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Hi,

I have recently seen a rheumatologist duu to systemic long term symptoms and am waiting for an EMG. I have a long growing list of symptoms including debilitating fatigue, dizzness and general aches and pains but my question at this stage is with regard to constant pins and needles that i have had in both hands and arms for the past 3 weeks. It is there constantly and the past few days intermittently spreads up to my shoulders to my neck and jaw area. Also both my feet and legs can be affected. This spread may last a few hours or a day or so before returning to just both hands and arms.

With ms, is pins and needles only felt on one side of the body at a time? Or can it be in both hands and arms at the same time? Can it lasr for a long time? The waiting time for the EMG is 3 to 4 months. Is it likely the pins and needles will still be there then? if not will it affect the accuracy of the test?

I had a positive ANA blood test in March when i was in the middle of a major flare of all of my symptoms. This is going to be repeated in 3 weeks time.

Any information would be very helpful as i dont know anything about MS but when i saw the GP last week due to the spread of the pins and needles im sure he said it couldn't be neurological cos it was on both sides of the body but he also mentioned MS as a possibiity. Is MS classified as an inflammatory disease, neurological or auto immune or what? Im abit confused.

I didnt have much confidence in the Rheumatologist i saw and i want to be as informed as possible about all of the possible causes before my follow up appointment.

Many thanks in advance.

Poppyfield wrote:I have recently seen a rheumatologist duu to systemic long term symptoms and am waiting for an EMG. I have a long growing list of symptoms including debilitating fatigue, dizzness and general aches and pains but my question at this stage is with regard to constant pins and needles that i have had in both hands and arms for the past 3 weeks. It is there constantly and the past few days intermittently spreads up to my shoulders to my neck and jaw area. Also both my feet and legs can be affected. This spread may last a few hours or a day or so before returning to just both hands and arms.

With ms, is pins and needles only felt on one side of the body at a time? Or can it be in both hands and arms at the same time? Can it last for a long time? The waiting time for the EMG is 3 to 4 months. Is it likely the pins and needles will still be there then? if not will it affect the accuracy of the test?

I had a positive ANA blood test in March when i was in the middle of a major flare of all of my symptoms. This is going to be repeated in 3 weeks time.

Any information would be very helpful as i dont know anything about MS but when i saw the GP last week due to the spread of the pins and needles im sure he said it couldn't be neurological cos it was on both sides of the body but he also mentioned MS as a possibiity. Is MS classified as an inflammatory disease, neurological or auto immune or what? Im abit confused.

I didnt have much confidence in the Rheumatologist i saw and i want to be as informed as possible about all of the possible causes before my follow up appointment.

Welcome to ThisIsMS, Poppyfield.

In order to be informed about one possible cause for your symptoms, please watch:

Diagnosing and Treating Vitamin B12 Deficiency: "Everything You Want Your Doctor to Know about Vitamin B12"

I highly recommend this 52-minute documentary featuring Sally Pacholok, RN, BSN, & her husband Jeffrey Stuart, D.O. (authors of the book, Could It Be B12? An Epidemic of Misdiagnoses and the new book, What's Wrong with My Child? – possibly available through your library); 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."
@1:46 "In 1948 scientists isolated a red crystalline pigment and named it vitamin B12. It is a primordial molecule responsible for the health of all the DNA in all our cells. The Framingham Offspring Study suggests 40% of Americans have suboptimal B12."
@4:50 Pacholok says, "MS is a demyelinating disease and so is B12 deficiency. You can't tell the two apart unless you test for that."

@23:40 Linda Assataurians, M.D., internal medicine, recommends B12 testing for vegetarians or vegans or those who do not eat red meat, for patients with fatigue, paresthesias, numbness/tingling, balance issues.

An abnormal sensation (such as your "pins and needles") is called "paresthesia." When the pins and needles sensation appears in the extremities (arms/hands, legs/feet), this is called "peripheral neuropathy." Peripheral neuropathy is the most commonly reported symptom among those who have B12 deficiency. It is consistent with many conditions, including MS. In my opinion and experience (I have no medical background), peripheral neuropathy occurs on both sides of the body when its cause is in the nerves.

Thanks for your reply.

I have had many blood tests and my b12 level is within normal range.

"With ms, is pins and needles only felt on one side of the body at a time? Or can it be in both hands and arms at the same time? Can it last for a long time?"

No two cases are exactly alike so there are no definitive answers to your questions. Since your symptoms are not 'normal', take some steps to help yourself feel better sooner: start a MS diet, do some sort of exercise daily, take nutritional supplements, especially vitamin D3 and an Omega 3/EFA and a good multi to start (have your vitamin levels checked), and remove all stresses from your life.

Regardless of what you have, being proactive can only help you.

"Is MS classified as an inflammatory disease, neurological or auto immune or what?" MS is considered an autoimmune inflammatory disease.

Hope you are feeling better soon!

Poppyfield wrote:Thanks for your reply.

I have had many blood tests and my b12 level is within normal range.

Your situation with B12 sounds good; it is very possible that a B12 deficiency is NOT responsible for your symptoms. MS is a diagnosis of exclusion, made after other more likely causes have been ruled out. There is no test or imaging that is specific for definite proof of MS (not EMG, not evoked potentials, not even lesions that might appear on MRI, not oligoclonal bands found in the spinal fluid of a lumbar puncture).

Also, as for B12 levels… Please be aware that many experts consider that the standard ranges for B12 at US labs are set too low. The authors Pacholok and Stuart recommend that B12 levels should be above 550 pg/mL (even in Japan, levels below 500 are treated as deficient). Compare your test results.

And even high levels of "serum B12" can be misleading – there can be adequate B12 in the blood with a deficiency still in the cells. The outdated, inaccurate "serum B12" test measures total B12 in the blood; all the B12 in the blood can be bound on the haptocorrin transporter molecule, which is the wrong transporter and it cannot get the vitamin into the cells. Only B12 carried on the transcobalamin transporter will get the B12 into the cells. The newer, more accurate HoloTranscobalamin (a.k.a. HoloTc) test measures this active B12; however, this test is not yet available everywhere.

OK. Great, thank you for your responses. Very useful.