Ok folks, hot off the press, went to see Dr. Norman Latov to get my results. 99.9% bloodwork normal--not even close to pre-diabetes. That was a relief. However they picked up that I was fairly deficient in B6, which he feels strongly is the root cause of the neuropathy. He said the skin biopsy revelead a mild to moderate small fiber neuropathy. Here are the numbers, feel free to talk amongst yourselves:

Diagnosis: Lt Cal, Epidermal Nerve Fiber Density: Skin with significantly reduced epidermal fiber density, consistent with small fiber neuropathy.

Lt. Thigh: Skin with normal epidermal nerve fiber density

Numnbers were

Lt Calf = 2.6 Abnormal is <5.4 Low Normal= 5.4 - 5.7
Left Thigh = 11.53 Abnormal is <6.8 and low normal is 6.8 - 8.0


No evidence of vasculitis or other histological . No amyloid detected by the Congo Red stain (I had asked for a Congo Magenta stain, but I was denied--that is a joke, please don't ask your doctor for this).

So he said that 50 mg B6 (and I think he also said I can also take niaminicide or something?) would have to be taken for at least a year. I had started with p-5-P per Mrs. D. He was fine with that. He also said it could resolve itself, but it would take at least a year to find out. Hard to predict, but he definitely felt that it will not progress to motor or autonomic (99% was the number he used), for which I was very grateful.

I also have these suspicious looking white spots on my hands....he commented that it could be vitiglio (sp). Great, I am turning into Michael Jackson. Latov laughed and asked if I wanted a glove--I told him the sequins would not look good on the surgical gloves he had. At that point, he asked whether I had sores or burning in my mouth (I did and thought I had BMS). He said that will abate over time as well...the guy is expensive, but he is good.

So, now onto my favorite topic. Pain management. 3,600 mg of Gabapentin, and it ain't doing the trick. So, he said that Cymbalta has a synergestic effect with Gabapentin. Since my knowledge of neurochemistry is limited to dissecting a pig in my bio class 30 years ago, I nodded sullenly and agreed with him. At that point, the pig had nothing to say either. So, 20mg, building up to 4 X per day. He said I could get relief from lower dose, but see how it goes. Not sure he liked my joke about frying bacon on my extremities...I think he keeps Kosher.

Thanks to everyone for listening. This has been quite the humdinger thus far. Figuring out what caused the B6 deficiency is the real rub (could coumadin have caused this?!???). Don't know, but hope all is well with everyone.

Mark