Lhermitte's sign? Or back tightness?

This is the place to ask questions if you have symptoms that suggest MS, but aren't yet diagnosed.

Lhermitte's sign? Or back tightness?

Postby tinocallis » Fri Jun 28, 2013 4:44 pm

Is this Lhermitte's? I know, kind of a stupid question, but it's hard to tell. I guess it should be obvious. I definitely experience sharp shooting pain when bending my neck forward, but it could just be tight back muscles. How do I tell the difference? I'd hate to go to the doctor for sore back muscles, and waste both our time.

I do have other symptoms, possibly of MS. Or, possibly just stress-related. In fact I think all of them could be attributed to stress/anxiety, for which I am definitely well known. But I really don't want to be that person who goes to the doc for all these "symptoms" and is told it's just stress. I was hoping you all could help me sort out the don't-worry-about-it stuff from anything possibly worth more attention?

-Tingling/buzzing sensation in toes and fingers (most often the tip of my left thumb gets a "zap" feeling).
-Muscle fasciculations every day. No one spot in particular -- seems like every muscle I have has felt it in the past few months. But most often is neck, abdomen, calves, and feet.
-Episodes of intense, almost unbearable nausea accompanied by severe headache. This has happened twice just in the past few months, and lasts for most of the day (but usually only a day). I never vomit, though I wish I would just to relieve the feeling!
-Diagnosed with GERD about 2 years ago, and have been taking Omeprazole most of that time. If I don't take that or a couple Zantac I end up getting "acid mouth" (gross) and sometimes regurgitating food (grosser). No matter what I eat.
-Increasingly poor fine motor control. Today was particulary bad -- at work I had trouble signing my name on letters, though that could be due to the delightful nausea/headache combo I was feeling today. But it's usually pretty poor; I can't do that peg game or pick-up sticks without shaking uncontrollably.
-Tremors, especially left hand.
-Urge incontinence. I typically pee 10-15 times a day, and I never feel like I've fully emptied my bladder. I can't really "feel" myself peeing either, if that makes sense. I can hear it hitting the toilet but hardly feel it coming out. It's also hard to get started peeing.
-My knees buckle occasionally, out of nowhere, sometimes when I'm just standing. But everybody's knees buckle now and then.
-Sciatica. This only happened once (a couple weeks ago) so it's probably nothing. It was in my left thigh/buttock, and hurt so bad I couldn't put weight on that leg. It made my toes all tingly, too.
-Shooting pains in hands and feet. This is probably attributable to something like carpal tunnel syndrome, especially since I just started a computer-work-heavy job.
-Tinnitus, left ear only. A symptom of almost anything, so who knows.

Side note - I happen to be a female with red hair. For what it's worth.

I know that's a lot to read through. Thanks if you've read this far!

Anyone have any thoughts to quiet my anxious mind?
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Re: Lhermitte's sign? Or back tightness?

Postby jimmylegs » Fri Jun 28, 2013 7:19 pm

hi :)

lhermitte's tends to involve an electric shock sensation referred elsewhere in the body and not felt in the neck itself (although definitely triggered by the neck motion).

recent member discussion re omeprazole general-discussion-f1/topic22349.html#p210152

so omeprazole is known to deplete magnesium and hypomagnesemia has strong links to anxiety and muscle tension/tremors/pain. i'd test and optimize mag status first, see what's left and whether the picture still looks like ms

I wouldn't take the knee thing lightly. that only used to happen to me when I was severely b12 deficient. I did permanent damage because I didn't know I was playing with fire.

other than meds, any dietary things you can think of that might be affecting your mag status? or other nutrients?
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Re: Lhermitte's sign? Or back tightness?

Postby lyndacarol » Sat Jun 29, 2013 7:30 am

Welcome to ThisIsMS, tinocallis.

You may not have MS at all, but there is always a possibility; it is an exclusionary diagnosis - made by ruling out other possibilities. Very often, it is not easy or quick to diagnose. Before expensive tests even existed to diagnose MS, doctors used to diagnose MS on the basis of symptoms and if those symptoms temporarily worsened when the patient sat in a hot bath for a while.

Find a good GP or internist, one who is a is compassionate and enjoys being a "disease detective." 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 suspect insulin involvement and developing insulin resistance in skeletal muscles because excess insulin is known to thicken and stiffen smooth muscles; (skeletal muscles, too) - this may explain your walking problems (knees buckling). Your problem with fine motor control – in signing your name – may be due to a loss of strength in the muscles of your hands. I believe the burning sensation in my feet and legs is actually due to the extremely irritating hormone, insulin, damaging the inside of my blood vessels or affecting the smooth muscles in the blood vessel walls - at first I described this as "buzzing - without the sound." You described tingling in your toes and fingers. Even your GERD can be the result of excess insulin thickening and stiffening the sphincter muscle (a smooth muscle) which then allows stomach acid to travel back up the esophagus. Urge incontinence certainly indicates a problem in the muscles – the detrusor muscles and the sphincter muscle around the urinary bladder are smooth muscles.

I suggest that you request your GP to order a "fasting blood insulin test" – this is NOT the same as a glucose test. The optimal insulin test result is 3 UU/ML or lower. All the best to you.
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: Lhermitte's sign? Or back tightness?

Postby tinocallis » Sat Jun 29, 2013 1:44 pm

Thank you both for your quick replies! They're very helpful.

jimmylegs - I feel the pain in my back, but, I agree that it does not sound like Lhermitte's. Whew! The omeprazole subject is interesting -- I hadn't even though to consider that. I will definitely look into the magnesium levels. I'm almost done with my current prescription of omeprazole, and my GP has already said she won't give a new one because she doesn't want me on long-term PPIs, which I agree with. Not sure what being off it will mean for the GERD, though... Other people have mentioned b12 deficiency to me based on my symptoms, so I'll pursue that as well. To answer your question, I don't take any supplements at all. My diet is mostly poultry, complex/high-fiber carbs, veggies, fruit, and some dairy. I don't eat red meat (don't like the taste) and avoid sugar, both refined and simple sugars. And I drink tons of water. I think my diet is "good" enough to be ruled out as a cause, but I'll try to find out for sure. Thanks so much for your suggestions!

lyndacarol - Wow, I didn't realize so much of our system is linked to insulin. Very thought-provoking. About a year ago I actually requested a blood glucose test from a doctor, because I was having crazy headaches, eye strain, pins and needles sensations in my feet, was thirsty all the time, and was peeing constantly. But it came back normal, plus the doc brushed me off like I was an idiot for even considering the test (I then found a new doctor). But you mention the fasting BG test, which I did not have. I'll see about getting it -- hopefully it will provide some answers!

Thanks again to you both!
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Re: Lhermitte's sign? Or back tightness?

Postby jimmylegs » Sat Jun 29, 2013 2:18 pm

k, check out your daily intake of magnesium from diet. here's good resource to get mag amounts for servings of different healthy foods.
http://www.whfoods.com/genpage.php?tnam ... #foodchart
since you've been taking omeprazole, i'd aim for 600mg per day. that's about 4 cups of boiled spinach (!) and spinach is one of the richest healthy sources.

fyi magnesium status is linked to insulin status too:
Oral magnesium supplementation reduces insulin resistance in non-diabetic subjects - a double-blind, placebo-controlled, randomized trial.
http://www.ncbi.nlm.nih.gov/pubmed/21205110
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Re: Lhermitte's sign? Or back tightness?

Postby lyndacarol » Sat Jun 29, 2013 3:24 pm

I suggested that you request your GP to order a "fasting blood insulin test" – this is NOT the same as a blood glucose test, which you say that you requested a year ago. The optimal insulin test result is 3 UU/ML or lower.

The fasting insulin test is not routinely done; it must be specifically requested.

Your body will always produce more insulin than necessary to drive the glucose level down to normal levels. With constant exposure to this excess insulin, cells will become resistant to insulin. At that point the body will produce even more insulin, until the pancreas is exhausted, and stops producing insulin altogether (this is type I diabetes).
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Re: Lhermitte's sign? Or back tightness?

Postby tinocallis » Sat Jun 29, 2013 8:26 pm

Ah! Thanks for the correction; it makes a lot of sense the way you put it. I'll be sure to be specific when I request it.

Is what I've described enough to warrant the test? I know I feel ill and like my body is sending out distress signals, but I've but I've been burned too many times by doctors who shrug off my concerns like they're trivial and meaningless. Should I wait for something really obvious to happen? Hate to waste both my time and the doc's for a test that comes back normal (not to mention money).
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Re: Lhermitte's sign? Or back tightness?

Postby tinocallis » Sun Jun 30, 2013 6:51 am

lyndacarol - I looked into the fasting blood insulin test some more, and it's my understanding that this test is commonly associated with type II diabetes, which I almost positively do not have. I have never been overweight in my life (currently 124lbs at 5'3"), never smoked, have a healthy diet, and I am Caucasian. I have none of the risk factors for type II. If anything, I may have type I diabetes -- would the fasting blood insulin test be helpful for determining type I?
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Re: Lhermitte's sign? Or back tightness?

Postby jimmylegs » Sun Jun 30, 2013 7:39 am

Insulin resistance is a risk factor for progression to Type 1 diabetes
http://link.springer.com/article/10.100 ... 004-1507-3
"Relatives positive for islet antibodies who progress most rapidly to diabetes have a subtle disturbance of insulin–glucose homeostasis years before the onset of symptoms, distinguished by greater insulin resistance for their level of insulin secretion. Taking steps to reduce this insulin resistance could therefore delay the development of Type 1 diabetes."

Associations of serum and dietary magnesium with cardiovascular disease, hypertension, diabetes, insulin, and carotid arterial wall thickness: the ARIC study
https://pinnaclife.com/sites/default/fi ... mg_cvd.pdf
Low intracellular Mg and low Mg intake have been associated with elevated fasting insulin levels ... Generally, serum Mg levels were lower in those with diabetes, hypertension, and/or CVD than in disease-free participants (without these three prevalent diseases). Participants with diabetes had the lowest values (0.73-0.81 mmol/l)*. Dietary Mg intake was inversely related to fasting serum insulin ..."

* these values are 'normal'. the normal range is 0.70-1.10 mmol/L. all kinds of sick people test 'normal' for serum magnesium when in fact low normal levels have well known associations with disease states

ensure your level is 0.95-1.1 mmol/L to match 'healthy controls' - ie, the very top of the 'normal' range.
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Re: Lhermitte's sign? Or back tightness?

Postby lyndacarol » Sun Jun 30, 2013 9:26 am

tinocallis wrote:Is what I've described enough to warrant the test? I know I feel ill and like my body is sending out distress signals, but I've but I've been burned too many times by doctors who shrug off my concerns like they're trivial and meaningless. Should I wait for something really obvious to happen? Hate to waste both my time and the doc's for a test that comes back normal (not to mention money).


In my opinion, your symptoms justify asking for the insulin test; I believe it will become routine in time, just as cholesterol testing is today. Even the vitamin D3 test has become more common lately. You have every right to ask for any blood test that you feel you need. And as for the cost/money (if insurance does not cover it)… the fasting blood insulin test is one of the least expensive blood tests. (I think the cost of my last one was $50 or less.)

http://www.mercola.com/nutritionplan/index2.html

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.


An elevated insulin level results in a weight problem ONLY if the person's diet is high in carbohydrates (sugar and starches). It is entirely possible to have elevated insulin levels AND be slender – I am an example of this; I suspect that you are too. I eat a very healthy diet, have never been overweight, have never smoked.

In type I diabetes, the pancreas is producing NO insulin; in type II diabetes, the pancreas is producing LOTS of insulin but the cells are resistant to it and won't let it "unlock the door" for glucose to get in. In either case, it should be known how much insulin the body is producing – insulin testing should be done!
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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