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Originally Posted by MetalMX
I might have had a B12 deficiency but i was using sublingual methylcobalamin 5mg so this helped with certain b12 symptoms i had.
I have been seen by a neurologist and he has done EMG and nerve conduction studies and apparently something is wrong with my nerves, their is some damage their. He notes to the peripheral nerves.
We don't know what is going on yet but he sent me to do a Brain MRI, Spinal MRI, and blood tests. He also wanted to exclude MS from these tests.
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Hopefully the testing will be more definitive, but never stop taking the B12... even after your level has come up. You need to keep it in the upper quartile of range forever. I've known several people whose doctor gave them B12 only long enough to bring them up to a moderate range, and then dropped treatment... with more damage to follow later. . Good to know you are taking oral methylcobalamin!
B12 deficiency does cause peripheral nerve damage as well degeneration of the spinal column. And when that degree of damage is done, it can take months
to years to repair. You may improve more yet, given more time. You may have other co-existing disease, so good for extra testing to rule other things out, but don't underestimate the damage the B12 deficiency alone can do.
Subacute combined degeneration: clinical, electrophysiological, and magnetic resonance imaging findings JNNP
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Also:
From: The Neurological Manifestations of Gastrointestinal Disease by Mark Skeen, MD.
Neurologic Clinics
Volume 20 € Number 1 € February 2002
"The most common manifestations are paresthesias, ataxia, memory loss, and extremity weakness.[88] Cerebral symptoms are reported frequently and on occasion they are the only manifestation.[88] Subacute combined degeneration of the spinal cord occurs, with degeneration of dorsal columns and corticospinal tracts. In many patients, peripheral neuropathy accompanies spinal cord manifestations, and paresthesias and loss of vibratory sensation may result from either or both pathologic processes. Although it is frequently difficult to distinguish which site of pathology is primarily responsible for distal sensory changes, some studies have demonstrated the existence of mixed axonal and demyelinating sensorimotor neuropathies.[41]
[104] "
"Subacute combined degeneration has also been reported in a patient with a high serum vitamin B12 level and an abnormal plasma vitamin B12 -binding protein.[130] Serum methylmalonic acid and homocysteine levels rise as a marker of tissue deficiency of cobalamin and decline in response to therapy.[81] [89] [106] Although serum methylmalonic acid level appears to be the most sensitive single test for tissue deficiency, further sensitivity results from the determination of both metabolites.[81] [89] [106] In addition, the demonstration of falling metabolite levels after therapy adds diagnostic certainty in atypical cases.[89
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Good luck on all the follow up tests!