could It Be B12? An Epidemic of Misdiagnoses".
Excerpt from myhdiet - Why Do You Need Supplements If You Are Eating A Healthy Diet?...
"Vitamin B-12. Research studies have shown that many of us, whether we eat plant or animal foods, are low in vitamin B-12, especially as we age. A study of about 3,000 people found that 39% of the group was low in B-12 despite following an omnivorous diet.1 Vitamin B-12 is essential for nerve health, including brain function, for homocysteine metabolism and for energy production."
Tucker KL, Rich S, Rosenberg I, et al. Plasma vitamin B-12 concentrations relate to intake source in the Framingham Offspring study. Am J Clin Nutr. 2000;71(2):514-522.
Your B12 is far too low. Take it from one who knows from experience (I have autoimmune pernicious anaemia).
Excerpt from the article...
B12 deficiency: a silent epidemic with serious consequences
"Why is B12 deficiency so under-diagnosed
B12 deficiency is often missed for two reasons. First, it’s not routinely tested by most physicians. Second, the low end of the laboratory reference range is too low. This is why most studies underestimate true levels of deficiency. Many B12 deficient people have so-called “normal” levels of B12.
Yet it is well-established in the scientific literature that people with B12 levels between 200 pg/mL and 350 pg/mL – levels considered “normal” in the U.S. – have clear B12 deficiency symptoms.
Experts who specialize in the diagnosis and treatment of B12 deficiency, like Sally Pacholok R.N. and Jeffery Stewart D.O., suggest treating all patients that are symptomatic and have B12 levels less than 450 pg/mL. They also recommend treating patients with normal B12, but elevated urinary methylmalonic acid (MMA), homocysteine and/or holotranscobalamin (other markers of B12 deficiency).
In Japan and Europe, the lower limit for B12 is between 500-550 pg/mL, the level associated with psychological and behavioral manifestations such as cognitive decline, dementia and memory loss. Some experts have speculated that the acceptance of higher levels as normal in Japan and the willingness to treat levels considered “normal” in the U.S. explain the low rates of Alzheimer’s and dementia in that country."
I'm assuming you know this because a doctor told you this. The doctor would be the person to ask, don't you think, not a bunch of amateurs like us. Those most likely to be deficient in B12 are vegans and vegetarians, as the most common foods high in it are animal foods.