[cyclelops]

Here is something to think about.....

I am running a low bicarbonate, well borderline low...one more tick and it is below normal. I was reading up on this, and it seems that if one runs a low bicarb, one is more susceptible to osteoporosis, and basically bone breakdown....I wonder if this could make one more susceptible to neuropathy....given diabetes generally results in ketoacidosis---different yes, but still acidosis.

People with this run low Vit. D as well, and usually don't absorb dietary or supplements until the bicarb issue is fixed.

My bmp is trending towards distal renal tubular acidosis type 1 (high chloride, low bicarb, low K, low Ca, normal anion gap). This comes with Sjogren's, but, perhaps could be a result of ivig due to hypergammaglobulinemia?? Don't really know I guess. But, I also drink reverse osmosis water which has no alkalinity? Perhaps my dietary intake of alkaline food and drink is low or else my kidneys are just not making bicarb as they should..... Or, I am falling apart.

Anyway, any thoughts on metabolic acidosis and small fiber....any one else have low bicarb? MRSD, you probably are familiar with this?

[mrsD]

Some drugs may do this... Topamax for one.

I really don't know about the kidney aspect... but low bicarb can be corrected with Sod. Bicarb tabs..and this is common in some older patients.

Low bicarb also impacts digestion, since the pancreas needs it to neutralize stomach acid as food enters the small intestine.

Acidosis can give lots of paresthesias too.

Most of the kidney stuff is beyond me. It is very complex.
There is a new poster on the boards...who got kidney problems from IVIG... I'll try to find him and link here to his post.~~

Here it is:
http://neurotalk.psychcentral.com/sh...highlight=IVIG
new members cannot send PMs...but they can receive them. To answer they have to hit the reply button on your PM to them. So if you contact this poster privately, you need to explain that to them.
Or you can just answer that thread.

[cyclelops]

They do a BMP and GFR on me every month. My labs are only trending not over the limit yet...I watch trends.

I did read a link on low vit. D, osteopenia, osteomalacia, associated with low bicarb. It sounds like a lot of people can have a subclinical acidosis.

Anyway, as long as the kidneys hold, then the ivig will continue. It is a lot of protein to excrete and I am sure it takes a toll. It seems to me, they could mitigate the low bicarb before it is a problem.

[mrsD]

I've been thinking....

If you are using Miralax frequently, I'd stop and see if things improve. The FDA is watching this product along with 18 other drugs for post marketing issues.

It is polyethylene glycol, and glycols are implicated in acidosis.

[cyclelops]

Nope....no Miralax. I gave that up in lieu of fresh veggies. Thanks, you must have really checked this out for me! I am leaning toward this distal renal tubular acidosis thing. My mom and grandma had horrible osteoporosis, and it makes me wonder if we have some issue. I believe my mom had some unidentified autoimmune disease....and my dad's family was loaded with it.

Anyway, thank you. I was just kind of wondering if the acidosis, even tho a different mechanism than ketoacidosis, may be responsible for neuropathy, and I am wondering if I should go ahead and do a bit of sodium bicarb. Docs seem unconcerned, but, they don't get concerned until AFTER the damage is done.

[mrsD]

Bicarb is used for "some" but not all acidosis. So be careful with it if you do it. The kidney doctors decide basically.

The kidney acidosis is much different from the diabetic one.

And yes, there are nerve issues...paresthesias...with acidosis.
Tingling and pain may occur depending on severity.