Hi there,
I have PN in my toes. The doc has run the tests with the electrical probes, stuck me with needles attached to hi-tech machines, and run many, many blood tests. He cannot pin down what is causing the problem. The B12 is at 350, which he said is normal. From what I read here, 400 is now considered normal.
My question today is, what type of dosage and how often should I be shooting for? I only weigh 155 lbs. and am 56 years old. Thanks for the help!
Gene

350 is not a normal level for B12. This clinician is using, in all likelihood, a very outdated lab reference range.

(I'd even be willing to say 400 would be too low--people have been known to have symptoms of B12 deficiency into the 500 or even 600 range.)

There is no harm in trying daily supplementation with at least 1000mcg of B12--preferably the methylcobalamin form, in case you're one of the minority of people who has genetic difficulties with methylation chemistry (the cobalamin B12 molecule has to be methylated in order to be utilized, and getting methylcobalamin means the body won't have to do this; the vitamin is readily utilizable). By megadosing and getting 1-2% of that dose passively absorbed, you should be getting at least 10-20mcg of B12 daily, hopefully enough to start to rebuild your levels.

You can, of course, take higher doses (many here take 5000mcg/day--B12 has no known toxicity level, although it can be energizing in higher doses).

Welcome to NeuroTalk:

Only the toes?

We had a poster not too long ago with toe pain only
And he turned out to have psoriatic arthritis. It can start
That way early on and not have skin lesions yet.

You can take the oral now, either 1000mcg or 5000 daily on
An empty stomach. Get retested in 3 months or so
To see where you are.
Psoriatic arthritis affects the tendons more than the
Joints..there are nerves in the tendons and that causes
the pain. If you don't see improvement investigate psoriatic
Arthritis... Or something else .

Thanks for the quick replies. I guess my feet are the problem. Where my toes meet my feet is where I have the tingling, burning sensation. It is not that bad. I only notice it after I kick my shoes off in the evening. My balance is off a bit, so I am seem to walk flat-footed. I have had epilepsy since a motorcycle accident at 16, but that is controlled by medicine. Otherwise I am in perfect shape. Never have to take an aspirin, because I seldom get a cold.
Thanks again!
Gene

Are you using Dilantin? This drug has been shown to cause
nerve damage. If so please discuss with your doctor any
medicine Changes or adjustments.

Now I take Topamax and Keppra. I did take Dilantin for 30 years though. I stopped taking it in 2004. I started to notice balance, or flatfooted, (or several folks wondered why I had a slight limp), about 4 years ago now. Hopefully with that gap from the time I stopped taking Dilantin, this is not the problem. Thanks for the input.
Gene