Quote:
Originally Posted by Megan
So what I can't quite understand are the discussions which talk about PN getting worse before it gets better once Vit B12 treatment has commenced! Can someone tease that out a bit more for me please?
|
I think the point is that it CAN happen, not that it always will. I think it probably depends on the severity and duration of the damage already done when a B12 deficiency is diagnosed.
I had sporadic symptoms for a period 5 years prior to being diagnosed, but what I call the onslaught of symptoms was during the last six months...when things were turning from occasional nuisance type things, to really scary things. In any case, I mostly just got better... except for a heavy fatigue that hit. The majority of my serious symptoms resolved over 3-6 months, but I continued to see improvements into the second and subsequent years. I like to think my cognitive problems are still improving (memory, attention, concentration).
Some people can actually experience worsening of symptoms, initially. I think the caution is given, so that people aren't discouraged and decide that the B12 isn't helping.
Here is an excerpt, highlighting that the response can be individual, and it may include an intitial worsening, with improvements sometimes continuing well into subsequent years. It is an excerpt from the section on B12 deficiency..
Quote:
|
From: The Neurological Manifestations of Gastrointestinal Disease by Mark Skeen, MD. Neurologic Clinics
Volume 20 € Number 1 € February 2002
"Although rare patients may demonstrate an exacerbation of neurologic
manifestations soon after beginning therapy, these patients subsequently
respond to therapy. Most patients respond dramatically to therapy, with a
decrease in paresthesias beginning within a few days of therapy and maximal
improvement within 1 to 3 months. Other neurologic manifestations begin to
improve in 2 to 4 weeks, with maximal response within 6 months.[61] Healton
et al reported one patient in whom objective functional improvement in signs
of myelopathy occurred beyond the third year of treatment.[61] Recovery is
inversely related to the severity and duration of symptoms prior to
therapy."
|