Hi there. I am a 47 year old female physiotherapist living in Auckland with no other health issues, with peripheral neuropathy symptoms appearing quite quickly over the last 2 months. Surprisingly it started with burning in previously injured sites with burning left ring finger. Persisted for about 3-4 days then I got a carpal tunnel like symptom in my right hand with burning and some numbness. Then playing sport started to get numbness in both feet right worse than the left in bottom of foot about a week after carpal tunnel symptoms.

Now over the last 3-4 weeks the burning has subsided somewhat and been replaced by numbness which comes and goes and random pain in my AC joint, shoulders and sock like symptoms in my legs. The numbness seems to be getting a bit worse staying longer, no loss of power or reflexes. Also had 3-4 burning type attacks in the middle of the night affecting upper body burning pain and lower body burning pain (sock distribution)

Have seen my GP and prescribed amitriptyline. Now take 30mg at night and have no problems sleeping. Also taking basic tablet of B12 own decision. Blood tests all negative, had 3 lots. B12 about 250. No pain, swelling, a full neurological test done by neurologist was negative. My neurologist was 90% sure it was viral and would get better over time. Now 6 weeks later it has changed but not got better. Going back to see neurologist this week.

Would appreciate any answers to these burning questions I have:
Would it be worth taking sub-lingual B12?
Would it be worth trying acupuncture?
If it is an acute viral onset would I expect symptoms to get better over time and how long?
What tests should I push for, nerve conduction, nerve biopsy?

Really would appreciate any advice as my job as a physiotherapist may be affected and I am really concerned....

Thank you in advance

--though I feel badly that is it neuropathy symptoms that have brought you here.

What you describe does sound like an acute/sub-acute neuropathy episode, and those often do improve with time, though the improvement may be patchy and incomplete. Unfortunately, with those type of neuropathies, which are often autoimmune or toxic in nature--and you should be getting testing for antibodies to peripheral nerves as well as potential toxicities (and you, obviously, would be the only one who could speculate as to what you might have been exposed)--it's very hard to predict prognosis.

While EMG/nerve conduction studies are generally indicated for any peripheral neuropathy, those that are predominantly small-fiber in nature (involving the thinly myelinated or unmyelinated fibers that subsume the sensations of pain and temperature, as compared to myelinated fibers that transmit mechanical touch, vibration, position, and motor functions) often show up as "normal" on these tests as they are not precise enough to localize small-fiber dysfunction--that often takes much more specialized testing up to and including skin biopsy to quantify intraepidermal nerve fiber density. Most of your symptoms so far seem to be small-fiber in nature.

One thing that is concerning is that B12 level--B12 deficiency can present this way (and often with subacute degeneration in the spinal cord as well). B12 supplementation is definitely encouraged. Sublingual wouldn't make much of a difference if you megadose to allow enough B12 to be passively absorbed--at least 1000-5000mcg/day to allow a 1-2% passive absorption rate and build up stores--and preferably a methylcobalamin source if you are one of those people who might have a methylation chemistry mutation that would cause difficulties converting the more commonly available cyanocobalamin (and nobody needs cyanide radicals running around the body anyway).

You should look at both our peripheral neuropathy section here:

http://neurotalk.psychcentral.com/forum20.html

And we have a distinct and very comprehensive B12 section:

http://neurotalk.psychcentral.com/thread85103.html

Hi there

Really appreciate your answer, will go and get some vitamin B12 today and start taking it. Wouldn't that be great if that was all that was required, here's hoping! The vitamin B12 links were also interesting. I also appreciate the feedback on toxics and tests that could be needed. I will breach this subject with my neurologist this week. All the best

Regards Karen Purdie

Hi kazzak21,

I, too, am sorry you have needed to research PN.
Yet, I know from experience, the PN forum here is outstanding and is a great place to reach out, if needed.

Glenntaj has written a comprehensive response.

I am just popping in to say hi and welcome to NT.

I hope you find the information and support needed to sort out your current health challenge.

Warmly,
DejaVu

Thanks for the welcome, I managed to find 1000mg tablets at our local health store, so will try taking them twice a week. Interesting in NZ how about 200 is considered within normal limits and in other countries it is 500 or 1000.

Cheers Karen

Karen,
I'm pretty sure that New Zealand is the same as here in Australia in that levels are measured differently from the US. Most measurements you'll read here are in pg/mL.

You'll probably need to convert your path results from our pmol/L to pg/mL

Easy conversion here -
http://www.endmemo.com/medical/unitc...itamin_B12.php

1st paragraph - Vitamin B12 – Reference Range Level Set too Low - from MTHFR Au.
http://www.mthfrsupport.com.au/vitam...level-set-low/

I buy mine from iHerb in the States and I've never found it here in my area in Au.. It's usually measured in mcg so I buy the 5000mcg and break it in half or quarters. I just do that to keep costs down especially with our low dollar at present.

Hello and welcome, happy to see you have come to be with us, it a great place to be. We have a great number and caring fellow members here, where you have find a supportive and relaxing place. Have fun looking into the different forums. Our shoulders are here for support in many ways.

Please keep us up to date on your condition. Again welcome, looking forward to seeing you around. My thoughts and prayers are with you.

Darlene

Hi there

Firstly I want to thank everyone for their warm welcome. I am finding the experiences here very helpful. Just wondering if anyone has experienced my current peripheral neuropathy symptoms where you wake up in the morning and it feels like you have slept on your arm or foot but you haven't. Like a fuzzy sort of feeling particularly bad in the wrist. Also over the last few days I have started to experience a slight dull ache in my right hip. When I move it or hop on it or touch it there doesn't seem to be any pain. This comes and goes.

Tomorrow I go for a followup appointment at the neurologist. I want to push for nerve conduction studies. My symptoms of peripheral neuropathy are worse in my right hand and wrist. Just wondering if it is worth trying to get a nerve biopsy of that area. Blood tests, reflexes, neurological test all normal last time I went. So far this peripheral neuropathy seems to be idiopathic. Have started taking 1000mg of vitamin B12 twice per day, B12 was a bit low.

I worry a bit as my job depends on my hands. Any advice of getting to the bottom of this peripheral neuropathy in terms of a cause. I want to leave no stone unturned. Main symptoms are in my introduction above. I have no fatigue, no eyesight problems, no muscle weakness or redness or swelling.

Sorry there are so many questions, would really appreciate your help.

All the best

Karen

Karen,

Don't forget to check out the

Peripheral Neuropathy Forum

The members there are dealing with similiar issues so will be able to offer you information and support.

and there's a wealth of information on this one below as well.

PN Tips, Resources, Supplements & Other Treatments SubForum

Oral works, sublingual is really just oral. The B12 dissolves in the saliva, and you swallow that.

So take your sublingual or oral on an empty stomach as, food blocks absorption. That assures that some will be absorbed.
Studies have shown 13mcg absorption from 1000mcg oral tabs.

Most people see substantial improvements in levels within 3 months if taken correctly.