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PostPosted: Tue Jan 15, 2008 2:31 pm 
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Last edited by Lyon on Wed Nov 30, 2011 4:03 pm, edited 2 times in total.

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PostPosted: Tue Jan 15, 2008 3:28 pm 
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Fantastic news- now just enjoy EVERYTHING!!!
muu


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PostPosted: Tue Jan 15, 2008 4:16 pm 
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just reviewing this thread. i think anyone who has spinal lesions that are "thoracic and cervical" should take any doctor's all-clear on b12 (and the b-complex in general) with a very, very large grain of salt!!!!!!!!!!

Quote:
The new neuro at Mayo, in reviewing the 12 vials of blood taken for the myriad of tests she ran, combined with the MRI of brain, spine (thoracic and cervical)


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PostPosted: Tue Jan 15, 2008 5:29 pm 
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i am re-submitting an item of interest from a much earlier post. from the info available at the link below, i have copied out the b12 items and highlighted points of interest.

http://www.neuro.wustl.edu/NEUROMUSCULAR/nother/vitamin.htm#B12

Quote:
CLINICAL FEATURES

Polyneuropathy
Sensory change: 2° spinal or peripheral nerve lesions
.....Early: Paresthesias
.....Loss especially of large fiber modalities
.....Distal
Motor: Later in course; Distal
Reflexes
.....Tendon: Reduced or absent at ankles
.....Plantar: Upgoing
Autonomic: Postural hypotension

CNS
Spinal cord: Earliest locus of involvement
.....Major cause of sensory & motor disability
.....Posterior column fiber loss
.....Spasticity in legs
.....Similar clinical features to N2O toxicity

Other CNS
.....Cognitive impairment in adults: Leukoencephalopathy on MRI [JL note: ie. multifocal brain white matter inflammation]
.....Mental retardation or encephalopathy in childhood syndromes
.....Sensory: Reduced smell & taste
.....Gait ataxia

Anemia: Megaloblastic; Due to reduced DNA synthesis

Gastrointestinal: Glossitis; Diarrhea

Fingernails: Hyperpigmented

TESTING

Serum
Low B12
.....Clinically significant: < 100 pg/ml
.....Suspicious: < 200 pg/ml
High homocysteine & methymalonic acid
.....Confirm biological significance of low B12 levels

MRI
Hyperintense T2 lesions in posterior columns (50%)
Lesions resolve after 8 to 12 months of therapy


Evoked potentials
.....Somatosensory: Abnormal tibial & median
.....Motor: Normal in most

PATHOLOGY

Spinal cord
Multifocal axonal loss & demyelination
Localization
.....Cervical & thoracic

.....Posterior column > Anterolateral & Anterior

Peripheral nerve: Axonal loss; Occasional ± demyelination

TREATMENT: 1 mg i.m. q 3 months

PROGNOSIS: Stabilization, or Some improvement

Paresthesias
Resolve within weeks

Rarely transient exacerbation after treatment

Myelopathy changes slowly if at all

CAUSES OF B12 DEFICIENCY: Normal body stores last 3 to 4 years

Gastrointestinal malabsorption
Deficient intrinsic factor production
.....Post-gastrectomy
.....Antibody vs parietal cells: Pernicious anemia
........Onset: Median = 60 years; Female slightly > Male
........Antibody targets: Gastric H+/K+-ATPase
...........Catalytic α subunit, and
...........Glycoprotein β subunit
........Regions of stomach affected: Fundus & body; Not antrum
........Mechanisms of B12 deficiency
...........Reduced intrinsic factor production 2° parietal cell loss
...........Antibodies to B12 binding site on intrinsic factor: Prevent formation of complex that is normally carried to terminal ileum & absorbed
.......Associated immune disorders: Thyroiditis; Diabetes; Addison's; Ovarian failure; 1° hypoparathyroidism; Graves; Vitiligo; Myasthenia gravis; Lambert-Eaton syndrome; Common variable immunodeficiency with low Ig or IgA (younger patients)
.......Associated neoplasia: Gastric carcinoma (1% to 3%)
.......Family history: 20% of relatives also have pernicious anemia; Especially 1st degree females
.......Gastritis treatment: Corticosteroids; Azathioprine

No digestion of cobalamin-R-binder complex
Pancreatic insufficiency

Consumption of cobalamin in GI tract
Intestinal bacterial overgrowth


Poor absorption by distal ileum
Sprue-related disorders
Autosomal recessive disorders
Anemia; Proteinuria; Juvenile onset

Parasitic infection: Diphyllobothrium latum

Dietary inadequacy in vegetarians
Sources: Meat & dairy products


Congenital disorders of B12 binding proteins
Vitamin B12 R-binding protein deficiency
.....Neurological B12 deficiency syndromes in adults

Gastric intrinsic factor deficiency
.....Congenital anemia & jaundice

Transcobolamin II deficiency
.....Megaloblastic anemia; Diarrhea; Immunodeficiency; Mental retardation

Abnormalities of synthesis of active forms of B12
Methylcobalamin deficiency, types E and G
.....Neurological (CNS) & hematological B12 deficiency syndromes
.....In children

Adenosylcobalamin deficiency
.....Episodic ketoacidosis; Encephalopathy; Neutropenia; Osteoporosis

Combined methylcobalamin & adenosylcobalamin deficiency
.....Types I and II
.....Mental retardation; anemia; ± myelopathy in slowly progressive cases

Nitrous oxide exposure
.....Oxidizes cobalt in cobolamin: Methylcobalamin inactivated
.....Inhibits conversion of homocysteine to methionine:
.....Reduced supply of S-adenosylmethionine

Abnormal release of B12 from lysosomes


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PostPosted: Tue Jan 15, 2008 5:40 pm 
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ps i just had to edit a mistake in my d3 labwork post. in case you had already printed it, here is the correction

Quote:
the main points are, take D3 not D2, and when you are having bloodwork done, the lab requisition should say 25(OH)vitaminD3 (or equivalent, i.e. 25-hydroxycholecalciferol. NOT 1,25 dihydroxycholecalciferol).


pps i used to faint as a child too!


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PostPosted: Wed Jan 16, 2008 4:40 am 
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fantastic!

(you know you could sell your story to the snake-oil people and make MILLIONS)

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Bibo ergo sum


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PostPosted: Wed Jan 16, 2008 7:19 am 
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Thanks everyone!
Isn't that strange, Jimmy about the fainting?!? Hmmm... well, guess all that's left for me to do now is to call Springer and see what I can drum up for an exciting life?!? :wink:
Kelli


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