[CrimeofPassion]

I am in desperate need of some help. I'm scared and I don't know what to do next.

First, a little background. Beginning last summer, I began having bizarre symptoms that seemed to baffle my doctors. Eventually, about 7-8 months after the symptoms first popped up, I had my B12 tested. It was 499 pg/ml, which was considered more than enough by my doctor. However, according to some research I did (and some of you lovely folk here), that’s considered to be the low end of normal – I believe other countries say that one’s B12 level should be at LEAST 500, preferably over. Everyone’s body is different, and sometimes people with only a mild deficiency have big issues, while others with a severe deficiency actually feel pretty decent. So, per the advice of some educated members, I decided to take Jarrow B12 5000mcg every day (along with SlowMag). I began taking the B12 on April 17, easy to remember because it’s my birthday. I continued to take it regularly through September, I think. There were a few weeks where I kept forgetting to take it, etc., in late September/October, but I was definitely taking it daily for at least 4 months. The bizarre symptoms I was having (burning/tingling/stinging in feet + increased sweating in feet) are gone. I still have painless muscle twitches in my feet/calves, but that could be due to another deficiency. They don't seem as strong as before.

I eventually bought Jarrow’s B-Right (complex) as well in May, which has 100 mcg of B12 in it, and started taking that generally every day. I’ve been seeing an acupuncturist recently, and she prescribed me a multi-vitamin and trace minerals supplement. Well, stupid me, I didn’t realize the latter had B12 in it too (5 mcg). So I was getting more B12 than I thought I was.

Flash forward to today. For about 3 months now I’ve been having very odd symptoms – air hunger, fast heart rate, and feelings of anxiety. It started out as just a fast heart rate. I initially thought it was due to some nitroglycerin cream (Rectiv) I was using for a fissure, since that can cause your heart to pound a bit. But I was wrong, obviously, since I stopped using it around 2.5-3 months ago.

I have to keep taking as deep a breath as possible to fill my lungs completely and feel like I’m not suffocating, but these deep breaths are only satisfactory some of the time. Because I'm taking in more air than I need, I'm burping quite a bit too. My heart is pretty much going at a rate of 95-102 BPM when I’m RESTING, and goes even faster when I do even a simple activity like standing up and walking to the bathroom, going up/down a flight of stairs, etc. At times it seems to thud/skip a beat too. And occasionally I feel sort of giddy/nervous, with trembling and feelings of weakness (jello legs). Sort of like how you feel when you try to shower or something after getting over a terrible bout of the flu, y’know? These past 2-3 weeks I’ve been getting some stomach upset as well. Mild nausea at times and food just going right through me. I’ve read that the palpitations and shortness of breath in particular can be symptoms of excessive B12. Does anyone have any experience with this? I don’t think I have so much B12 that it’s TOXIC and I’m DYING, but I can’t help but wonder if I’m getting too much now. I got particularly suspicious a few days ago when I took my B12 and Jarrow B-Right and within 15-20 minutes had to run to the bathroom. I felt sick all the sudden - cold and a bit nauseous. Just really odd. Maybe it was just a coincidence, but I've stopped all supplementation except for vitamin D and magnesium right now.

My doctor, who’s a family physician, ran a few thyroid blood tests: Antinuclear Antibodies Screen, Auto Hemogram/plate/diff, Thyroid Autoantibodies, Thyroid Stimulating Hormone Reflex, and Assay Thyroid Stim Hormone (TSH). He said all came back normal, immediately diagnosed me with anxiety, and gave me Zoloft. I haven’t touched the pills yet. I want to make absolutely certain anxiety is the cause before I take them.

I may get my B12 level tested for a second time through an independent lab, as it hasn’t been tested since April, but I’ve been spending SO MUCH lately on health-related stuff. I had my ferritin levels checked a few weeks ago through an independent lab when I started having the breathing/heart issues, because I thought it could be anemia (my doctor refused to entertain the thought, hence my using the lab); it was 54 ng/ml, which I think is normal. Correct me if I’m wrong. I also had my vitamin D level tested at the same lab. I was SO CERTAIN that would be the culprit, because there are people online who describe the shortness of breath and heart issues due to vitamin D. Plus, I've been feeling pretty fatigued these past few months - more than usual (I'm generally always tired to some degree). Although I’m very pale, I don’t like the outdoors and spend 90% of my time inside. When I am outside, I’m slathered in very strong sunscreen. Plus, I work in an office, so all in all very little sunlight. And yet my results came back as 60 ng/ml! I was completely shocked and confused. Could supplements have created a false high? I read that there's a known 20-30% error in vitamin D lab tests - anyone else ever heard this?

I thought for a while this could be relating to acid reflux, which I doubted I had, but I tried taking Prilosec for a few weeks anyway just as a test. It didn't do anything.

I’m heartbroken at the thought that this could be purely emotional anxiety. I don’t need that in my life, nor do I need another pill. I’ve heard nasty things about Zoloft. I do tend to stress out easily and be a little on edge. I have situational anxiety (nervous about going to the doctor’s, giving a speech, having a job interview, etc.) but never unexplained random anxiety that’s not related to a specific person or event. I had TONS of stress in college maintaining a 3.9 GPA and studying abroad in China. Why would anxiety hit me now and not then? It just makes no sense. All I do right now is a boring 9-5 job. Plus, a lot of people describe anxiety as happening in short bursts – panic attacks! But mine seems to be every hour I’m awake. It starts within a few seconds of waking up, and continues until I fall asleep.

Let’s see…what else? It does seem like my breathing is easier when I’m lying down. It has never woken me up in the middle of the night. So frankly, I’m not positive whether it’s happening when I’m asleep. I notice when I’m having a LOT of fun that I tend to forget about my breathing, and hours later I’ll realize, “hey, did I stop gasping?” That was one thing that made me kind of think the doctor was right – that it’s anxiety. Thinking about it/having that constant awareness of my breathing definitely makes it worse, and during very stressful moments at home/work I’ll start struggling for breath more (usually if I'm angry). But the problem is, the shortness of breath causes anxiety itself. The ROOT CAUSE, however, may be something else. I’m just not convinced yet. I often feel better when I'm having a REALLY great time, because it distracts me.

It is physically and mentally exhausting to struggle for breath all day long and feel like my heart is going too fast. I feel more tired than ever, and often get headaches because I think I'm technically hyperventilating. I feel like I'm going bananas.

I just want to explore my options and get some advice. Do you think I should see any specific doctors? Request any tests? Any advice would be very welcome.

[mrsD]

Some people get elevated calcium when using high dose Vit D3.

I would cut back on your Vit D dosing by 50% and see what happens.

The heart will beat faster if the blood pressure falls. So I think you should invest in a blood pressure cuff and start keeping a log of your pressures during the day.

The amount of B12 absorbed orally is quite small. I would think the 100mcg in the B-Right would not be significant. A study measuring absorption has shown only 13mcg in volunteers was absorbed and measured in the blood from a dose of 1000mcg daily.

I would keep a journal of your blood pressures, pulse readings, and food intake, to see if there is a dietary trigger to your symptoms.

When you log your statistics, you can then show them to your doctor, to help him/her evaluate your symptoms.

Once you get your next B12 test, you might have more information at your disposal to decide what to do next. If your test shows over 1000pg/ml, you can cut back on dosing to maybe twice a week.

Too much magnesium can also lower blood pressures. So taking your own measurements would be an excellent way to monitor things. Normally people will excrete excess magnesium via the urine, if the kidneys are working properly. It is very unlikely to have excess magnesium from a supplement, as diarrhea usually happens before any toxicity can mount.

Excess serotonin in the GI tract can cause loose stools, and air hunger. Zoloft may make your GI symptoms worse. If it does, this hint, points to carcinoid syndrome... and should be tested for.
http://en.wikipedia.org/wiki/Carcinoid_syndrome

Also certain blood pressure drugs increase bradykinin too...ACE inhibitors. If you use these, you could have symptoms like you describe.

And also elevated thyroid will cause symptoms like you are having. (this the doctor can screen for with blood tests).

Since your symptoms worsened with the new multivitamin, I'd drop that for now. Study the ingredients carefully...as there may be high B6 in it.

[CrimeofPassion]

I’ve had my blood pressure taken twice since these symptoms developed – it was normal both times. I’ve never had an abnormal blood pressure reading. Obviously that can change/fluctuate, but so far everything has been good on that front. Still, that might be a good idea. Just because I haven’t had a abnormal reading yet doesn’t mean it isn’t happening.

All of my thyroid readings came out normal. Is there a specific thyroid test I should be asking for? I’ve heard TSH can actually be unreliable/misleading, and I’ve read a bit about the importance of Free T3 and Free T4 testing. Anyone have any info in regards to this? I can order my own tests if I want through an independent lab, but at this point I don’t know what to try next, and I don’t want to waste even more money. I have heard that folic acid deficiency can cause shortness of breath, etc. To my knowledge, the only other vitamins that can cause the breathing/heart symptoms are ferritin/iron, D, and B12. I wonder if the twitching in my feet/calves is related to this…

I don’t think I felt worse after taking the multivitamin. It’s just that due to this bowel movement frequency, I figured I might be overloading a bit and thought the smart thing to do would be to stop all supplementation (save for the magnesium and D), just as an experiment. It isn’t always loose stools, just going a bit too much (2-4 times a day when I normally go once a day).

I will say that I feel a bit better now than I originally did when everything first started. I would be heaving for breath with my heart going a mile a minute. Now, on average my pulse seems to be around the mid-90s when I’m resting (which is indeed a touch better, although still too fast), and the shortness of breath is still very troubling but also a little better. It could be because I’m panicking less, because it can be very scary when you’re short of breath and your heart is racing. There were moments I wanted to go to the ER.

I forgot to mention, I tried taking some more natural anti-stress supplements (Pure Life Naturals Stress Stop & 5-HTP) without much success. I stopped them a while back, but I may give them another go, just to see. I thought they would work better if my symptoms were truly being caused by stress/anxiety, but I suppose that might not be realistic. Otherwise why wouldn’t most everyone go the natural route instead of taking Zoloft, etc.?

But I guess the thing that confuses me is, if this is anxiety, wouldn’t I specifically be feeling ANXIETY? The shortness of breath and fast heart rate happen even when I’m relaxed – reading a book, watching a favorite movie/TV show, etc. And again, it doesn’t come in short bursts. It starts up right upon awakening and continues through the majority of the day. I guess I would have thought I’d feel nervous/anxious/frightened/on edge/etc. with true anxiety worthy of being medicated. This is really all new to me, though. But it seems like when I do feel anxious, it’s because the breathing and heart are causing the anxiety, and not the other way around.

I don’t even know what kind of doctor to see at this point. An internist? An endocrinologist? A shrink?! Ugh.

[mrsD]

Well if you try the Zoloft, and are worse, that points to a serotonin problem. (and gives a hint pointing to carcinoid syndrome)

Having a rapid heart beat tends to raise blood pressure.

A resting pulse over 90 suggests something is wrong. It might be difficult getting it tagged however. Rapid heart beats can come from cardiac things... like cardiomyopathy.

I'd stop the magnesium for a week or so and see what if anything changes. I'd also drop the Vit D by 1/2 of what you normally take.