[Jdeelm]

Thanks for all the links and supplement suggestions . Just to clarify the tingling in my hands and feet started before I took any antibiotics so how could a medication I had not taken yet cause it? Although it might be contributing to it now it can't be the only problem.

Thanks again for being so helpful !

[mrsD]

Tingling in the hands and feet are common in normal people.

When this occurs occasionally, it is called a paresthesia (not PN).
It can happen when cold extremities warm up (like when you come in from the snow, and warm up) or from low blood sugar episodes.

When it becomes a constant every day thing all day long, that points to a more serious cause and PN has to be considered. Drugs that are toxic to mitocondria, will damage them and add to the daily assaults that everyone gets from time to time and may push a temporary situation into a permanent one. Abberations in calcium metabolism also cause tingling. Fixing Vit D levels if low, may correct this cause.
Chronic hypothyroidism also causes pins and needle symptoms. This cause tends to last all day long because it is compressive in nature.

[Jdeelm]

Thank you again for the information. My tingling doesn't last all day but does happen everyday serval times a day so i guess i have paresthesia. I also have had my thyroid testing except for free T3.

Today I got my results back from the gp and she said they are all fine.

B12 443pmol/L (162 - 811)
Red Cell Folate 1739 nmol/L (545 - 3370)
Vitamin D3 85nmol/L (50 - 300)
Ferritin 51ug/L (15 - 290)
Magnesium 0.9mmol/L (0.7 - 1.1)

When converting b12 I got 600pg/mL, so does that mean I don't have a deficiency as I read under 500 would suggest deficiency. Although another thing I noticed on one of the blood tests when I got home was a comment noting 'Mild Neutropenia' and when I did a quick search on the term b12 and folate deficiency came up as one of the causes which I found interesting but may not be relevant.

[mrsD]

Mild Vit D deficiency may cause paresthesias, due to poor calcium control in the body. Improving your Vit D may help the tingling. Do 2000IU D3 daily for a month or two and see if there is any difference.

The low range in your test results is not really normal. You should really be at 150 or so (your units).

It would not hurt to try some methylcobalamin... 1000mcg daily orally on an empty stomach, and see if there is any change.

Another cause for numb feelings and tingling are episodes of low blood sugar. So if you log the times you get them, compare to what you ate before--up to 6 hrs before---to see if they come more often with high carb intakes (as opposed to high protein intake).

[Jdeelm]

I think I will try the D3 supplement and methylcobalamin as these things could explain my symptoms and I've already tried alot of other things without success so hopefully this helps atleast a little bit. I'll see if any health food stores have the b12 otherwise I'll use the sites you suggested earlier . So the 1000mcg would be enough instead of the 5000mcg?

I'll also keep note of when I eat in relation to the tingling as I do have poor eating habits since becoming ill.

[mrsD]

With your B12 somewhat in acceptable levels, I don't think you need the 5mg dose. 1mg will raise you to about 1000 I think, and that level is good. Dr. Snow found some people in his study that he published, had relatively good levels of 400-500, and still had neuro symptoms. They improved with B12 supplementation, and he recommends trying it anyway if neuro symptoms are present.

We are lucky that B12 is safe to use, and we can do this ourselves. Other vitamins are have trade offs like B6 for example, and people have to be more careful with it.

[karsten]

Cobamamide which is also referred to as adenosylcobalamin and dibencozide is another active form of vitamin B12 that doesn't get nearly as much publicity as methylcobalamin.

I have heard that this form of B12 maintains different neurological processes within the human body compared to methylcobalamin. I believe that a portion of methylcobalamin is converted to adenosylcobalamin or perhaps visa versa.

My questions is do we need to take both forms to be safe? Is it possible that some people are adenosylcobalamin deficient even while supplementing with methylcobalamin?

I would be interested to hear any opinions on this. Thanks!

[mrsD]

That is a complex question. I haven't seen much on this
as a medical problem, or on PubMed.

It is always possible because of some genetic flaw, the chemistry can get messed up, when enzymes don't work.

We have an article on Health news headlines, on twins today, and DNA flaws, that occur with aging. It maintains that DNA strands break and fail to perform in some people with aging.

http://neurotalk.psychcentral.com/thread164384.html

The following are some complex examples of the chemistry:

http://chemwiki.ucdavis.edu/Biologic...in/Cobalamin_1

The "R" group varies among the different cobalamins:
http://chemwiki.ucdavis.edu/Biologic...ymes/Cobalamin

This is an example of a specific use of cobamamide:
http://en.wikipedia.org/wiki/Cobamamide

For most intensive purposes, people who do not respond to
methyl B12, may have some genetic need for another type.
That I think is highly specialized, and difficult to find at the layman level.

from Dr. Sahelian MD:
http://www.raysahelian.com/methylcobalamin.html

Four cobalamines (methyl-, hydroxy-, adenosyl- and cyancobalamines) are considered as natural forms of vitamin B12 in human and animal tissues. Methyl- and adenosylcobalamines are the coenzymes of more than 10 enzymes, catalyzing important reactions of lipid, carbohydrate and protein metabolism. The four natural forms of vitamin B12 are interconverted in presence of corresponding enzymatic systems. Content of individual forms of cobalamines and of corresponding coenzymes depends on the function of enzymatic systems involved in their synthesis as well as on the enzymes, which use these derivatives as coenzymes. Spectra of cobalamines in human and animal bodies are dynamic systems, distinctly and specifically responding to various effects.

Thus genetic failure can be serious...but I have no idea how that would be identified. I would think failure to respond, would suggest trying another form. But I don't think this is very common.

[karsten]

Thanks MrsD. I agreee that there isn't a lot of research regarding the use of adenoslycobalmin. It is a topic that doesn't get much attention. I think it should.

What really interests me is that this form of active B12 functions in the mitochondria by being at the base of the Kreb's cycle producing ATP. With all of the current interest in mitchondria damage and how it relates to PN, it seems like Ad12 could be a crtical cofactor in the reapir of nerve damage.

It appears that most people convert a portion of Mb12 to adenosylb12 within their body. I wonder if the conversion process is enough to recover from a potential deficiency of this active form of B12.

I have been taking this form of B12 along with Mb12 as an insurance policy to what I believe is improving my PN. Unfortunately, we just don't have enough solid information out there to know if this active form should be supplemented or not. Fortunately like MB12 there is very little risk of taking too much of this on a daily basis.

[mrsD]

Yes, I agree with you... we are are supremely lucky that B12 is so easy to do ourselves. If we left this to doctors... well we see commonly how helpful they are.

It won't hurt to take both. In fact before methyl became so easily available I used the adenosyl type myself from Country LIfe. I found that in a store near me a decade ago... in fact.

But I have never been really low in B12 either. My long ago first test was 849. I take it only as insurance, "just because".

I think it is more likely to be low in the methyl form because of methylation errors being found today... like MTHFR mutations, of which there are many. (I read once on a Merck site that a while back there were 25 of them...mutations so far. Maybe today there are more being found?

Let us know how you do with both.... this may be very helpful for some people on this forum.