23 Years Old, Scared

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23 Years Old, Scared

Postby Becca5766 » Thu Jan 15, 2015 12:02 pm

Okay so I will introduce myself here. My name is Becca and I am 23 years old. I grew up with a mother with MS my whole life, and she raised me to be who I am today. Long story short my issues began at age 18 when I woke up one morning and couldn't see out of my right eye. The ER flushed it and I could still not see. Went to the eye doctors and got an optic neuritis diagnosis, when they did an MRI on me only one lesion was found at this time (they weren't keen on diagnosing me with MS because it was one lesion, the optic neuritis should of been a red flag) so I decided to keep living my life normally once my vision came back. I was doing well until an episode of vertigo where I couldn't stand up for three days when I was 21. This subsided, but I was too scared to go back to the doctor.


I am 23 now, and am currently on medical leave since November, because I was having vision changes and weird heavy/lightheaded head sensations. I almost passed out at work, and came to the conclusion that it was time for the doctor and ask for another MRI because something felt wrong. They found several white matter lesions in my brain so the doctors are leaning towards an MS diagnosis like my mother. They are doing a spinal tap in February to get the diagnosis officially, than figuring out my treatment once this is verified. In the past week I have had weakness on my right side, with a numb/heavy feeling in my right leg/right arm, especially after showering or being in the cold (even exercising) so things are difficult and scary right now, sometimes I feel like I am dragging my leg through mud as I walk. I'm so young and I am preparing for the diagnosis but mainly joined here for support through this new journey. I am terrified and can't get an appointment for these new symptoms sooner. Is there any advice you all have for me? In a matter of months I can't do half as much as I used to (I previously worked overtime, could carry heavy laundry, walk far without my head feeling funny) and I am anxious to get meds so I can somewhat have my life back.

How did you cope with your MS diagnosis? What medications are good to try at first? How do you exercise (what kind) without exhausting yourself? Do you recommend medical marijuana as an additional way to treat symptoms? What symptoms do steroids have? (If this keeps up I have a feeling I'll be on some if this is a flare up) Did you still choose to have children?

Thank you for reading.. a lot going through my mind

Every bit of input helps. I forgot to mention my mom has relapsing remitting, and my uncle had progressive before he died of the complications when I was 7. So this does run in my family, a lot of people have gotten MS around the area my mother grew up in.

My right side heavyness/numbness has eased today but is still noticeable. I am remorseful because I need to shower today and know it will worsen after (even with warm water)

I am angry, upset, and sad because I don't feel like the same person I used to be even though I know I am.

I cared for my mother for years and now I more than likely have this disease that I originally helped her with. She is helping me through it instead when I would have her lean on me to walk during relapses. Now its me she's bringing to doctors and watching over. Me....

I know it will get better and I pray I can function at work normally after treatment and gain full feeling in my right side again...
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Re: 23 Years Old, Scared

Postby ElliotB » Thu Jan 15, 2015 7:10 pm

Welcome to TIMS.

Many do extremely well through diet, exercise, supplements, medication and lifestyle change. Do your homework! You will be fine.

I take Copaxone. If you decide to take a DMD, check them all out and decide on the one that is a best fit for you.

As far as exercise, I typically spend 3-4 hours per day doing some form of exercise that doesn't get me hot. Swimming is excellent. I do a lot of walking, bike riding and have even restarted using an elliptical exercise machine (on a limited basis with a fan on me) as well as a vibration plate machine. Try not to get hot. Swimming makes me feel great because I get a great workout and stay cool (the temperature is controlled year round). When it is hot outside, I wear a cooling vest.

Diet? Like medications, there are many. All work for some. You can get some great info here on TIMS:

diet-f9/

I have tried a couple, but settled recently following the Wahls' Diet. I strongly recommend you read Dr. Wahls' book, The Wahls Protocol, along with other popular MS books.

Wishing you future success and know that you will feel better.
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Re: 23 Years Old, Scared

Postby Becca5766 » Thu Jan 15, 2015 7:46 pm

Thank you so much for the information... swimming sounds like the best idea for exercise I've gotten so far and I really think I should get a membership at the YMCA so I can swim there. I was feeling hopeless for exercise because everything feels so overwhelming right now. I'll look into that book and look foreword to getting to know people better on this site and hope to learn a lot of the tools I need to push through this. This is a difficult time in my life and I am thankful for the support
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Re: 23 Years Old, Scared

Postby ElliotB » Fri Jan 16, 2015 3:46 am

I know you are going through a tough time right now. Just be patient. You will feel better soon.

I also just wanted to mention a couple of 'key' things that may help you get over your current attack. Exercise obviously as I previously mentioned. With regard to diet, there are many choices but eliminating foods high in saturated fat is a common theme - eliminate fried foods especially. If you are going to eat meat, eat only 100% grass fed meats. Most diets eliminate meats almost totally but 100% grass fed meats are high in good fats and have essential fatty acids (EFAs) which are, well, essential for good health. If you are going to eat fish, eat only wild caught fish, and stick with fish high in Omega 3 fat like salmon, tuna and sardines. I also suggest you consider going wheat and gluten free. Do research and read as much as you can so you can make educated decisions.

Supplements are considered by many to be quite important to good health. Some of the more common ones you should consider at least to start with would be D3, Omega 3, and B-12. Taking a good multi-vitamin is also a good idea. There are many, many more to consider.

Eliminate all stresses from you life. This is paramount.

Unfortunately there are many in your situation (age wise) here but the good news is that they will chime in and offer their words of wisdom that can really, really help you. Don't be scared - be proactive!

Feel well...
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Re: 23 Years Old, Scared

Postby lyndacarol » Fri Jan 16, 2015 10:17 am

Becca5766 wrote:Okay so I will introduce myself here. My name is Becca and I am 23 years old. I grew up with a mother with MS my whole life, and she raised me to be who I am today. Long story short my issues began at age 18 when I woke up one morning and couldn't see out of my right eye. The ER flushed it and I could still not see. Went to the eye doctors and got an optic neuritis diagnosis, when they did an MRI on me only one lesion was found at this time (they weren't keen on diagnosing me with MS because it was one lesion, the optic neuritis should of been a red flag) so I decided to keep living my life normally once my vision came back. I was doing well until an episode of vertigo where I couldn't stand up for three days when I was 21. This subsided, but I was too scared to go back to the doctor.


I am 23 now, and am currently on medical leave since November, because I was having vision changes and weird heavy/lightheaded head sensations. I almost passed out at work, and came to the conclusion that it was time for the doctor and ask for another MRI because something felt wrong. They found several white matter lesions in my brain so the doctors are leaning towards an MS diagnosis like my mother. They are doing a spinal tap in February to get the diagnosis officially, than figuring out my treatment once this is verified. In the past week I have had weakness on my right side, with a numb/heavy feeling in my right leg/right arm, especially after showering or being in the cold (even exercising) so things are difficult and scary right now, sometimes I feel like I am dragging my leg through mud as I walk. I'm so young and I am preparing for the diagnosis but mainly joined here for support through this new journey. I am terrified and can't get an appointment for these new symptoms sooner. Is there any advice you all have for me? In a matter of months I can't do half as much as I used to (I previously worked overtime, could carry heavy laundry, walk far without my head feeling funny) and I am anxious to get meds so I can somewhat have my life back.

How did you cope with your MS diagnosis? What medications are good to try at first? How do you exercise (what kind) without exhausting yourself? Do you recommend medical marijuana as an additional way to treat symptoms? What symptoms do steroids have? (If this keeps up I have a feeling I'll be on some if this is a flare up) Did you still choose to have children?

Thank you for reading.. a lot going through my mind

Every bit of input helps. I forgot to mention my mom has relapsing remitting, and my uncle had progressive before he died of the complications when I was 7. So this does run in my family, a lot of people have gotten MS around the area my mother grew up in.

My right side heavyness/numbness has eased today but is still noticeable. I am remorseful because I need to shower today and know it will worsen after (even with warm water)

I am angry, upset, and sad because I don't feel like the same person I used to be even though I know I am.

I cared for my mother for years and now I more than likely have this disease that I originally helped her with. She is helping me through it instead when I would have her lean on me to walk during relapses. Now its me she's bringing to doctors and watching over. Me....

I know it will get better and I pray I can function at work normally after treatment and gain full feeling in my right side again...

Welcome to ThisIsMS, Becca (Becca5766).

From your introduction here, you stated, "they weren't keen on diagnosing me with MS," and later, "doing a spinal tap in February to get the diagnosis officially," "doctors are leaning toward an MS diagnosis like my mother," and even later, "more than likely have this disease." Just because your mother has had an MS diagnosis does not mean that you necessarily have MS. There can be a totally different cause for your symptoms.

You have not listed all the testing that has been done. Since your symptoms are consistent with a vitamin B12 deficiency, I hope your doctor has ordered a HoloTranscobalamin (HoloTc) blood test to rule it out.

By the way, has your mother been tested for a B12 deficiency? You mentioned that your mom has relapsing/remitting MS, that your uncle had progressive MS and "this does run in my family." Be aware that vitamin B12 deficiency can also run in families. MS and B12 deficiency look exactly the same; they have the same symptoms; they can only be told apart by testing. (An extreme form of B12 deficiency known as Pernicious Anemia is deadly – I wonder if your uncle could have had PA as well as MS, or could even have had PA instead of MS.)
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Re: 23 Years Old, Scared

Postby Becca5766 » Fri Jan 16, 2015 10:52 am

I just see a lot of the same symptoms that my mother had prior to her diagnosis and I am almost 100% sure I do have it, not to be a downer. When I was younger the neurologist refused to diagnose me at that time in my life because of the one small lesion that was found. I know it possibly could be other things, I am however highly doubtful that this is the case. I will keep everyone updated, but when a physician lean towards an MS diagnosis, and speaks to me as though I do have it, is why I feel this way. Once the spinal tap is done by my neurologist it will be final. I know I am jumping to conclusions, I just feel in my heart that I have many reasons to assume I have MS like her. My mother does not have a b12 deficiency and neither did my uncle.

I'm trying not to be scared, but honestly someone telling me other things that it could be is helpful and appreciated, even though I am firm on this possible diagnosis.

Testing so far:
-They have done a full panel of blood work (my mother looked at it with me and they tested every possible thing under the sun) my Doctor stated my B12 is fine, so she did try to rule that out.

-an EKG and an ECG

-MRI only on skull base and orbits, results state "multiple small sites of T2/Flair signal hyperintensity within the petriventicular and corona radiata white mater bilaterally. Several of the periventricular lesions are oriented antiparallel to the long axis of the lateral ventricles" " Assymetric right intra-orbital optic nerve atrophy and multiple small T2/Flair hyperintense lesions within the periventricular white matter, corona radiata white matter, right parietotemporal suboccipital white matter and left thalamus" " Lesions with patients history of optic neuritis are highly suggestive of demyelinating disease. Clinical correlation and CSF sampling are recommended, MD personally reviewed the images and interpretation and agrees with the final report"
lots of big words here but that is the brief overall and another reason why I assume I have MS. My mother also has a T2/Flair in her brain.

About the running in families, my mom and uncle lived and grew up near a lake in a certain area where multiple families who lived around it (such as my exes sister whos mom grew up there, and another neighbor my mother had) have blood relatives who have MS or ended up with MS themselves. I am still unsure to this day why this is the case and feel it's environmental.

Lifestyle changes so far:
-On wellbutrin and haven't had a cigarette in over a week
-Slowly weening off as much sodium and fatty foods so I can go gluten free eventually
-Exercising such as walking to the store and stretching since yoga or anything too physical is too intense for me at this moment in time
-Researching and ordered a book for myself to read

Thank every single one of you for the supports and suggestions, it means more than you know
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Re: 23 Years Old, Scared

Postby lyndacarol » Fri Jan 16, 2015 2:04 pm

Believe me, I understand how you (with all your similar symptoms) can identify with your mother's diagnosis of MS. We do not want you to be scared. I only want other more likely possible causes for your symptoms to be ruled out first.

Most other possible causes (a B12 deficiency, for example) have effective treatments available. My worst fear is that someone's B12 deficiency will go undiagnosed and untreated for such a long time that symptoms become irreversible.

You have been willing to share details of your symptoms, history, and testing; so I assume you will not take offense at other private questions – if my question is too personal or intrusive, please ignore it: I am curious about "full panel of blood work." I assume this was a Complete Blood Count (CBC) and it includes a line labeled "MCV" – this indicates the average size of the red blood cells.

In my latest testing, my MCV value was 95.2 (standard range: 82.0-96.0 fL). I am curious about your MCV value and whether it was at the high-end of the standard range. It is perfectly understandable if you do not wish to share such personal details.

Because your mother and uncle and other people with cases of MS grew up in the same geographical area, it is logical to suspect an environmental cause. There are scientists working with the same suspicions trying to explain clusters of MS. Unfortunately, we are all trying to search out the cause for MS; but so far the cause is unknown.

We have no choice but to keep looking, to keep trying new things, to share our findings, and – most of all – to be supportive of each other. We want to encourage you, Becca. You have a good start with your lifestyle changes: Smoking is a no-no (it has been proven that it worsens MS); I personally think gluten-free is a good idea (but it is not easy!); exercise is always a good idea for everyone; as a book lover, I highly recommend books and lots of reading and researching!

We are here to listen and share ideas, Becca. We are glad you found us.
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Re: 23 Years Old, Scared

Postby Becca5766 » Fri Jan 16, 2015 4:19 pm

I am an open book when it comes to my health but I appreciate you making sure first. :-D
My MCV count (I looked online where I can log in and see my test results) was a 86.6

here is what it says for what they tested in my bloodwork that included my MCV:
CBC + DIFFERENTIAL is what they called it.

Leukocytes 6.8 thou/uL
Erythrocytes 4.56 mil/uL
Hemoglobin 13.6 g/dL
Hematocrit 39.5 %
Mean Corpuscular Volume 86.6 fL
Mean Corpuscular Hemoglobin 29.8 pg
Mean Corpuscular Hemoglobin Conc 34.4 g/dL
Platelet Count 300 thou/uL
Erythrocyte Distribution Width SD 40.0 fL
Erythrocyte Distribution Width CV 12.7 %
Neutrophils Percent 64 %
Lymphocytes Percent 28 %
Monocytes Percent 6 %
Eosinophils Percent 1 %
Basophils Percent 1 %
Immature Granulocytes Percent 0 %
Neutrophils Absolute 4.34 thou/uL
Lymphocytes Absolute 1.90 thou/uL
Monocytes Absolute 0.40 thou/uL
Eosinophils Absolute 0.08 thou/uL
Basophils Absolute 0.04 thou/uL
Immature Granulocytes Absolute 0.01 thou/uL

they also tested these other things in my blood:
TSH REFLEX THYROXINE FREE
COMPREHENSIVE METABOLIC PANEL
MAGNESIUM
VITAMIN B12 + FOLATE LEVELS
(My vitamin B12 level was a 434, Folate was a 13.8...Doc says it all came back normal)


I appreciate the encouragement and information. I don't know what I would do if I never came across this website. I was feeling so alone and I am so glad to be surrounded by people my age and other people who even aren't my age that are going through this. It's literally given me more hope when I previously felt like I didn't have any. I can't only have my mom for support I needed other people too. I also suffer from major depression (as well as my mother) and have been getting it treated. I know this is also common in people with MS.

*Big Hugs to ElliotB and lindacarol* :X
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Re: 23 Years Old, Scared

Postby ElliotB » Fri Jan 16, 2015 5:33 pm

Thanks...

You may also want to get your Vitamin D level checked. Vitamin D is definitely one you want to take. And probably in higher than typically recommended doses. Ask your doctor first. I take 20,000 IU daily.

"I also suffer from major depression"

Get an emotional support/service animal (dog). At the time of my diagnosis, I was in bad shape. He has and continues to make a tremendous difference in my emotional state.
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Re: 23 Years Old, Scared

Postby jimmylegs » Fri Jan 16, 2015 7:58 pm

hi and welcome :)

that's amazing that they tested magnesium :D was it rbc or serum mag? do you have that result? not used to seeing mag on a typical test panel. pleasantly surprised.

b12 level isn't fantastic - could stand to be higher. just an fyi - 'normal' for bloodwork isn't good enough. people can eat below the recommended daily amounts of essential nutrients all over the place, and still the blood tests come back 'normal'. the measurement tools are pretty broken!

one good thing to consider doing, is to go through your diet to see if you're meeting the RDIs for the nutrient that are of particular concern for ms patients. such as zinc, magnesium, copper, iron, omega 3 fatty acids, b-vits (all of them) etc.

also, you can check whether your typical foods eaten are more inflammatory, or antiinflammatory. here are two wonderful resources for checking the food you each day for nutrient density and inflammation factors:
http://www.whfoods.com (you can put that site and any food, mineral, or vitamin into google and you should get a nice quick result - i find the site nave on whfoods.com is a bit counter-intuitive but google searching gets you to the page you need!)
http://inflammationfactor.com/look-up-if-ratings/

if you pick one nutrient (maybe magnesium since you have a test result handy to compare) and go through your typical day's food tallying up each thing's contribution to the recommended daily amount of mag in diet, that might be an interesting step 1 :) if you have *any* questions or need help with it feel free to ask!
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!
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Re: 23 Years Old, Scared

Postby Becca5766 » Fri Jan 16, 2015 9:26 pm

I think it was pretty basic, because it simply stated I have a 2.0 for a magnesium level.


Looked in my metabolic panel. My calcium level is currently a 9.8
I don't know what any of the levels mean, but I will talk to the doctor about vitamin D supplements and a multivitamin. What multivitamin is best? Any brands suggested? I have heard that some brands of multivitamin don't have a good amount of supplement in them (not sure if this is true)

Animal wise, I do have a cat but only see him when I go to my moms. My nephew isn't good with cats so I let her hold onto him. He is therapeutic but he is safer and happy with her other three cats (:

I appreciate the websites and all the info, there are things I never imagined (like the b12 deficiency) which makes sense as to why the doctor mentioned my b12 level being okay and other reasons as to why she did a whole panel of tests.

I have so much to research and learn, the good news is I did my taxes so soon I can get a lot more healthy food in the house that is good for me. (I will stock up on frozen broccoli being one of the things.. love it) been pretty broke being out of work not having as much income on my short term disability.

The suggestions based on my results are so helpful, I don't know much about levels and what range is considered normal or just okay.

So now is the waiting game until February. My right side is feeling heavy enough to be noticeable and numb enough to know I can feel more on my left side. I successfully showered without it increasing so I feel some of these symptoms are subsiding *knock on wood* I feel much better than the past few days.
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Re: 23 Years Old, Scared

Postby lyndacarol » Sat Jan 17, 2015 10:07 am

Becca, in my opinion, jimmylegs was correct when she said: your "b12 level isn't fantastic – could stand to be higher."

I urge you to read the book, Could It Be B12? An Epidemic of Misdiagnoses by Sally M. Pacholok, RN, BSN, and Dr. Jeffrey J. Stuart, D.O. (This may be available at your library.): http://b12awareness.org/could-it-be-b12 ... diagnoses/

On page 11:
There is much controversy as to what constitutes a normal result for this test [serum vitamin B12 test]. Because of this controversy, this test is often used in conjunction with other markers of B12 deficiency (MMA, Hcy, and more recently the HoloTc).

… We believe that the "normal" serum B12 threshold needs to be raised from 200 pg/mL to at least 450 pg/mL because deficiencies begin to appear in the cerebral spinal fluid (CSF) below 550 pg/mL.

At this time, we believe normal serum B12 levels should be greater than 550 pg/mL.…

We commonly see patients with clinical signs of B12 deficiency who are not being tested. Others who are being tested are not being treated because their serum B12 falls in the gray zone [between 200 pg/mL and 450 pg/mL]. This error results in delayed diagnosis and an increased incidence of injury.


Compare your B12 test results (434… I assume the unit of measurement was pg/mL) to those recommended by the authors. And if you took any vitamin B supplement before testing, that can make the B12 test results inaccurate and unreliable.

If possible, request that your GP order a couple more blood tests: a homocysteine (Hcy) test and a methylmalonic acid (MMA) test (actually, the urinary form of this test is considered more accurate – and, at about $150, is less expensive; maybe insurance you might have would even cover these). If these two test results are high, there should be further investigation into a possible B12 deficiency.
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Re: 23 Years Old, Scared

Postby Becca5766 » Sat Jan 17, 2015 12:22 pm

Okay this really interests me. So you both are saying that my b12 is below the recommended level of the author? I prefer to wait for the spinal tap before I jump to the b12 side of things, I do believe supplements are necessary at this point when I do talk to my doctor. Don't mind my foggy mindedness, can you have MS and a b12 deficiency? At this point I'm not trying to be but I'm somewhat skeptical since they stated it was average (I know the average can be questionable according to some people) trying to be as open minded as possible here but I am having extreme difficulty thinking that this is the issue. As I said I will look into supplements, if it could be higher i assume its not that far off,I am taking a lot of this in as I am typing this but I will do the research as requested by you both and see if she will do that blood work for me. My red blood cell count is fine so in all honesty I am not too concerned
Because if it was a b12 deficiency my red blood cell count would also be off if I am correct.
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Re: 23 Years Old, Scared

Postby lyndacarol » Sat Jan 17, 2015 2:32 pm

All this "medical stuff" is quite a lot to take in. In my opinion, you have reasonable thoughts and questions and a good plan of action.

To answer your first question… Yes, the authors of the book recommend that a person's serum B12 test should have a result greater than 550 pg/mL. Your level of 434 is below their recommended level.

About your spinal tap scheduled for February… Please be aware that there is no one definitive test that can say, "Aha, this is MS!" – Not even a spinal tap. In fact, since MRIs have become available, I believe that more importance has been placed on MRI findings than spinal taps.

To answer your second question… The spinal tap cannot say definitively that you have MS; it could still be a false diagnosis. Even if o-bands are found (these can be found both in MS and in B12 deficiency). Since a spinal tap will be done in February, consider calling the doctor who ordered it and request that the spinal fluid also be tested for your B12 level.

To answer your third question… Yes, a person can have multiple conditions at the same time. You can have both MS and a B12 deficiency.

I encourage you to be skeptical – very skeptical – about all this stuff. It is good to be open-minded, but always ask lots of questions; ask us and ask your doctors LOTS of questions.

Vitamin B12 is the largest of all the vitamins; it is necessary for every cell in our bodies; it has the most complicated pathway (or journey) of any of the vitamins from the food source to the cells (and there are MANY ways this pathway can be blocked).

A person can eat plenty of B12 (either food or supplements); the B12 can even get through digestion (if there are no problems with digestion – although many medications can cause problems here); and the B12 can even be absorbed into the bloodstream (problems with wheat/gluten can interfere here) – but even if a good amount of B12 makes it all the way to the bloodstream (and so there is no deficiency in the bloodstream), there can still be a deficiency in the cells, if there is not enough of the proper transporter (transcobalamin II) binding with B12 in the blood and carrying it to the cells. In other words, the B12 level can look good in the blood, but still be deficient in the cells (where it is necessary for energy, among other things).

If you do have the start of B12 deficiency, and the problem is beyond the bloodstream, you could swallow bottles and bottles of supplements and not correct the problem.

I have no way of knowing if this is the cause of all your symptoms, Becca; but because B12 deficiency has been found in up to 40% of Americans, I think it needs to be ruled out thoroughly. If your GP is unwilling or unable to do the necessary testing, would she refer you to a hematologist? This kind of specialist is certainly used to problems of this sort.
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Re: 23 Years Old, Scared

Postby jimmylegs » Sat Jan 17, 2015 3:10 pm

hey there :) it is interesting stuff, isn't it :D

b12 deficiency is the oldest and best known nutritional differential dx for ms. low or deficient b12 should be used to help exclude an ms diagnosis where it exists.

that doesn't always happen though. when i was diagnosed with ms i had serious b12 deficiency in my medical records but the docs missed it because of a computer glitch. the test was only sensitive down to 75 pmol/L and they couldn't find any so my levels was just "less than 75". because it wasn't a number, the software didn't pick it up for display. i didn't realize that was what was going on until much later. so at very least, i hope that you feel a little better about your level even though it's not optimal. in the 400s, you're a lot farther from the fire than i ended up ;)

by the time the docs were testing my levels during diagnosis i was supplementing frantically and my b12 levels had only made it up to around 300. so since that qualified as 'normal' they decided there was not a nutritional component to my situation. they also said that because i had other things going on that were not specific to b12, that it was not responsible for my problems. that was a narrow and short sighted way to look at it imho. for one thing i've since found correlations between b12 deficiency and other 'ms-specific' tests results (such as elevated CSF o-bands) in the literature. they also failed to consider that other concurrent nutritional issues might be muddying the picture and that they shouldn't rule out b12 deficiency just because i also had other things going on. over the years to follow i would read, ask for tests, and every time i would find a new deficiency to fix.

with b12 the blood count effects start to show when the levels are really depleted. much earlier than that, other effects that aren't visible in terms of the size of blood vessels can start to creep in. for example, reversible cognitive functioning can occur long before the blood counts start to look off. not all effects are reversible.. in the early days of my quite serious deficiency, i had a lot of numbness and weakness but could recover fully if i took b12 supplements. in the end it got so bad that i now have permanent sensory damage. if i had known what was really going on i would have taken everything far more seriously.

if you can fit a pack of frozen salmon into your budget periodically, that should make a big difference in a lot of ways. it's great for b12 and omega 3 fatty acids for example. i buy 4 packs of fillets for $7 or so, which is a pretty good deal per meal :D

healthy b12 food list: http://www.whfoods.com/genpage.php?tnam ... #foodchart
lots of good info on that page and worth reading the whole thing.

if you can handle sardines (i can't) they're even better for b12!

your serum magnesium level is suboptimal too. again, yes it's 'normal', but not good enough. the ranges for magnesium are just as bad if not worse than the ranges typically in use to define 'normal' b12. aim for 2.3-2.7 mg/dL and you'll be in much better shape. when you are trying to build up your levels and stores, try for 500-600mg of magnesium per day. when you want to maintain, 300 should be fine. get as much as possible from diet, so that it is properly balanced with other essential nutrients. excessive magnesium from low quality magnesium supplements will give you terrible diarrhea while excessive mag from high quality mag supplements might be felt as a sort of muscle weakness. if you can find magnesium glycinate and use 100-200mg per day to augment your diet, that one is a high quality, absorbable form. at my local store i can get a month's worth for 20 after tax. you can probably find it much cheaper in maine. kirkman labs is a good brand with a pill that delivers 100mg of elemental magnesium per capsule.

healthy food sources of magnesium: http://www.whfoods.com/genpage.php?tnam ... #foodchart

with spinach, for optimal nutrient density it's best to cook it. same with any greens. read here re best cooking methods and times to retain nutrient density:

http://www.whfoods.com/genpage.php?tnam ... ce&dbid=43
"Spinach is one of only three vegetables that we recommend boiling to help reduce its concentration of oxalic acid. We recommend boiling for just 1 minute to minimize loss of nutrients and flavor."

i love making spinakopita with spinach (in that case i just buy it frozen ie already boiled and drained) with homemade tzatziki sauce on the side. delish!
also whfoods has this recipe for a 1-min spinach side dish: http://www.whfoods.com/genpage.php?tnam ... e&dbid=101

http://www.whfoods.com/genpage.php?tnam ... ce&dbid=16
"Swiss chard ... is one of the most nutritious vegetables around ... It is also one of only three vegetables that we recommend boiling to help reduce its concentration of oxalic acid. Slice leaves 1-inch wide and the stems 1/2-inch wide and boil for just 3 minutes."

hope all that helps :) there's lots you can do just with evaluating and adjusting your diet!
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!
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jimmylegs
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