Uveitis, tibialis anterior spasms, please help.

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Uveitis, tibialis anterior spasms, please help.

Postby Jewelianna » Thu Mar 14, 2013 6:37 pm

Hello all,
I joined this group to hopefully get more information from regular everyday people. I am not a hypochondriac, but the last few months have made me feel like maybe I am.

Most recently, I was diagnosed with uveitis in my right eye. Began October 2012. Initially a doctor treated me for pink eye as the flare up was really bad. But I continued to have distorted vision in my right eye, pain, inflammation, sensitivity to light and my depth perception was out of whack at night, and still having flare ups. So of course I started researching my symptoms and pretty much decided I had uveitis, which was confirmed at an appointment with an ophthalmologist this year. He put me on some drops, the flare ups went away, vision improved some and then he took me off the drops, and within 2 weeks I had a flare up, he put me back on the drops. He ordered a lot of blood work to see if I had gout, rheumatoid arthritis, syphilis, lyme disease, and cat scratch fever, all of which came back negative. He wants to do chest and spinal xrays to rule a couple of other things out, and then I don't know after that. Other blood work done by my pcp came back deficient in D and B-12, both of which I am taking supplements for now.

I have also started having a non-painful cramp/spasm in my left tibialis anterior muscle which is weird and sporadic. Those are the only two things that I am currently associating with MS. However, I had gastric bypass surgery in 2009 and the further I get from that date, the worse my constipation has gotten, so I don't know if it's from the surgery, or an exacerbation of something that was waiting to come out anyway. I am always constipated it seems, then I do what I have to to get normal, but I never really get to normal. I am also contributing the constipation to my monthly cycle as that is when it seems to get the worst. And I wasn't having one every month before the surgery.

The only other thing of concern is my speech and short term memory. I sometimes can't pronounce a word and it takes me several attempts to say it right, or for whoever I am speaking with to say it correctly and then I am able. And very rarely, I forget how to swallow, but it is a very rare occasion that this happens. My short term memory has also fallen by the wayside the last year or so.

I have done a lot of research as my mother has MS. I do know it is not genetic or hereditary, however, I do run a higher risk of developing it as a result of her having it.

She was going to several doctors for specific things, and it took 6-7 years for one of the drs to say "hey! let's check you for MS!" She was initially diagnosed and treated for bipolar disorder, and then she was treated for IBS, and then acid reflux and a couple other issues, when in reality it was all MS.

Am I crazy? Or should I make an appointment with a neuro? Any help is greatly appreciated.
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Re: Uveitis, tibialis anterior spasms, please help.

Postby jimmylegs » Fri Mar 15, 2013 2:44 pm

hi j and welcome. was going to reply last nite but lost my connection. i saved what i had written so here it is now:

you're not crazy. ms has an associated set of nutrient depletion issues. gastric bypass patients are at risk of nutrient depletion also, for obvious reasons.

fyi vit D3 and b12 both are absorbed better when there's enough zinc in your system. zinc is known to be lower in ms patients and is commonly deficient in gastric bypass patients.

zinc is also critical to intestinal health and eye health. if your PCP tested your serum zinc, see if you can find out what the result was. fyi, very important: zinc deficiency or just hypozincemia is known to occur INSIDE the 'normal range'. this fact does not seem to be well understood in general practice.

sample related science, just general info applicable to anyone:

Effect of Zinc Supplementation on Respiratory Tract Infections in Children With Cystic Fibrosis
http://deepblue.lib.umich.edu/bitstream ... sequence=1
Zn adequate CF subjects (Znþ) were defined as those subjects with 90 mg/dl plasma Zn as determined by flameless AA at baseline. Subjects exhibiting inadequate Zn status (Zn) had plasma Zn levels 89 mg/dl or two standard deviations below our normal database of 110 +/- 10 mg Zn/dl. Although all subjects exhibited plasma Zn levels within the clinically accepted ‘‘normal’’ range (70–120 mg/dl), results from a number of our research studies have demonstrated that subjects exhibiting low Zn levels (<90 mg/dl) are more susceptible to infections and tend to have higher levels of plasma oxidative stress molecules and inflammatory cytokines even in the absence of outward infections.

so. normal ranges are way off for zinc in terms of what is 'good' normal and what is 'bad' normal, and the normal ranges can vary widely from lab to lab.

where you really want your serum level to be is around 18 umol/L. (that converts to 118 mg/dL if you want to compare to the study above.. note how close this number is to the extreme top of the 'accepted 'normal' range' as quoted above (their emphasis on the term normal, yay!) .

moving on to specifics in your case:

Zinc deficiency: a frequent and underestimated complication after bariatric surgery.
BACKGROUND: Although zinc deficiency is common after bariatric surgery, its incidence is underestimated. The objective was to monitor zinc and nutritional status before and 6, 12 and 24 months (M6, M12 and M24) after gastric bypass (Roux-en-Y gastric bypass), sleeve gastrectomy and biliopancreatic diversion with duodenal switch (DS) in patients receiving systematised nutritional care.
METHODS: Data for 324 morbidly obese patients (mean body mass index 46.2?±?7.3 kg/m(2)) were reviewed retrospectively. The follow-up period was 6 months for 272 patients, 12 months for 175, and 24 months for 70. Anthropometric, dietary and serum albumin, prealbumin, zinc, iron and transferrin saturation measures were determined at each timepoint.
RESULTS: Nine percent of patients had zinc deficiency pre-operatively. Zinc deficiency was present in 42.5% of the population at M12 and then remained stable. Zinc deficiency was significantly more frequent after DS, with a prevalence of 91.7% at M12. Between M0 and M6, variation in plasma prealbumin, surgery type and zinc supplementation explained 27.2% of the variance in plasma zinc concentration. Surgery type explained 22.1% of this variance between M0 and M24. Mean supplemental zinc intake was low (22 mg/day). The percentage of patients taking zinc supplementation at M6, M12 and M24 was 8.9%, 20.6% and 29%, respectively.
CONCLUSIONS: Reduced protein intake, impaired zinc absorption and worsening compensatory mechanisms contribute to zinc deficiency. The mechanisms involved differ according to the type of surgery and time since surgery. Zinc supplementation is necessary early after bariatric surgery, but this requirement is often underestimated or is inadequate.

Macronutrient and Micronutrient Disorders
Too rapid a weight loss induced by RYGB is not uncommon and occurs from inadequate calorie intake (owing to gastric restriction), possibly combined with a relative protein and fat malabsorption (dependent on the length of the common channel). The rapid phase of weight loss occurs within the first 6-12 months after RYGB in most individuals. Maintaining proper nutrition after RYGB is, therefore, a complex challenge currently facing physicians ( Box 4 ). The requirement for proper nutritional surveillance is especially important in those individuals who have undergone a malabsorptive bariatric procedure, such as a duodenal switch (a type of biliopancreatic diversion) or a distal gastric bypass.[59]

put the info about the 'normal' range and your situation together and you can see see it's entirely likely that you have an unrecognized case of hypozincemia.

in this case study, zinc therapy simultaneously improves a patient's eye, skin and bowel problems:

Zinc deficiency manifested by dermatitis and visual dysfunction in a patient with Crohn's disease
http://link.springer.com/article/10.100 ... 2?LI=true#
odd sx? no dx? check w/ dietitian
DRI=MINIMUM eg bit.ly/1vgQclQ
99% don't meet these. meds/lifestyle can affect levels
status can be low in ms & other cond'ns
'but my results are normal'. typical panels don't test all
deficits occur in 'normal' range
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Re: Uveitis, tibialis anterior spasms, please help.

Postby lyndacarol » Fri Mar 15, 2013 6:09 pm

Welcome to ThisIsMS, Jewelianna.

YOU ARE NOT CRAZY! And I am not sure it is time for a neurologist yet.I tend to believe that if you see a surgeon about a problem, he will find a solution in surgery; if you see a neuro, he will only see the problem/solution in neurology. I just read an article that summed this up well: "doctors are experts in, and only test for, those parts of the body in which they specialize."

I suggest you ask your PCP, GP or internist, to order a "fasting blood insulin test" for several reasons: 1) Insulin is known as a "fat-storage hormone." – You mentioned that you had gastric bypass surgery in 2009. 2) It is my opinion that excess insulin dumped into the intestine damages the villi and microvilli, which then interferes with nutrient absorption. – You said that blood work showed deficiencies in vitamin D and vitamin B12. 3) Excess insulin leads to insulin resistance in skeletal and smooth muscles (Insulin thickens and stiffens smooth muscles.) – Many of your symptoms (swallowing, cramps/spasm, constipation, even vision) can be due to muscles which are thickened and stiffened by insulin.


Factor #1: Your Insulin Level
Insulin and leptin are absolutely essential to staying alive, but the sad fact is that most of you reading this have too much, and it is pushing you towards chronic degenerative illness and increasing the rate at which you age.
Most adults have about one gallon of blood in their bodies and are quite surprised to learn that in that gallon, there is only one teaspoon of sugar! You only need one teaspoon of sugar at all times -- if that. If your blood sugar level were to rise to one tablespoon of sugar you would quickly go into a hyperglycemic coma and die.
Your body works very hard to prevent this by producing insulin to keep your blood sugar at the appropriate level. Any meal or snack high in grain and sugar carbohydrates typically generates a rapid rise in blood glucose. To compensate for this your pancreas secretes insulin into your bloodstream, which lowers your blood sugar to keep you from dying.
However, if you consume a diet consistently high in sugar and grains, over time your body becomes "sensitized" to insulin and requires more and more of it to get the job done. Eventually, you become insulin and leptin resistant, and then diabetic.
If you have high cholesterol, high blood pressure, type 2 diabetes, or are overweight, it is highly likely that you are eating too many grains -- yes, even unrefined whole grains -- as this is the most common culprit causing your insulin level to become abnormal.
Compounding the problem, when your insulin and leptin levels rise due to an excess of carbohydrates, they send your body a hormonal message telling it to store fat while holding on to the fat that is already there. So not only will excess carbohydrates make you overweight, they will effectively hamper your weight loss efforts too.
Your Fasting Blood Insulin Test
To find out your insulin and leptin levels, you need to get tested by your doctor. The test you need to ask for is a fasting blood insulin and leptin test, The tests are done by just about every commercial laboratory and the insulin test is relatively inexpensive.
Facts about Your Fasting Insulin Test:
o This test is profoundly useful. It's one of the least expensive tests in traditional medicine, yet it is one of the most powerful. A normal fasting blood insulin level is below 5, but ideally you'll want to be below 3.
o You can safely ignore the reference ranges from the lab as they are based on "normals" of a population that has highly-disturbed insulin levels.
o This is a great test to do BEFORE you start your program as you can use it to assess how well you are progressing in the program.
o If your level is above 5 you will want to consider significantly reducing most sugars and grains, even whole wheat grains, until you lower your level. Once you've normalized your insulin level you can reintroduce grains into your diet at a lower level to optimize your health.
o Exercise is of enormous benefit in improving the sensitivity of your insulin and leptin receptors, and to help normalize your insulin level far more quickly.
My hypothesis: excess insulin (hyperinsulinemia) plays a major role in MS, as developed in my initial post: http://www.thisisms.com/forum/general-discussion-f1/topic1878.html "Insulin – Could This Be the Key?"
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Re: Uveitis, tibialis anterior spasms, please help.

Postby Jewelianna » Fri Mar 15, 2013 7:54 pm

Thank you both for your responses. In reading your posts, I realized that I didn't give enough info healthwise. I recently had complete fasting bloodwork for my pcp, plus specialized blood work for the issues my ophthalmologist ordered. The only issues I had were with the two vitamin deficiencies. I am not diabetic or hyper/o-glycemic, my cholesterol (good and bad) are fine, red blood cell count was good. My sedement rate was at 20, which is almost too high and possibly indication some sore of inflammation, but not so much that my pcp or opth were concerned, so good blood work. I went back and checked the results of my labs and did not see the test for my zinc, so I might have that tested. Thank you again. I really appreciate the responses. Gives me more avenues to look into.
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