I have low b12 levels and high red cell count. what does this mean?

Have you seen?: Have you seen a hematologist? Increased red cell count can be primary (bone marrow problem) or secondary (many possibilities, including smoking for example). Low B12 can be very serious. Get folate (folic acid) on board first then begin B12 replacement. Sounds like you need to seek help from experienced md. Perhaps a hematologist.