MamaCat wrote: I saw my primary care doctor, who did an in-office neurological screening (that was fine) and ordered some tests on the basis of the slight tremor she could see in one hand only and my symptoms. Metabolic panel, kidneys, liver, and vitamin/mineral levels were all normal.
Welcome to ThisIsMS, MamaCat. We are happy to share our opinions; you are not "butting in". Many of us share your symptoms.
The very first testing ordered by your primary care physician (or neurologist or ophthalmologist) should be to investigate a possible vitamin B12 deficiency. Please watch the following and compare your symptoms to the list of Signs and Symptoms; many of yours are there: migraines, fatigue, weakness, mental impairment ("Spacey"), visual disturbances, abnormal gait ("swaying"), tingling/numbness, etc.:
"Everything You Want Your Doctor to Know about Vitamin B12"http://www.youtube.com/watch?v=BvEizypoyO0
I highly recommend this 50-minute documentary from the filmmaker Elissa Leonard, featuring Sally Pacholok, RN, BSN & her husband Jeffrey Stuart, D.O. (authors of the book, Could It Be B12? An Epidemic of Misdiagnoses
); Lawrence Solomon, M.D., hematologist with Yale Medical School; Ralph Green, M.D., hematologist at UC Davis; and Donald Jacobsen, PhD, at the Cleveland Clinic (Homocysteine Research Lab).
@1:23 "The neurological manifestations well precede the hematological manifestations."
If these were not done, ask for them and ask for copies of the results for your own file. There have been several malpractice cases, which won million of dollars each (!) when doctors did not look for vitamin B12 deficiency and patients went on to develop irreversible neurological damage.
Initial testing usually includes #1 serum B12 test, #2 serum folic acid test, #3 serum homocysteine test, and #4 a urinary
methylmalonic acid test.
This is the recommendation by NHE: " In addition to watching the documentary, be sure to read the book "Could It Be B12?" http://b12awareness.org/could-it-be-b12 ... diagnoses/
To eliminate B12 as a possibility, your doctor will need to run a full panel of tests. These include...
• serum B12
• RBC folate
• urinary methylmalonic acid (uMMA)
• fasting homocysteine
• unsaturated B12 binding capacity
The tests should be run after not taking either B12 or folate supplements for at least 72 hours."
We wish you all the best.