I apologize in advance for the long and convoluted story that gets to my subject question ....

I am a 45 year old female who was first diagnosed with Peripheral Neuropathy as the result of a Vitamin B-12 deficiency at age 33. I was under a maintenance plan of monthly B-12 injections and 400 mg daily of Neurontin for years, after the initial treatment. Every couple of years, I would have flares, and would have to increase both meds for a couple of months to get things under control - but then back to maintenance mode.

That all changed a year ago when my body basically spiraled out of control on me. From my thighs to my toes, elbows to fingers, scalp, face, mouth - my body was in constant pain, although it changed between burning, tingling, stabbing (all the typical PN symptoms) - the really fun part being different body parts might experience different things at the same time. The change came upon suddenly, like flipping a light switch. And, at the same time, my vertigo spiraled out of control with the 2nd worst bought I had ever had. I never had the pleasure of having both spike at the same time. My body basically shut me down.

It took 5 months and a dozen doctors to finally get to the bottom of things. Along the way, I went from one diagnosis to the next, being told I might have M.S., Raynaud's Syndrome, Sjogren's Syndrome, Celiac's Disease, and a variety of other less interesting things.

In the end (thanks to Dr. Latov and a really great Gastro doctor at Weill-Cornell) the puzzle fits together like this:
- I have a condition called Achlorhydria, whereby my stomach does not produce acid. As a result, my body doesn't break down nutrients properly.
- The Achlorhydria causes the Vitamin B-12 deficiency (which previously couldn't be explained). I had never tested positive for Pernicious Anemia, since I don't have the intrinsic factor problem. But, basically have the same thing because of my inability to absorb B-12 as a result of the Achlorhydria.
- The B-12 deficiency is responsible for the Peripheral Neuropathy. Skin biopsies showed that the disease had indeed progressed (vs. biopsies taken 4 years prior)
- The vertigo was even related to the PN.

Now - for the kicker. My teeth have always been extremely sensitive (because of the nerves) and over the previous couple of years, my dentist had resorted giving me Nitrous Oxide just to clean them! My last cleaning was right before my body spiraled out of control. Dr. Latov explained to me that Nitrous Oxide is linked to B-12 depletion, and was most likely the key to what had suddenly happened. Up until then, although I obviously had a problem with the B-12, my body was managing to protect itself as best it could, but the Nitrous Oxide depleted the levels and 'flipped the switch', and the PN went out of control. As I looked back on the documented history of those 'flares' that I had over the years, most could also be tied to a visit to the dentist.

I'm managing the illness with a cocktail of medications, and moved from New York to North Carolina in December in order to get to a more temperate climate and to simplify my life. I am happy to say, there is definite improvement since the move.

The hardest thing has been establishing with all new doctors, and today, I went to a dentist for the first time. She was not aware of the link between B-12 depletion and Nitrous Oxide (Dr. Latov told me many aren't or don't see the direct effects) so I want to help educate her, and am looking for articles that I can give her when I go back in a couple of weeks. I've searched the web, but mostly have found personal websites, forums, and wikipedia sources - I want to have something more "medically" sound. If anybody can point me in the right direction, I'd appreciate it. And, the more the merrier.

Sorry for the long story ....

Patti