Not diagnosed but have questions about symptoms

[BethAnn]

Hello All.

I've been experiencing numbness in my back for several months. There is often times pain also. The numbness spread to my face and ear. I've also been having some trouble finding words or saying words all garbled. I had been feeling some fatigue also. I had an MRI and he some lesions but the neurologist said they were inconclusive. I also had a nerve conduction study and the neurologist said I had some malfunctioning nerves but it wasn't "that rare". I have also fallen into my house a couple times. My leg didn't raise as high as I thought and I tripped. That also happens getting in my car sometimes. It's hard to describe but sometimes the nerves in my back feel alive. Like I can feel them. I tried to describe it to my mom almost like it's restless legs.

My numbness and pain had subsided for a couple months. I was still numb but it wasn't as bad. I was B12 deficient and so I started taking supplements and also Vitamin D. All of a sudden my numbness is back with a vengeance. My whole lower back is numb and I have horrible pain and spasms if I stand up cooking or walk very far. My face is also numb including my lips.

I see the neurologist again later in the month. He seems very conservative, which I think is good. He doesn't think I have MS but doesn't know what else is causing my problem. I have been taking Duluxitine for my mood and discovered it helped with knee pain I was having. I also take gabapenton.

Any info or ideas would be greatly appreciated.

[NHE]

Hi BethAnn,
Welcome to ThisIsMS.

My numbness and pain had subsided for a couple months. I was still numb but it wasn't as bad. I was B12 deficient and so I started taking supplements and also Vitamin D. All of a sudden my numbness is back with a vengeance. My whole lower back is numb and I have horrible pain and spasms if I stand up cooking or walk very far. My face is also numb including my lips.

I'm curious what your B12 level was and also what form you're taking, e.g., cyanocobalamin, methylcobalamine, adenosylcobalamine or hydroxocobalamine?

Also, did you have folate, homocysteine and methylmalonic acid tested as well?

[jimmylegs]

ah ha my favourite kind of drug research:

COMPARING THE EFFECT OF DULOXETINE WITH GABAPENTIN IN THE TREATMENT OF DIABETIC PERIPHERAL NEUROPATHY: A RANDOMIZED CLINICAL TRIAL
http://en.journals.sid.ir/ViewPaper.aspx?ID=483501
Background: Diabetic neuropathy is the most common micro-vascular complications of diabetes. The drugs including gabapentin and duloxetine are often used for the treatment of pain associated with diabetic neuropathy. This study aimed to compare the efficacy of duloxetine and gabapentin in the treatment of diabetic peripheral neuropathy.
Materials and methods: Totally, 34 patients aged 40 to 70 with diabetic neuropathy were randomly divided into two groups treated with duloxetine and gabapentin and received medical treatment for 45 days. Patients were evaluated for pain before and after treatment using visual analog scale, and also their serum glucose and zinc levels were measured.
Results: In both groups statistically significant reduction in mean blood glucose, pain scale, as well as an increase in serum zinc levels at the end of the study was observed compared to baseline. There was no significant difference between the two groups for the mean decrease in blood sugar, but the increase in duloxetine group showed significant improvement compared to gabapentin in increase serum zinc levels and reducing pain.
Conclusion: The use of duloxetine in patients with diabetic neuropathic pain is more effective than gabapentin because duloxetine causes a better increase in the serum zinc. Due to the high price of duloxetine in the treatment of diabetic neuropathy, gabapentin administration can be recommended during the first phase of disease and duloxetine can be used in poor and/or insufficient response.

i went looking for drug nutrient *depletion* info, but instead found a list of *interactions* so started following up one by one. every now and then you do find research demonstrating that a drug's action replicates what you could achieve on your own with good diet, and supplements if needed. one of these days i'm going after this in a systematic way, will be interesting.

[jimmylegs]

next one. fascinating.

Response to Vitamin B12 and Folic Acid in Myalgic Encephalomyelitis and Fibromyalgia
http://journals.plos.org/plosone/articl ... ne.0124648
Question 3
What is the role of strong analgesics for the overall response to B12 and folic acid treatment?
...Duloxetine (SNRI) is also undergoing demethylation as part of its normal metabolism, which makes it potentially more apt to interact with B12/folic acid treatment in pharmacological dosages. We have made repeated clinical observations that B12/folic acid may cause paradoxical sedation when combined with SSRI/SNRI drugs; the sedation vanishes when the SSRI/SNRI dosage is reduced or cancelled. This might be in analogy with the old pharmacological observation that demethylation converts potent sedatives into antidepressant agents [17]. Maybe B12/folic acid, by its remethylating potential, reverses the normal demethylation of SSRI/SNRI and thus keeps SSRI/SNRI in its original form, which is much more sedating than its demethylated form?

[jimmylegs]

Duloxetine in the treatment of elderly people with major depressive disorder
http://www.rivistadipsichiatria.it/r.ph ... 8_2012.pdf
The physician should carefully assess, for elderly patients with depression, any underlying organic causes and comorbidities, including diabetes (14,15), hypertension (16), cardiovascular diseases (17), obesity (18,19), deficiency of vitamin B12 (20,21), vitamin D (22,23), folate (20,24,25), homocysteine (20,25,26), anemia or iron deficiency (27,28) or iron overload (29- 32), and in general, the state of nutrients and micronutrients that might influence mood (33).

re micronutrients affecting mood, i would add b6 and magnesium to that list. zinc too, since copper zinc ratio is actually linked to criminality/violence.
Reduced violent behavior following biochemical therapy
http://www.hriptc.org/pdfs/Behavior%20p ... al%202.pdf

that one is downright fascinating. love all this science. so much. but it's frustrating.