I had been really tired since about 1997 (probably earlier). Then I was so tired that I felt sick. I had numbness/tingling (paresthesias) in my hands, feet, and face, low back pain, off and on severe headaches, palpitations, feeling of being faint, increasingly lower white blood cell count, and more odd little symptoms.

The fatigue was so bad that I felt as though I was dying in the last several months. I had to finally beg my doctor to run the test in 1999.

My homocysteine was elevated. Methylmalonic acid can also be elevated with a deficiency. People can be "deficient," meaning that not enough B12 is getting to their tissues, and still have a normal B12 level. Mine was below normal.

The cause of my B12 deficiency was a lack of stomach acid. I was also having reactive hypoglycemia due to that.

A good doctor will ask for all of your symptoms and really listen. Writing them down will help a lot, since it takes less time to look at a list of them than to hear them.

One thing your internist could run is a CPK (creatine phosphokinase).

Are you at all short of breath? Or do you only have muscle issues?

Good luck with the appt.!

Annie