Is 244 low in b12?

YES (and no)...: In the us a level of 244 is often officially considered "normal" but deficiency symptoms are common with levels below 350 and some will have deficiency symptoms with levels below 500! see http://chriskresser.Com/b12-deficiency-a-silent-epidemic-with-serious-consequences for more info. I would certainly treat someone with levels that low.

Yes: 244 is definitely low! Optimal levels are around 800. You definitely need more B12.

Absolutely!: ideal b12 levels are above 1500 in blood. often times I will recommend that people take shots or very high levels of vitamin b12 10,000 mcg if they are less than 500. It can make a huge difference in energy, sleep, cognition, memory and any nerve problems you may have. You will also want to figure out why you have low b12. It could be due to an autoimmune condition or too low stomach acid.