This Is MS Multiple Sclerosis Knowledge & Support Community

Hi everyone. I had an appointment with a neurologist today. I went for numbness and tingling in my hands and feet, extreme fatigue, loss of balance, headaches (only at night) recent memory loss (forgetting my purse at work, names of coworkers, phone numbers) and sometimes my words come out funny... I'm 39, married with two boys.
I first saw the PA and then the doctor both of whom I know (I work at a hospital) they both did the same tests (reflexes, have me walk, push back when they push etc) They nodded in agreement that my reflexes on the left side were greatly diminished and my right side was hyper? However, they also said my right side was prominently weaker than my left. He ordered a bunch of blood work, an MRI and an EMG. He told me we need to rule out MS and some kind of blockage? I've heard MS can mimic things, what else could be going on here?

LilDarlin wrote: I've heard MS can mimic things, what else could be going on here?

Vitamin B12 deficiency is pretty common. Please see the discussion at http://www.thisisms.com/forum/natural-a ... 24857.html for more information.

LilDarlin wrote:Hi everyone. I had an appointment with a neurologist today. I went for numbness and tingling in my hands and feet, extreme fatigue, loss of balance, headaches (only at night) recent memory loss (forgetting my purse at work, names of coworkers, phone numbers) and sometimes my words come out funny... I'm 39, married with two boys.
I first saw the PA and then the doctor both of whom I know (I work at a hospital) they both did the same tests (reflexes, have me walk, push back when they push etc) They nodded in agreement that my reflexes on the left side were greatly diminished and my right side was hyper? However, they also said my right side was prominently weaker than my left. He ordered a bunch of blood work, an MRI and an EMG. He told me we need to rule out MS and some kind of blockage? I've heard MS can mimic things, what else could be going on here?

Welcome to ThisIsMS, LilDarlin.

Since there is no definitive test for MS, it cannot be considered until the other likely causes for your symptoms have been ruled out first. (There are tests to rule out these other possibilities.) As NHE has said, vitamin B12 deficiency needs to be investigated and ruled out; likewise, vitamin D deficiency must also be investigated.

Over 1/2 of the world's population is deficient in vitamin D (70% of the US population). Your symptoms are consistent with vitamin D deficiency. In the "bunch of blood work" ordered by your doctor, have you had a 25-hydroxy D test? Do you have the actual number results? If so, compare them to the range recommended by GrassrootsHealth (http://www.GrassrootsHealth.net).

You may find their recent newsletters interesting (http://www.thisisms.com/forum/coimbra-h ... 27529.html)

and even this whole recent discussion: http://www.thisisms.com/forum/coimbra-h ... tocol-f57/

Hi,
My labs were just drawn yesterday and they called this morning asking me to go back to the hospital they need more blood (they took 7 tubes yesterday) I haven't gotten my results yet.
I did have a vitamin D deficiency a couple years ago. I was put on D2 50,000 units twice a week. I switched to D3 2,000 daily after a couple months which I am still taking daily.

LilDarlin wrote:My labs were just drawn yesterday and they called this morning asking me to go back to the hospital they need more blood (they took 7 tubes yesterday) I haven't gotten my results yet.
I did have a vitamin D deficiency a couple years ago. I was put on D2 50,000 units twice a week. I switched to D3 2,000 daily after a couple months which I am still taking daily.

Your history of "a vitamin D deficiency a couple years ago" and the prescribed treatment for it lead me to believe the D deficiency was severe.

If your vitamin D status has not been monitored regularly, it is possible that your D level is quite low again. (Some people simply do not absorb and utilize vitamin D as efficiently as others. Two people can be taking 2000 IU of D3 daily – the blood level of one can be high; the blood level of the other can be low… on the SAME daily dose!)

The best course of action is to measure your serum level (I hope one of yesterday's 7 tubes of blood was intended for this purpose. If not, contact your doctor and request the 25-hydroxy D test be done with the next blood draw. My latest reading in The Vitamin D Solution by Michael F Holick, M.D., PhD, finds his opinion that it is not necessary to stop D supplements in a washout period before testing: on page 251,

Q. Should you stop taking vitamin D supplements just before having your vitamin D status checked?
A. There is no need to stop your vitamin D to have your 25-vitamin D level checked.

Yes it was low a 7. I did see that test on the lab sheet along with B12, ANA, cmp, sed rate, I can't remember them all. My MRI is on the 29th. I'm not sure when the EMG is...I'm anxious to find out the levels now

LilDarlin wrote:Yes it was low a 7. I did see that test on the lab sheet along with B12, ANA, cmp, sed rate, I can't remember them all. My MRI is on the 29th. I'm not sure when the EMG is...I'm anxious to find out the levels now

I am curious to find out the levels, too. Please ask for your own copy of all of these blood test results – it is important to have the actual numbers.

And… if you are willing, please share your results with us (Some of us are especially interested in the B12 and D testing.).

Sorry for the delay..
My b12 was 336 and vit D was 36

LilDarlin wrote:Sorry for the delay..
My b12 was 336 and vit D was 36

Thanks for sharing your test results.

Your vitamin B12 at 336 pg/mL falls in the "gray zone" (between 200-450 pg/mL) described in the book, Could It Be B12? An Epidemic of Misdiagnoses by Sally M. Pacholok, RN, BSN, and Jeffrey J. Stuart, D.O. (This may be available at your library.) These authors and other B12 experts consider standard ranges for B12 set at US labs to be too low.: http://b12awareness.org/could-it-be-b12 ... diagnoses/

On page 11:

"There is much controversy as to what constitutes a normal result for this test [serum vitamin B12 test]. Because of this controversy, this test is often used in conjunction with other markers of B12 deficiency (MMA, Hcy, and more recently the HoloTc).

… We believe that the "normal" serum B12 threshold needs to be raised from 200 pg/mL to at least 450 pg/mL because deficiencies begin to appear in the cerebral spinal fluid (CSF) below 550 pg/mL.

At this time, we believe normal serum B12 levels should be greater than 550 pg/mL.…

We commonly see patients with clinical signs of B12 deficiency who are not being tested. Others who are being tested are not being treated because their serum B12 falls in the gray zone [between 200 pg/mL and 450 pg/mL]. This error results in delayed diagnosis and an increased incidence of injury."

In Japan, any B12 test result below 500 is considered deficient and is treated as such.

This would be a good topic to discuss with your doctor. Vitamin B12 is water-soluble; any excess that your body does not use will be flushed out in urine. If he suggests you try a B12 supplement, be aware that sublingual (under the tongue) tablets are quickly dissolved and usually well-absorbed by most people. You can find these in several forms – cyanocobalamin is the cheapest form, but it is NOT the most easily absorbed by the body (it must be decyanated first, before the body can use it). Methyl-cobalamin is generally preferred because it is more easily absorbed. You have to check the label for the right form.


Your vitamin D level at 36 is below the range recommended (40-60 ng/mL) by the California-based group, GrassrootsHealth (http://www.GrassrootsHealth.net). According to their chart (http://grassrootshealth.net/media/image ... single.pdf), you are at Step 2: "Establish recommended intake level."

To reach the more optimal end of their recommended range (60 ng/mL), the chart suggests that a daily intake of 9000 IU on average would raise one's serum level to 60 ng.

In addition to B12, I encourage you to discuss also your vitamin D situation, the chart and intake amount with your doctor. Also, schedule another vitamin D test in 3-6 months. With your history of extremely deficient vitamin D levels, it is especially important to monitor and maintain your vitamin D at the optimal level – testing twice a year at "peak and trough" times.