Is it common to have a hard time making decisions and is fatigue an issue that often goes hand and hand with Neuopathy? I ask because I seem to be having daily memory issues and question my decisions often since the onset of my symptoms. I don't sleep well and stress most of the night so I'm sure that could be a contributing factor.

I suffered a heart attack back in June of this year...was treated with stents that saved my life. However, I started to have pain in my left thumb several days after leaving the Hospital. A day later it spread to my right hand. As you can imagine this was quite perplexing. Several weeks later it spread to the feet and ankles. It's now been 3 months and I have the pain in most areas of my body with the exception of my face, back, chest, stomach. Sleep is hard to come by and I suffer from fatigue and extreme depression. Pins and needles, shooting pain, muscle atrophy, muscles tremors in the thighs that move on their own. dry mouth and eyes, in addition to eye floaters.

I have been to several Neurologists. Blood work and EMG came up negative. Yesterday I had a small fiber skin biosy but won't know the results for 3 weeks. My folate level is low but B12 shows 460. Having said that I am wondering if it's a b12 deficiency causing my symptoms but that's probably wishful thinking. I have read the book "could it be B12"?

Of course all of the above has changed my life to the point that I am no longer the person I was in the past. Soon I will lose my job and health insurance if I can not return to work.

Pain management so far has been Tylenol every 6 hours. I was given Gabapentin but have so far been to scared to try it especially given I don't have a diagnosis yet, although all the clinical signs point to Neuopathy.

Thanks for listening .....

Cliffman

Your B12 is in the low end range. So it would be a good idea to bring that up to 1000 at least. 5mg of active methylcobalamin daily on an empty stomach and get retested in 3 months or so.
(stop the supplement about 7 days before any testing).

I'd get information on that stent, and what metal it is made from and research that.

What medications do you take OTC and RX. Have you looked into them all in detail?

Low folate and fairly low B12 suggests a MTHFR mutation. There is a DNA test for that -- many people with heart disease have it.
I'd get that done, if I were you. It is less expensive than most of the other tests you get. 23andme does it online for 99 dollars.
If you cannot methylate properly you cannot repair nerve damage or make neurotransmitters well. Many of our posters showing up here who cannot get results from doctors, end up with having this test and show significant problems because of it.

You can learn more about this here:
http://mthfr.net/
10% to 30% have this.

I have some similar symptoms and tests sounds like some kind of neuropathy, but could be fibromalygia. Gabapentin generally has favourable reviews for fibromalygia on drugs.com. Probably not a bad move, but there is always a risk. I'm undiagnosed but can get by just about without meds so I do. Whatever it is b12 supplementation should be worth a go. It's usually worth trying a few sensible options before long term pain killers eh?

Hi Chris,

How do you handle the pain? Anything over the counter?

There's a place in FL called Defy Medical that one can purchase from to self inject B12...just not sure if this safe without a doctors go ahead?j They have you fill out a medical questionaire in order to get around a formal doctors prescription.

Cliffman

Injectable and oral have been studied recently and found to yield the same results. So why use injectable? Don't make it more expensive and complicated for nothing better.

Well for very low critically ill patients injectable is often started at 1000mcg/day for about 7 days in a row. Absorbed from that is about 145mcg.

typically injections for others are once a month. This typically does not work well, and only provides a yo-yo response, of feeling better for a few days, then declining again until the next shot.

Here is a link with a study comparing them.. oral and injectable.
One has to take oral on an empty stomach to get the comparable returns as microgram doses can be bound to food present and reduce the passive absorption.

http://www.ncbi.nlm.nih.gov/pmc/arti...able/T1/#TF1-4

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2532799/

http://www.aafp.org/afp/2003/0301/p979.html

Trust me, most people will have levels of 1000 or more after 3 months of oral. Many of our PNers have done this here over the years. You might even get higher levels, like I did of 1999. Most labs only calibrate to levels of 2000.
Oral costs pennies a day... can't beat that price either.

Hi Cliffman:

I'm just curious - With your history of heart problems, are you taking statins? (They are pretty well known to cause PN, even if a lot of doctors continue to deny it.)

I would also follow mrsD's advice about oral methylcobalamin to bring your b12 up. And consider some methylfolate since your folate level is low.

And, with the low folate and marginal B12, mrsD's advice about having the genetic testing done to determine of you have any MTHFR mutations also makes sense. Those mutations impact your ability to convert and use the folic acid that all of our foods are supplemented with as well as the cyanocobalamin that is in most of the generic vitamins we take. I had the testing done, and found I had some of those mutations. I am now taking some specific supplements to treat the combination of mutations I have, and I seem to be doing better. (Not a miracle cure, but I believe it is helping to some extent.)