MS? other autoimmune problem? Sport-induced partly

[jimmylegs]

interesting - my own has only ever been high (2170) after taking 1000 mcg folic acid per day in a particular b-complex i had started at the time, which was early in the learning curve. i got side effects. since then, after balancing other nutrient levels, i can take 1000 mcg per day with no side effects. if memory serves, the top end of the range at my lab, at the time, was 1800 or close to it.
list of related posts
http://www.thisisms.com/forum/search.ph ... mit=Search
one where i mentioned my specific lab result
http://www.thisisms.com/forum/general-d ... ml#p191419

[yirara]

I only found two references about folat units: "Values are typically around 6-7 nmol/L, but not above 45 nmol/"

That's all I can find as I had the bloodtest in a country I don't really know the language. Not easy googling as all results I find are about folat substitution, not about blood results.

Well.. I must admit I don't eat much meat. Usually my husband and me share a chicken breast and we hardly ever have red meat. But to be honest: we first lived in a country where any meat was ridiculously expensive, and now in a place where the quality is rather poor. Fish as well, btw apart from the locally caught one. So that's lots of rice or pasta and veggies. And bread made from wheat, which is pretty much the only bread we can get here.

One positive thing: I don't think I had any irregular heart beat in almost two weeks now. Maybe the supplements I'm taking now are doing something at least. I'm off to vacation tomorrow and will be back early December, and then go to a doctor again.

Thanks guys, your're brilliant!

[jimmylegs]

well that is very strange - the range you mention looks more like a plasma folate range not an erythrocyte folate range.

http://emedicine.medscape.com/article/2085523-overview
plasma: Adults: 2-20 ng/mL, or 4.5-45.3 nmol/L
RBC: Adults: 140-628 ng/mL, or 317-1422 nmol/L

at this point i am leaning towards NHE's assessment ie some sort of misprint on the lab report.

if these are indeed plasma folate results, note: "Folic acid can be measured in the liquid portion of blood (plasma). This reflects a person's recent intake of folic acid in the diet."

re the diet info, yours can't be *too* terrible for animal sources, or your b12 level would be much lower. that said, if you were to introduce some red meat and seafood, it would probably give it a boost! are you able to get any canned shellfish (perhaps clams and/or oysters) at a reasonable price?

sounds like it couldn't hurt to try to diversify your dietary sources of grains. a lower nutrient density diet plus nutrient-depleting wheat could put you into a net deficit situation. if you can't feasibly boost the nutrient density of your food, then it's probably best to try to cut back on the proportion of gluten grains in your diet.

preparation is also a consideration - are there any bakeries near you selling sourdough bread?

http://www.cbc.ca/news/health/sourdough ... -1.2420209
http://allrecipes.com/Recipe/No-Commerc ... t-Starter/
http://allrecipes.com/Recipe/San-Franci ... px?evt19=1

glad you are noticing improvements heartbeat-wise. what is your daily supplement regimen at this point in the process?

[yirara]

So I've finally been to see some doctors again and had some blood tests and a scan. Lots of interesting stuff, not quite happy with the results but it could have been worse I guess. I'm seeing the doctor again on the 24th.

here are the latest results:
Free T3 2.41 pg/mL (2.3-4.2)
free T4 1.17 ng/dL (0.89-1.76)
TSH 1.99 uIU/mL (0.55-4.78)
Thyroglobulin Antibody (Anti-TG) 318 IU/ml (positive: >60)

MCV 96 fL (80-100) - up from 94
MCH 30.8 pg (27-32) - down from 31.4
MCHC 32.1 g/dL (31.5-34.5) - down from 33.5
RWD 13.7% (11.6-14.eight) - down from 16

Iron 13.5 umol/L (5-30.5)
Total iron binding capacity 78.8 umol/L (46.7-85.6) - down from 103.1 umol/L or 576.9 ug/dl if the converter is right
Trans sat % 17.1 (14.0-50.0)
Ferritin 40 ng/mL (10-291) up from 26.9

Vitamin B12 340 pg/mL (193-982) - down from 442
(no idea why the lab didn't do the other tests )
Vitamin D (25-hydroxycholecalciferol) 27 ng/ml (insufficient range 10-29)
Mg 0.78 mmol/L (0.74-1.73) - up from 0.63
Ca 2.22 mmol/L (2.23-2.58) - up from 2.16

I've been taking Iron, Magnesium, Calcium and Vitamin D-3 for nearly 2 months now. Nothing else as I wanted to see the results first. Guess I have some more thyroid tests coming up and some more supplements on my list.

The tingling has almost vanished, but still comes back every time I work out. I do wonder if some vitamin deficiency is the culprit here. I find it interesting that it's always at the same spot (just above my wrist and ankle on one side), the same spot a numbness occurs if I don't move enough on my office chair or read a book in bed on my back with the elbows on the mattress - but then on both sides. The numbness then moves on to hands/feet and up the limb.

[jimmylegs]

great that you have these results!

looks like you could try to get the serum ferritin from 40 up closer to 80, the b12 up to at least 500, vit d3 up to 40, and magnesium up to at least 0.95 (yikes currently *up* to 0.78, from 0.63!?! holy crap that was LOW)

one thing to think about - might be an idea to take a multivitamin as a foundation for any other work with isolated supplements. i'm curious about balancing and timing, eg how many mgs of mag you take, compared to how many mgs calcium per day, and how you time your dosage and intake in relation to the d3. also, if you balance your iron intake against any supplemental zinc?

hopefully you'll get to have a look at serum zinc sometime soon - i am curious whether the isolated iron supplements had a depressant impact on your zinc status.

all in all, really useful info there - nicely done

[lyndacarol]

Jimmylegs is right: it is great that you have these results!

As you probably know, yirara, I am currently focused on possible vitamin B12 deficiency.

First of all, your serum vitamin B12 at 340 pg/mL is low, according to the authors Pacholok and Stuart who think that the standard ranges are outdated and set too low. They think that values below 550 pg/mL indicate a genuine deficiency. (The country of Japan uses 500 as the cutoff point, I believe.)

A methylmalonic acid test and a homocysteine test can be used to confirm a deficiency in the blood, or rule it out. Many experts are increasingly preferring the HoloTranscobalamin test, which more accurately indicates that the B12 can get to the tissues (the cells).

Your MCV value at 96 fL is still in the high-end of your lab's standard range (even the new range for the testing done at this time). The high MCV value contributes to the possibility of B12 deficiency.

In my opinion, this area needs further investigation.

[yirara]

Thanks a lot guys.

Yes, I'm seeing the doctor again in two days. Really no idea why the lab didn't do those B-12 tests as I specifically requested them. What I also find somewhat scary is that there are thyroid antibodies in my blood. I guess there will be more thyroid tests coming up and I would not be surprised if it ends up as hashimoto or something similar in the end.

Now that I'm writing this: I need to check with the radiology department. When I got the surprise asthma attack they did a scan with contrast fluids. I wonder if they used one containing iodine and if that might have started all the troubles I'm having in the first place.

[jimmylegs]

no worries

afaic, tests cost $$, and it's fine to push serum levels up (in a balanced, well rounded way), and then, if there are still issues, look deeper with more in-depth testing.

fyi mcv can also be elevated with depleted magnesium - and you have been outright deficient in magnesium, even by current poorly-defined standards. a comparably poor b12 level would be down around 175 or so.

also, you may find these studies on magnesium and asthma interesting: http://scholar.google.ca/scholar?hl=en& ... 5&as_sdtp=

[yirara]

Well.. that was close to useless...

the doctor said my only problem is a low calcium and low Vitamin D3, for which he said I should continue taking supplements. He prescribed better calcium and much higher-dosed D3. My B12 apparently is ok as is, but after some discussion he prescribed Mecobalamin 2x500 per day, though he thinks it's useless. My thyroid is also fine as the 'so important' TSH is ok (there are two high TSH values on file at that clinic). The antibodies 'probably come from a virus infection'. That my leg and wrist still tingle? Who cares! I'm healthy and the problems I have probably originate from the mild D3 deficiency. At least the MRI was ok. After some more discussion he transferred me to an endocrinologist who 'will explain to me why my thyroid is ok'. I guess I somehow have to get hold of the neurologist again, though every appointment takes three months. Well.. that's to be expected in a country that has 1 neurologist for every 400.000 inhabitants.

[jimmylegs]

no you need to work on magnesium too. if you only work on d3 and calcium, it will either keep the magnesium too low, or make it worse. esp now that he's prescribed much higher dose d3.

your doc hasn't seen all the studies challenging the reference range for magnesium or proposing revisions. i have seen proposed lower cutoffs in the neighbourhood of .95, compare your 0.78 ... no good so then if you have to think about your mag level as 'normal', consider that healthy controls tend to have levels in the top half of the normal range, and patients in the lower half of the normal range. which normal subgroup do you want to be like?

also given that youve been taking iron it would be *really* smart to know your zinc level. you need zinc to handle d3 properly and taking iron as a supplement drives down zinc levels. i suspect your doc needs to give you a referral to a nutrition specialist!

[yirara]

I know that by now, jimmylegs. I'm just running against walls here. Fact is I cannot expect anything anymore from this doctor. His goodbye was pretty much a: don't bother me anymore. Guess I need to find someone else as according to him all the important tests are done and I'm fine apart from the calcium and D3. The problem with doctors here is that they are not used to someone asking questions. If you do they pretty much kick you out. Doctors are gods here. *sigh* Time for a call out to the expat community. Lets see if something comes up.

[jimmylegs]

ok ugh sounds frustrating :S hope you can find a local specialist that will take your info requests seriously! might be a good idea to print some abstracts next time you go in. so that if necessary, you can show the doc that science has your back ;)