Enough to see a doctor?

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

Enough to see a doctor?

Postby SeanaR » Wed Apr 25, 2018 7:53 am

I have been having some weird (annoying but not impeding on my life) sensations for a couple of years now. Tingling in my fingers, first two toes on each foot, and what feels like a hair or tickling on my face. My right leg sometimes feels like it is wet but nothing is there. I also have noticed that when I'm walking, my foot (front of toe) catches and I trip much more frequently.

I am 44 years old, have had Hashimoto's since I was 17, and was diagnosed with Rheumatoid a little over a year ago. Both are being controlled (levothyroxine and methotrexate) and my lab tests come back normal.

I am wondering if these symptoms warrant a trip to the doctor? My rheumatologist suggested MS when I mentioned the symptoms to her but I also don't want to over-react.
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Re: Enough to see a doctor?

Postby ElliotB » Wed Apr 25, 2018 9:35 am

Why not? You have nothing to lose. The symptoms you mention are not 'normal'.
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Re: Enough to see a doctor?

Postby NHE » Thu Apr 26, 2018 2:07 am

SeanaR wrote:I have been having some weird (annoying but not impeding on my life) sensations for a couple of years now. Tingling in my fingers, first two toes on each foot, and what feels like a hair or tickling on my face. My right leg sometimes feels like it is wet but nothing is there. I also have noticed that when I'm walking, my foot (front of toe) catches and I trip much more frequently.

I am 44 years old, have had Hashimoto's since I was 17, and was diagnosed with Rheumatoid a little over a year ago. Both are being controlled (levothyroxine and methotrexate) and my lab tests come back normal.

I recommend getting your B12 levels checked. This includes not only B12, but red blood cell (RBC) folate, homocysteine and methylmalonic acid (MMA).

Methotrexate can interfere with folate and low folate can inhibit B12 recycling. Over time, this can lead to a B12 deficiency. A plethora of neurological symptoms can arise from a B12 deficiency, some of which can be irreversible if the deficiency is allowed to persist.

https://labtestsonline.org/conditions/v ... ficiencies

Methotrexate, an anti-cancer drug, affects body metabolism and use of folate.

You may wish to read the following topic for more information about B12.

natural-approach-f27/topic24857.html
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Re: Enough to see a doctor?

Postby jimmylegs » Thu Apr 26, 2018 9:28 am

hi do you have serum vit d3, serum selenium and serum ferritin on file?

Multiple Nutritional Factors and the Risk of Hashimoto's Thyroiditis
https://www.ncbi.nlm.nih.gov/pubmed/28290237

aside from pharma, do you have a nutritional regimen in place to address your existing dxs? if so can you describe in detail?
which blood tests specifically come back 'normal' and do you have exact results detail on file?


re RA - excerpt from some recent private correspondence (no real difference from any TiMS post lol)

"for this study, emphasis is purely on assessing serum mag status in RA. D3 tie will come later.

Note re the below, the minimum target for serum magnesium (above which fewest individuals exhibit magnesium deficiency symptoms in spite of 'normal' levels within the normal range) is at least 2.3 mg/dl aka 0.95 mmol/l

*****

Evaluation of Serum Magnesium, Lipid Profile and Various Biochemical Parameters as Risk Factors of Cardiovascular Diseases in Patients with Rheumatoid Arthritis (2015)
Vilas U. Chavan,corresponding author1 DVSS Ramavataram,2 Payal A. Patel,3 and Mihir P. Rupani4

Abstract

Background
Rheumatoid arthritis (RA) is chronic inflammatory disease, associated with increased risk of cardiovascular diseases (CVD) than the general population. Chronic inflammatory conditions are likely to alter magnesium level and various biochemical parameters.

Objectives
To study the probable changes in serum magnesium, lipid profile and various biochemical parameters and to assess risk factors of CVD in newly diagnosed RA patients compared to controls.

Materials and Methods
We studied 50 newly diagnosed RA adult patients and 50 healthy individuals as controls. Serum magnesium, calcium, lipid profile, uric acid and other biochemical parameters were measured in study subjects. Results were expressed as Mean ± SD and compared between RA subjects and controls by Independent sample t-test and Pearson correlation.
...

Magnesium (Mg) is an essential nutrient and fourth most abundant mineral found in the body [9] Mg levels are changed in chronic inflammations and decreased level of Mg has been suggested to be reasonable marker of RA [4]. Magnesium is routinely measured in the blood and has many functions in the cardiovascular (CV) system, like as an activator of sodium potassium ATPase, antiarrhythmic and associated with risk of CD [9-12].
...

Results
The present study was conducted in 100 subjects (39 males and 61 females) of which 50 RA and 50 control subjects [Table/Fig-1]. We found lower magnesium concentrations in RA subjects (1.73 ± 0.46 mg/dl) compared to the controls (2.12 ± 0.25 mg/dl), t (98) = 5.12, and data was statistically significant [Table/Fig-2,,3].3]. Serum calcium level was lower in RA (7.75 ± 0.63 mg/dl) compared to controls (9.99 ± 0.66 mg/dl), t (98) =17.17. Alkaline phosphates level was increased in RA subjects (348.54 ± 99.51 IU/L) compared to controls (150.02 ± 52.26 IU/L), t (98) = -12.48. In RA subjects there was higher total cholesterol and LDL cholesterol (p = 0.054) and (p = 0.008) respectively RA patients had statistically significantly lower HDL 2cholesterol levels compared to control group. There were significant increase in the levels of phosphorus, total proteins and albumin in RA subjects compared to controls [Table/Fig-2]. The study found that RA patients had higher uric acid and alanine transaminase (ALT) compared to controls. Serum creatinine and urea was decreased in RA cases compared to controls. There was no significant difference in the levels of triglyceride, VLDL cholesterol, total bilirubin, direct bilirubin, indirect bilirubin, urea, glucose, aspartate transaminase (AST) and electrolytes (Na+, K+ and Cl-) between RA cases and control group [Table/Fig-2,,33].
...

Conclusion
Our study concludes that newly diagnosed RA patients had significantly lower serum magnesium, calcium levels and increased levels of alkaline phosphatase, phosphorus, total proteins, albumin and uric acid compared to controls. We observed atherogenic lipid profile characterized by increased total cholesterol, LDL cholesterol and a reduction in the HDL cholesterol in newly diagnosed RA. Low level of magnesium, dyslipidemia and increased uric acid observed in our study together may be more potent risk factors for CVD in newly diagnosed RA subjects. We recommend that serum magnesium should be investigated as a part of cardiovascular risk management in RA. We suggest that magnesium supplementation, may prove to be beneficial to reduce the risk of CVD in RA patients. Further prospective, long-term studies are needed to determine the role of inflammation and its impact on various biochemical markers and cardiovascular outcomes in patients with RA."


"Some info on healthy serum vitamin D3 targets:

Note in the study below the difference between serum mean D3 in patients with RA in remission, and matched 'healthy controls'.

With proper attention to essential nutritional cofactors, i consider 50 ng/ml an appropriate starting target for serum 25(OH)vitamin D3. That converts to 125 nmol/L. (50 x 2.496 = 124.8).

Yes, in the study below the healthy controls mean is lower than 50 ng/ml. Consider though, that 34% of this study's 'healthy control' group were vit D3 deficient.

*****

Assessment of Vitamin D in Rheumatoid Arthritis and Its Correlation with Disease Activity (2018)
Narendra Meena, Sumit Pal Singh Chawla, Ravinder Garg, Anil Batta,1 and Sarabjot Kaur
free full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812075/

Abstract

Background
Vitamin D is believed to have an immunomodulatory and anti-inflammatory action, and its deficiency has been linked with several autoimmune disorders, including rheumatoid arthritis (RA). The relationship between the severity of RA and serum levels of Vitamin D is a subject of immense interest and therapeutic implications.

Materials and Methods
This was a prospective, comparative study conducted on 100 participants, 50 cases of RA and 50 healthy controls, all in the age group of 18–75 years. Serum Vitamin D levels were measured and compared in cases and controls. Vitamin D levels in RA patients were also assessed in different stages of disease activity to assess the correlation between the two.

Results
Eighty-four percent patients of RA were Vitamin D deficient versus only 34% of controls.
The serum Vitamin D levels were also significantly lower in the RA patients (mean value of 21.05 ± 10.02 ng/ml), as compared to the controls (mean value of 32.87 ± 14.16 ng/ml). There was a significant inverse correlation between serum Vitamin D levels and RA disease activity.
The mean serum Vitamin D levels were 35.28 ± 9.0 ng/ml, 33.80 ± 4.1 ng/ml, 22.47 ± 6.18 ng/ml, and 14.21 ± 6.97 ng/ml in the remission, low disease activity, moderate disease activity, and high disease activity groups, respectively.
...
Limitations of the study
This was a single-center study with a small sample size.

Conclusions
Vitamin D deficiency is more common in RA patients and may be one of the causes leading to development or worsening of RA. In RA, as the disease activity increases, the serum Vitamin D levels tend to decrease. There is a need for proper evaluation of Vitamin D status in all RA patients to ensure the intake of the recommended amount of Vitamin D. Further research is required so that the antiproliferative, immunomodulatory, and anti-inflammatory properties of Vitamin D could be exploited to treat a variety of autoimmune rheumatic diseases."

tons of overlap here with nutrients of concern in ms. you can work to rule out low nutrient problems and then see what you might be left with on your symptom list!
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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