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I have had 15 months of progressive burning pain all over my body (mostly in extremities) since having a flu vaccine in Oct 2012. Burning is worse with activity, and warm and cold extremes, tight clothing etc.. Also I have noticed recently that accupuncture makes it worse.
I have had extensive neurological workup, including multiple MRIs, EMGs, NCV, LP and Therapath skin biopsy. The biopsy was done 1 year ago and showed normal nerve fiber density and sweat glands. A new symptom over the past 3 months has been severe fatigue and insomnia along with depressed mood. I have tried numerous medications and cannot tolerate much with exception of Neurontin. I have been on methyl-b12/folate since the beginning with a recent b12 level of 1400. I am also taking vitamin D3. I could not tolerate SSRIs and SNRI meds or Lyrica. The fatigue and insomnia have gotten so bad that I've had to go on medical leave from work (I am a physician myself). My integrative doc wants me to take a supplement called Nuvoxil (which has L-tryptophan, l-theanine, taurine) to help with sleep and mood. She also wants me to switch to Methyl-b12 subcutaneous injections. I am confused as to what to do: 1. Do I ask my neurologist to repeat a skin punch biopsy to look again for SFN since it's been 1 year? 2. Do I consider IVIG? 3. Any other nutritional/supplement recommendations - esp. for the severe fatigue and insomnia? 4. Would things like d-ribose or acetyl-l-carnitine help? I've been reading Dr. Teitelbaum books. Thank you so much. |
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