MRI Results

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MRI Results

Postby ua08 » Mon Mar 19, 2012 9:07 am

My MRI came back with "some abnormalities", and some lesions -- couldn't hear if it was one or two, but lesion(s). The radiologist stated that it "is not convincing of MS", and my bloodwork came back normal (save very slightly low copper levels which I was told to help with a vitamin).

I'm not convinced, basically. Not that I "want" to have MS, but I have tons of symptoms, two family members with it, and at least one lesion or two.

Anyone have a first MRI like this? Feedback? Anyone?

Spoke with the radiologist, but my neurologist is going to look at them when he returns from vacation.
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Re: MRI Results

Postby MarkLavelle » Mon Mar 19, 2012 10:13 am

ua08 wrote:Anyone have a first MRI like this? Feedback? Anyone?
My 1st MRIs were also considered insufficient for dx. The key issue is the "multiple" part of MS -- dx requires two attacks and/or two different lesion areas separated in time and space. Check out the "2010 Revisions" of the McDonald criteria in Wikipedia: http://en.wikipedia.org/wiki/McDonald_criteria

Have you had any spinal MRIs, or just brain?

RRMS dx 3/3/11; Copaxone since 12/1/11
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Re: MRI Results

Postby ua08 » Mon Mar 19, 2012 10:36 am

MarkLavelle wrote:
ua08 wrote:Anyone have a first MRI like this? Feedback? Anyone?
My 1st MRIs were also considered insufficient for dx. The key issue is the "multiple" part of MS -- dx requires two attacks and/or two different lesion areas separated in time and space. Check out the "2010 Revisions" of the McDonald criteria in Wikipedia: http://en.wikipedia.org/wiki/McDonald_criteria

Have you had any spinal MRIs, or just brain?


Well, Neck, Spine, and Brain w/ and w/o contrast. I really need to hear from the neurologist to know anything more, but she said the lesions were on the brain mri.
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Re: MRI Results

Postby jimmylegs » Mon Mar 19, 2012 10:41 am

symptoms such as...? any thoughts on why your copper levels might be low? for example, low dietary copper (see below), or supplementing zinc without balancing copper, possibly higher dietary fructose, higher dietary fat, etc....

also, recall the 'normal range' tends to include plenty of sick ppl, so you could be on the low side and possibly still account for some of your symptoms (more on the reference range vs healthy average below).

RESEARCH
fyi...
Clinical significance of the laboratory determination of low serum copper in adults.
http://www.ncbi.nlm.nih.gov/pubmed/17727313
"Abstract
BACKGROUND: Low serum copper is often indicative of copper deficiency. [JL edit: ie low normal *and* deficient - low normal does not equate to healthy] Acquired copper deficiency can cause hematological/neurological manifestations. Wilson disease (copper toxicity) is associated with neurological manifestations and low serum copper, with copper deposited in tissues responsible for the toxicity. Low serum copper can also be observed in some carriers of the Wilson disease gene and aceruloplasminemia. This study was undertaken to determine the clinical significance of low serum copper.
METHODS: The Mayo Medical Laboratories', Metals Laboratory database was reviewed over a 9-month period to identify patients who received their care at the Mayo Clinic and had low serum copper. The medical records were analyzed to determine the significance of the low copper.
RESULTS: In six of the 57 patients with low serum copper, the low copper was due to Wilson disease. In the remaining 51 patients, copper deficiency due to an underlying cause was identified in 38 as a reason for the low serum copper. The most commonly identified neurological manifestation of copper deficiency was myeloneuropathy. Coexisting nutrient deficiencies and hematological manifestations of copper deficiency were often but not invariably present.
CONCLUSIONS: Copper deficiency, Wilson disease (or a carrier state), and aceruloplasminemia are all associated with low serum copper. The presence of coexisting neurological or hematological manifestations that are recognized sequelae of copper deficiency should be considered prior to making a diagnosis of copper deficiency. Gastrointestinal disease or surgery is a common cause of acquired copper deficiency. Even in patients in whom low serum copper is indicative of copper deficiency, the cause of the copper-deficient state may not be evident."

*wish* i still had full text access. will have to scout to determine possible 'coexisting nutrient deficiencies'.

here's another interesting study (yahoo, full text! hehe):
Copper Deficiency Myeloneuropathy Resembling B12 Deficiency: Partial Resolution of MR Imaging Findings with Copper Supplementation
http://www.ajnr.org/content/27/10/2112.full

that's really interesting, since b12 deficiency is a known syndrome which looks very similar to MS, but i have never heard or read anything before about ruling out copper deficiency before dxing MS.

COPPER DEFICIENCY SYNDROME
my fave vitamin syndrome web site, on copper - check this out for sure, long list of neuro signs and symptoms, you can compare notes:
http://neuromuscular.wustl.edu/nother/v ... htm#copper

A TARGET COPPER LEVEL
here's a healthy controls serum copper level (again, full text!) see page 30, tables 3 and 4 for the serum values
http://hera.ugr.es/doi/15028227.pdf
the mean level was 1.10 mg/l. (recall the copper-zinc ratio is important - notice that only in one case did the sick patients have higher copper levels than healthy controls, but all the sick folks had much lower zinc levels compared to the healthies)

anyway. si units for clinical data
http://www.unc.edu/~rowlett/units/scale ... _data.html
conversion factor: µg/dL 0.157 µmol/L

so since we're starting with mg/l which doesn't match, we'll say *1000 on the top to get µg, and /10 on the bottom to get dL, so overall multiply by 100 to get to ug/dL which gives us 110. *0.157 = 17.3 umol/L.

here's another study where mean serum copper in healthy controls was 114.84 (μg/100 ml) (which is μg/dL but hey, why be straightforward :S)
which converts over to 18.0 µmol/L:

Evaluation of serum copper and iron levels among oral submucous fibrosis patients
http://www.medicinaoral.com/pubmed/medo ... 7_p870.pdf
(table 1, p. e872)

so, 100-114 ug/dL or 17.3-18 umol/L looks like a plausible 'sweet spot'. did they tell you your exact result? if not, can you get it?

THE COPPER 'NORMAL RANGE'
reference range according to wiki is 70-150 μg/dL (11.0-23.6µmol/L ) which as usual is much wider than where you find the controls in health and disease research.
http://en.wikipedia.org/wiki/Reference_ ... lood_tests (you have to scroll right on the graphic table to find the ug/dL section)

interestingly, in this case the healthy controls mean does appear to sit very close to the centre of the reference range (110) aka peak of the bell curve. not always the case.

HEALTHY FOODS RICH IN COPPER
foods rich in copper: http://whfoods.org/genpage.php?tname=nutrient&dbid=53
eg Calf liver, Crimini Mushrooms, and Asparagus are excellent; Swiss Chard, Spinach, Sesame Seeds, Kale and Cashews are very good.

(interesting, many of those foods are also rich in zinc and/or magnesium).

it should be very interesting to see what resolves as your serum copper levels go up. just make sure you don't inadvertently drive zinc down with copper supplements!
READ ME key info on nutrient targets - www.thisisms.com/ftopict-2489.html
my approach: no meds so far - just nutrient-dense anti-inflammatory whole foods, and supplements where needed
info: www.whfoods.com, www.nutritiondata.com
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Re: MRI Results

Postby ua08 » Mon Mar 19, 2012 11:45 am

No real clue about the copper levels yet. She said they were only slightly low and would be improved by a multivitamin containing copper.


My symptoms? Last year I was here discussing heat sensitivity that sent tons of pins and needles shocks down my spine/crawling up back of my head for a good bit. It happened for a few months and would come when I least expected it. Never really had any symptoms for a year -- at least that I noticed and said, "These are odd."

Then I was out to eat this past October and was with a friend. I had noticed my hands tingling a bit but it seemed to happen when I got flushed and hot and wouldn't go away until my body cooled. Well, I got done eating and took a step and my both legs tingled from my knees down. They tingled with every step -- like a crawl + shock. I got home and noticed when I sat down they were still tingling. Since then they've tingled almost 24/7 to this day. It started mainly in my feet -- and it still is -- but I can now feel it in my calves and occasionally upwards to my knees and in my thighs. The constant tingle is in my lower legs from the calves down, though. The tingling reaches a point of "numbness" later in the day. I will lay down for bed and they will be tingling and I know they are touching each other but I can't feel it. However, I move then and can feel them fine once I do that. I also feel off and on burning and prickling in my extremities (namely the legs).

I've also had chest pain. It's a pain that is sharp and on the left side of my chest. It comes and goes over the course of 15-30 minutes it seems, but it's painful and makes me grimace and take very short breaths so I don't breathe in too much and feel it.

Also had a lot of muscle twitches in my legs as well, as well as muscle and leg weakness when they are tingling heavily. Also, the tingling seems worse at certain points in the day.

I also think I have had unnatural fatigue. I feel like I could fall over, and almost disoriented like my head is throbbing/heart beating hard after walking around the grocery store or on campus.

Heat makes me tired, and when I'm heated or in the heat I feel the pricks of pins and needles all over -- almost in a crawling fashion.
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Re: MRI Results

Postby jimmylegs » Mon Mar 19, 2012 2:00 pm

it'd be interesting to see if the levels are below that 110-114 range. also would be interesting to see what the lab is using to define their 'normal range'. if they're using 70-150, even a value like 90 could look 'slightly low'. anyway time will tell if a multivit with copper is strong enough to get you into that 110-114 zone.

http://en.wikipedia.org/wiki/Copper_deficiency
Hematological Presentation
Most sufferers generally complain about tiredness, fatigue, and light headedness. These are all common symptoms of anemia.
Peripheral Neuropathy
Another common symptom of copper deficiency is peripheral neuropathy, which is numbness or tingling that can start in the extremities and can sometimes progress radially inward towards the torso

two case studies with really nasty symptoms
http://archneur.ama-assn.org/cgi/reprint/60/12/1782.pdf
"serum level 17 μg/dL (2.7 μmol/L) (normal range, 75-145 μg/dL [11.8-22.8 μmol/L])"
"Laboratory study findings were remarkable for undetectable serum copper levels (normal range, 75-145 mg/dL [11.8-22.8 μmol/L])"

another case study - again more severe, with difficulty walking, but also with tingling and shortness of breath.
http://www.jabfm.org/content/19/2/191.full
"serum copper level was not checked until the third day of supplementation and was found to be low at 38 μg/dL (normal range, 80 to 155 μg/dL). Her copper level increased to 53 μg/dL by the sixth day and to 72 μg/dL by the fourteenth day of treatment."
"Four months after discharge (at the time of this writing), she was still being treated with parenteral copper. Her copper level had normalized to 97 μg/dL."
(still not quite at the 110-114 level)
and, disappointingly, "Although her symptoms had not improved since going home, neither had they worsened."
wonder if she did eventually improve...
fyi they gave that patient the equivalent of 2mg elemental copper per day to achieve that increase in serum levels. and because her issues were caused by GI surgery they had to do it parenterally.
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my approach: no meds so far - just nutrient-dense anti-inflammatory whole foods, and supplements where needed
info: www.whfoods.com, www.nutritiondata.com
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Re: MRI Results

Postby shaight » Tue Mar 20, 2012 9:15 am

jimmylegs wrote:\\
Asparagus are excellent; Spinach, Sesame Seeds, Cashews are very good.


my copper level must be very good! maybe i'll drain some out and sell it off...the copper market is going up! :-D
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Re: MRI Results

Postby shaight » Tue Mar 20, 2012 9:25 am

ua08 wrote:No real clue about the copper levels yet. She said they were only slightly low and would be improved by a multivitamin containing copper.


My symptoms? Last year I was here discussing heat sensitivity that sent tons of pins and needles shocks down my spine/crawling up back of my head for a good bit. It happened for a few months and would come when I least expected it. Never really had any symptoms for a year -- at least that I noticed and said, "These are odd."

Then I was out to eat this past October and was with a friend. I had noticed my hands tingling a bit but it seemed to happen when I got flushed and hot and wouldn't go away until my body cooled. Well, I got done eating and took a step and my both legs tingled from my knees down. They tingled with every step -- like a crawl + shock. I got home and noticed when I sat down they were still tingling. Since then they've tingled almost 24/7 to this day. It started mainly in my feet -- and it still is -- but I can now feel it in my calves and occasionally upwards to my knees and in my thighs. The constant tingle is in my lower legs from the calves down, though. The tingling reaches a point of "numbness" later in the day. I will lay down for bed and they will be tingling and I know they are touching each other but I can't feel it. However, I move then and can feel them fine once I do that. I also feel off and on burning and prickling in my extremities (namely the legs).

I've also had chest pain. It's a pain that is sharp and on the left side of my chest. It comes and goes over the course of 15-30 minutes it seems, but it's painful and makes me grimace and take very short breaths so I don't breathe in too much and feel it.

Also had a lot of muscle twitches in my legs as well, as well as muscle and leg weakness when they are tingling heavily. Also, the tingling seems worse at certain points in the day.

I also think I have had unnatural fatigue. I feel like I could fall over, and almost disoriented like my head is throbbing/heart beating hard after walking around the grocery store or on campus.

Heat makes me tired, and when I'm heated or in the heat I feel the pricks of pins and needles all over -- almost in a crawling fashion.


i think i'm somewhat similar to you. my first mri had a few lesions, but the dr would not say 'absolutely' ms, but they did suggest possibly. i did see three other neuro's and went thru their tests (which were all very similar) and they all verified one another. i continued on with one specific ms specific neuro and have had several more tests...no spinal. we are quite sure i have ms.

i have triggered tingling in my legs when i bend my neck. there is a legion visible on the lower back part of my brain that is most likely causing this sensation. after a run or bike (heat) that tingling enhances for a short period and settles down.

i had my second mri last evening (ohh, the joy!) and i will be interested to see the results.

best of luck moving forward. it takes time to diagnose or rule out this disease. hopefully you do not have it.
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Re: MRI Results

Postby jimmylegs » Tue Mar 20, 2012 3:00 pm

@shaight - just as important not to go too high with copper.. high copper can drive zinc down. so fun. lots of disease states including cancers involve a high copper to zinc ratio. :( so if you ever get a test and find it's on the high side, you might bre in for some easy $$$ (provided that draining idea works out for ya) ;)
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Re: MRI Results

Postby shaight » Tue Mar 20, 2012 4:13 pm

thanks JL! i have not had my copper level tested, but i am taking a zinc supplement daily as well as a multi. the multi has a small amount of copper...i forget % off the top of my head.

i go in to review my mri in a couple weeks, so i'll have a blood test then.

i follow the copper mrkt a little due to my job...hence the attempt at humor!
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Re: MRI Results

Postby jimmylegs » Tue Mar 20, 2012 8:52 pm

heya, no worries - tell me how much total zinc and total copper in your daily supplements if poss.
for comparison i take 50mg zinc with 2mg copper right in the same capsule. and then the multi.
there's more zinc in my multi, so for a while i decided to drop to the 50/2 zn/cu pill every other day. but then i ended up fighting a cold, and with serum levels only around 14.6 or something.
so went back to daily zn/cu, plus multi as well. all good now :)
READ ME key info on nutrient targets - www.thisisms.com/ftopict-2489.html
my approach: no meds so far - just nutrient-dense anti-inflammatory whole foods, and supplements where needed
info: www.whfoods.com, www.nutritiondata.com
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Re: MRI Results

Postby shaight » Thu Mar 22, 2012 10:00 am

JL - i'm taking 50mg of zinc. my multi has 11mg of zinc and .5mg of copper. i am interested to see where my copper level is due to my food consumption. i am addicted to cashews and we eat spinach often...almost daily. i've always like spinach, but it was a critical part of our diet (for the iron) in my veggie days. admittedly, i was half paying attention to my dietary needs back then. i was eating healthier then most people i knew and we were not vegan, so the iron was the only one i was aware of that could have been an issue. it's difficult for me to think that my ms was a result of diet. granted, i feel that enhancing my dietary supplements now is nothing but a good thing, but to say it had any cause in where i am today just doesn't add up (not that anyone is saying that, just talking out loud).
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Re: MRI Results

Postby jimmylegs » Thu Mar 22, 2012 12:58 pm

heya, your zinc-copper balance from supplements looks a little low on the copper side of things. i would think you'd need more like 2mg per day - wonder if your dietary copper is doing the trick. anyway, if you get a test of both serum copper and serum zinc you should get a useful picture re current regimen efficacy.
READ ME key info on nutrient targets - www.thisisms.com/ftopict-2489.html
my approach: no meds so far - just nutrient-dense anti-inflammatory whole foods, and supplements where needed
info: www.whfoods.com, www.nutritiondata.com
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