MrsD,

Thank you so much for your commitment to this multi-year thread. I feel more educated regarding B6 (active vs inactive), plasma and intracellular testing, etc. I truly appreciate your thoughtful replies and posts linking research to help answer questions members have. I hope to provide a comprehensive story (and future follow-up) that can be helpful to others. I apologize for the lengthy post... just looking for a few answers and hoping to help others. I apologize if it appears I'm "hijacking the thread." I can always delete and move to a different forum.

Here it goes!...

Personal Background:

31 year old male
6'0"
~135-140lbs
Northern European Caucasian decent
Grew up in Chicago (1982-1998). Lived in Florida since.
BS Engineering 2004
MS Business 2005
Work at NASA / KSC since 2006
Excellent Health History except for Migraine History (lately with aura)
Type A Personality
High Stress / High Anxiety
Diabetes, Cancer, and Cardiovascular Diseases do run in the family
Minimal neurological family history
Divorce 2007
Remarried 2009
Expecting first child May 2014

Health Complications / Neuropathy Genesis:
- Sold first home Dec 2012
- Attempted to buy second home Jan-Jun 2013
- Very stressful time

*** Diagnosed with Central Serous Retinothapy (CSR) June 2013 (fluid discharge behind retina)... completely healed ~ 6 months later. Linked to Type A high stress / high anxiety. I really scared myself during the process though. I literally convinced myself before seeing a doctor that I had macular degeneration, was going blind, etc...
- Started taking vitamin supplements and increased exercise vigor almost daily as recommended to reduce stress: acquired gym membership to weight train, ran 3-4 miles approx 3-4 times / week.
- Vitamin supplements were as follows:
- Isagenix Ionix Compound (basically a multi-B) B1 - 3mg (200%), B2 - 4mg (235%) Niacin 13mg (65%), B6 6mg (300%), B12 - 120mcg (2000%).
- Isagenix IsaLean Pro (basically a protein compound loaded with vitamins)
- Isagenix Greens (basically a digestive enzyme compound)
- I felt EXCELLENT taking these products for about 2 months.

*** Aug 2013 - Developed chest tightness. "Dealt" with it for a week or so until I started developing numbness in my right ring and pinky fingers. I initially thought that was ulnar nerve entrapment from weight training. Saw an orthopedic doctor who did not find any nerve entrapment and felt my symptoms were just transient and on their way out. I followed up with my GP to discuss the chest pain. I was diagnosed with costochondritis (rib cartilage inflammation). I took an anti-inflammatory for a few weeks and haven't had the problem since. To rule out heart problems, my GP also ran an EKG on me. I spit out an abnormal EKG (polarity issue). Said it was common in athletes. I still followed up with a cardiologist. After kicking the snot out of a stress test and getting near perfect imaging on an echocardiogram, I was told they don't want to see me for a heart related issue for 30 years!

*** Sep 2013 - Left leg developed some numbness and tingling.
*** Oct 2013 - Right finger neuropathy "spread" to right thumb and index finger
- I thought I needed more vitamins (they're good for you right!?)
- Organic multi-vitamin
- Ginko Biloba
- Biotin
- Multi-B
- Omega 3,6,9
- Magnesium (200-400mg)
- I was taking all this with the Isagenix supplements. At it's peak, I was taking roughly 12-13mg B6 / day. I know that is much less than values quoted for toxicity (see blood results below).
*** Nov 2013 - Starting getting neuropathy in left hand and right food.
*** Dec 2, 2013 - Woke up with twitching in calves. I believe stress threw me into a wave of other symptoms as my internet research was pointing at MS... I started to stutter for a few days, was forgetful. I made an appointment with a neurologist, but couldn't be seen for a week or so. Between Dec 2-9th I started developing some wicked fatigue, leg weakness, minor hip gait, upper back burning, increased urination frequency. I was convinced I had MS and my "first exacerbation."
*** First visit with Neurologist Dec 9th - Discussed symptoms and all supplements. Scheduled me for bloodwork and MRI. Suspected my B6 was toxic based on all the supplements I presented. She recommended I stop all supplements. My neurological test was fine (my balance was good, no numbness, etc).
*** Bloodwork results - All minerals, vitamins (including D and B12), cholesterol, sugar were "excellent." My B6 was 82 with 7-22 quoted as "normal." I see many posts regarding the misinterpretation of this and what "normal" is defined as. I plan to pursue some intracellular bloodwork. I will acquire copies of the blood work and post actual values.
*** MRI results - found two small white matter lesions. Believed to be migraine history related. Dr. wasn't concerned with size or location and doesn't believe I have MS.
- I significantly changed my diet to almost vegan. I did a massive amount of research regarding MS dieting while I was waiting for test results. Paleo, Swank, McDougall, etc. I've felt generally in better health since switching my diet. I have gluten food sensitivities. Just trying to avoid inflammation.
- I workout lightly 2-3 times / week
- Since I switched my diet to vegan and thought I had MS, I have starting taking the following supplements:
- B12 - 500mcg once / day
- D3 - 5,000IU once / day
- Omega 3 (don't recall intake amount)
- Magnesium - 400mg (75% absorption)
- Dandelion - mild effort to start a "cleanse"
- I am no longer taking any B supplements or Isagenix products
- My neurologist was OK with me taking these supplements and changing my diet.

Current status 1/4/2014
Symptoms include:
1) Small muscle twitches in random locations at random times of the day. I'll wake up with nothing, then I'll move a bit and my calves will twitch a few times. My right ear was twitching this morning. It will be in my back, in my stomach, in my arms, my glutes, my feet. Nothing so bad as to hinder movement, walking ability, picking things up, etc. Someone that isn't as sensitive to their body as I am may not even notice them or pay attention. It's just annoying and kind of scary because it's unpredictable... and I've always had perfect control over my body. As a sit here and type I can just feel a few "bubbles" in my legs and right temple area.
2) I just feel a little tight / weak in the legs after walking a lot.
3) My balance is off a bit, but I believe I'm fighting a dry sinus infection. MRI showed a deviated septum and my eyes have been dry. I'm tender around my nose and eyes.
4) My hands feel like I'm wearing thin gloves, and sometimes they will ache or I'll get a shooting pain that lasts a few seconds. My hands generally feel better the more I do something or the further I get into my day.
5) I notice that after I workout, the twitches are a little more severe and they aren't spaced out in time as much. But, they do decrease after a few hours.
6) I do feel some slight buzzing / tingling in my legs at random times.
7) Overall just kind of irritated / uncomfortable from the hand issues and twitches spreading in different locations.
8) I will note that I literally had no twitches from 12/26-12/31 after being on a diet very strictly for ~ 2 weeks... then all of a sudden they came back after I loaded up with food on New Years Eve. I ate swordfish, grilled chicken, hot dogs, corn chips... things loaded with B6... (so much for my diet plan). But, I'm back on it. I think this may be a key as to how my body processes B6...?
Food on my grocery list currently include: (egg whites, apples, pears, tangerines, asparagus, celery, cucumber, carrots, yellow and orange sweet peppers, shrimp). I know this isn't a "balanced" diet. I'm just trying to avoid B6 as much as possible and see how I do. Not sure if this is a correct approach.
9) No / minimal fatigue
10) Clear thought process
11) No stuttering

Near Term Plans:
1) I'm really tired of the guessing games and diagnosing myself. I plan to see a nutritionist soon and follow-up with my neurologist in late February.
2) I'm fully intent on following a strict diet (no gluten, vegetables, healthier low fat proteins, etc)
3) I plan on starting a massage protocol
4) I plan to continue working out lightly
5) I'm doing some light meditation / yoga
6) Pursue additional lower level / intracellular blood tests

Questions:
1) Do you believe my ~vegan diet and B12, D3 supplemental approach is ok?
2) Should I be supplementing with P5P?
3) Do you believe the change in my muscle verticulations after eating high B6 foods for a day or so is indicative of a pyridoxal kinase process deficiency? I saw your links to the autistic studies. I've never had a problem or reaction like this before.
4) Does this all sound like something more severe than just a B6 issue?

Again... thanks graciously for your time.

Just on the surface, it doesn't appear that you take much in the way of B6 as a supplement. B6 is stored for short periods of time in muscles. People working out therefore have a higher need for it than sedentary types.

May I ask what is the brand and type of Magnesium you are using?Is it Oxide?

Twitching muscles can be due to imbalance calcium/magnesium.
They also occur during low blood sugar times. These are the two most common causes.

Did you have an A1C done on your blood? Fasting glucose?

You are quite thin for a 6 footer. If you are working out you need a good source of protein. Not everyone does well on a vegan type diet. Type O can have problems with gluten. And also need meats of some type. Type B's also need protein and some dairy too. Type A's do the best on vegetable based diets. (these are blood types). The research on this comes from Eat Right 4 Your Type by
http://www.dadamo.com/

There is a magnesium based lotion now for topical use. It is called Morton epsom lotion. It is rather new and not in all stores yet. You can find it at WalMart, Walgreen's and online at Amazon.
Apply it to twitching muscles and if it stops them quickly, or prevents them, used daily, then your answer is probably magnesium shortage. Your migraine history suggests that too. You don't slather this on, but use small amounts where you need it. That bottle should last a long time...2-3 months with daily use.

Read the reviews here: (many of us on NT now use this lotion. It is really extremely good and very helpful).

http://www.amazon.com/Morton-Epsom-L.../dp/B008X365AU

I think it is best to make changes, and introduce new supplements slowly... one at a time to see what is working and what is not.

I am concerned about the retina issue. I'll have to think about this. If you can get a homocysteine test. If this is elevated it illustrates a problem with methylation of B12, and folate. Elevated homocysteine can affect the blood vessels in the eye..often showing up first there. Your B12 should be the methylcobalamin type, and also folate as methylfolate. Many people have the hidden MTHFR mutation which is a serious health issue for the blood vessels and other parts of the body.

Do you take acid blocking drugs? statins for cholesterol? Did you have thyroid tests?

Sometimes I have to think about things, so if you can.. post again and maybe as a new thread...since we will most likely get offtopic on the B6 issue.
You are welcome to come to our PN forum... we have lots of people with various types of PN and also who follow various diets for various reasons.

http://neurotalk.psychcentral.com/forum20.html
This is the link. There is a subforum there as well with mostly informational posts.

Hope to see you there.

Thank you so much for the swift reply. I'm currently visiting family, but will follow-up with a new thread in the PN forum with more bloodwork and current supplement details early this week. Ill have to visit my neurologist for a copy of the bloodwork. I do remember her saying my thyroid looked fine. I dont even know my blood type... that's just how infrequent Ive been to doctors and how health problem free Ive been...

--GatorGuy, you mentioned you were gluten sensitive; do you have any specific serological (elevated anti-gliadin or anti-transglutaminase antibodies), dermatological (dermatitis hepatiformis), or intestinal (villious biopsy) evidence of that?

Gluten sensitivity/celiac can lead to all sorts of neurological problems, certainly including the ones you describe. This can actually occur through two mutually exacerbating mechanisms--malabsorption of nutrients leading to deficiencies and neurological symptoms, or cross-reactivity of gluten antibodies with certain nerve structures in their own right (the true "autoimmune" reaction).

As Mrs. D notes, you do seem rather thin for your height, and I wonder what your nutritional status is as regards a number of minerals, vitamins, etc. that are normally absorbed in the digestive tract.

You definitely should be perusing The Gluten File--lots of comprehensive information about this:

http://neurotalk.psychcentral.com/thread1872.html

Thanks for the Gluten-File link. I will definitely research. I do not have any scientific evidence that I have a gluten intolerance. I have not been tested for it. My mother is celiac and I've "self-diagnosed" myself based on some of the symptoms she used to exhibit when exposed to gluten. After I eat a food with gluten I literally feel like a tire is just inflating around my abdomen for several hours after. Significant stomach discomfort. But, I've never exhibited any nuerological symptoms after say going on a binge fest eating pizza, fast food, etc. I have done my best to avoid gluten for about the last 6 months...

FWIW, I looking to have some professional nutritional counseling in the near future to be tested for specific food sensitivities.

Thanks... (also I'm starting a new thread in the PN sub forum as I receive a copy of my bloodwork and MRI today).

Hi

I had a comprehensive vitamin and mineral blood test a few weeks ago.

Everything came back normal except Vitamin B6 and K-1.

Vitamin B6 (pyridoxine) was 99 and normal reference range between 5 -20.

I did the test because i have been having Skin rashes, hives, sensitive reddish skin, dermotagrpahic uriticaria problems for last year.
They are recurring conditions with bad itching.

I do not understand how I got this high level. I used to take some vitamin C supplement that has 15 mg daily and a year ago a focus pill with 20 mg.
MY understanding these are very low levels to cause toxicity (> 200 mg daily).

My questions:

1) Vitamin B6 is water soluble. Why is not the body excreting that with urine?

2) MY understanding body uses active form of B6 (P-5-P) for metablic processes. Is there a different test
for P-5-P when requesting blood work? When i check with labs they tell me Vitamin B6 and P-5-P are the same.

3) Do I have B6 toxicity now and could this be causing all my skin issues.

4) Is it possible that my liver is not converting Pyridoxine to P-5-P and i have P-5-P deficiency?

5) What follow-up blood work shall I do to confirm this condition? IS there different test for p-5-P than pyridoxine?

mrsD

Do you have any answers for my above question posted a while back.

Thanks,

Sorry I missed this post some how....

I'd stop all B6, and get retested.

But you know when you are taking vitamins they will show up in the testing as "highs" but you may be having symptoms from something else.

How old are you? Old enough for blood pressure medications?
The dermatological issues may be from something else you are eating or taking in RX medication form?

The prime cause of dermagraphia can be ACE inhibitors used for blood pressure. Angioedema can be from allergies or a condition called hereditary angioedema. The latter is from excess bradykinin and not histamine which is in the allergic type.
They are similar since both chemicals are biogenic amines. But the cause is different. The ACE inhibitors cause a buildup of bradykinin, and if a person is low in C-1 inhibitor, due to genetic reasons, then the excess causes all sorts of symptoms. Swelling of parts of the body, dry cough, difficulty breathing and the skin redness/itching etc are all symptoms. With HAE there are GI symptoms too, pain, cramping diarrhea, vomiting are all possible.

Blood work from labs does not take into account any vitamins you may be getting in food. OTC products like 5 hr energy, energy drinks, fortified cereals, etc can all have B6 in them. The lab ranges vary depending on the lab too. All the ranges were made using "normals" who were NOT taking any B6. Labs make mistakes and miscalibrate machines. Quest did this TWICE and one of those times lasted a whole year with Vit D testing! All their reports for that year were erroneous!

I have on this thread, a paper done on autistic children who were screened prior to B6 therapy...and some were found to be high in B6 already and not using B6 at all. This situation demonstrates that some people may be high in this vitamin, and just not know it. And it calls into question how accurate labs may be or not, and how useful the testing really is. All of the B6 papers I've seen only address intake resulting in symptoms. The blood work often does not make it into the abstracts available on PubMed.

I believe that the testing for B6 tests for all forms in the body, and pyridoxine has 2 other forms that are floating around.
It is possible that handling of the specimen can result in lysis (rupture) of the cells which then spill out their contents into the serum, which is tested. This happens with potassium testing, as well. It is called a factitious result.
http://ajcp.ascpjournals.org/content/131/2/195.full
B6 testing is not that common, and may not have made it to the research level yet, to reveal errors of this type.

Long term high dosing at one time was common, in treatments for PMS in women. Some people were taking 500mg or more a day. This has moved out of the common arena today, so B6 testing is not commonly done. Having a lab do a CELLULAR value would demonstrate more IMO. Only some special labs do this type of nutrient evaluation.

The classic symptoms of B6 toxicity are neurological, with numbness and difficulty walking predominately. Not rashes or hives which suggest allergy or bradykinin issues.

I'd consult an allergy doctor for your skin problems, if you haven't already, and if you have other symptoms that point to HAE, I'd get the testing for that which most immunologists do:
http://emedicine.medscape.com/article/135604-overview
If you don't have Medscape, it is free and easy to sign up for.
Their copyright does not allow for posting their pages here.

Another cause of severe allergic issues is mastocytosis.. and that is genetic too.

Certain foods and families of foods can cause skin reactions.
Histamine releasers and histamine found in food are something you should check, after you look at any RX or OTC drug you may be reacting to:
http://diagnosisdiet.com/histamine-intolerance/

So I do really think you need further evaluation by a doctor specializing in allergies etc.

mrsD,

Thank you for your reply..

Here is additional information about me that address your questions.

1) I am 49 years old male. I don't have blood perssure or diabetes. My cholesterol is borderline high and I used to take Niacin 1000 mg daily for it. It went up when I stoppped niacin for 6 months due to my skin issue and I went back and took niacin and Cholestoff (6 tabs/day). It dropped from 260 to 190 and LDL from 199 to 130.

2) I am not taking any supplements with B6 or any high energy drinks. I used to have a memory/focus pill and Emergen vitamin C drink that has 20 mg of B6 but stopped it a while back. The quantity is also very low to cause a high level of Vitamin B6.

3) I do lots of exercise (5 times/week) doing variety of things. I do have microscopic blood in urine for several years but from what I read this is normal and unrelated.

4) I have seen over 10 doctors and I have lost faith in the medical field. I saw two allergists, four dermatologists, three internists, infectious disease specialist, etc..

They did all kinds of tests and nothing came positive. In fact, one allergist made things worse by the anti bacterial cream he gave me. I also did urology tests thinking some urinary tract infection might cause this but it was not. Some dermatologists suspected Schistosoma (parasitic infection) but I tested for it three times and it was negative.

My diagnosis was "Uriticaria Dermatogrpahia" and the best they can do is prescribe AntiHistamines like Allegra, Doxepin, Zyrtec, Claritin, etc..

5) I did the food and chemical allergy tests and the tests shows some allergies to peanuts and some unknown chemical used in hair dyes.

I know that my case is not related to allergic reaction becaus I had those several times and they would go away when I stop the a supplement or powder.

6) My symptoms (red itchy rash on legs) started after I had some knee pains and I strated taking knee supplement.

I took this this product "ostesport" for 3 months starting in September, 2012

and Flex animal for 2 weeks in December, 2012

Then I woke up with Hives and my skin problems started and it kept coming back in a cycle.


I always suspected that these supplements are the one that caused my condition and I stopped immediately all
kinds of supplements.


I always thought my condition was due to some internal infection (not external skin) like Parasite, Fungus, bacteria.

I started doing the Natural Health treatment. I took Hulda Clark Parasite cleanse and felt a difference after taking the green blackwalnut black hull. This convinced me that this must be some kind of parasite.

from what I read there are 100 types of praasites and labs that do stool or urine tests may not be accurate because it may not exist and they might use a small sample that does not have it and they only look for one type.

The other thing I Suspected was the abnormal high VItamin B6. I am not taking any B6 supplement. Also I do not understand why it is not being excerted with urin since it is water soluble.

I also suspected Liver issue due to High B6 since the liver converts it to P-5-P.
I want to do another test for B6.
Can Labs test for B6 and P-5-P in two different tests? Everytime I ask them They do not seem to know the difference.

Also, B6 is a soluble and should be exerted in urine so I don't understand how can a blood test show high value?

I was also considering MMS (miracle mineral supplement) since it was listed as the best cleanser for parasites.
I have not taken that yet and I noticed that the ban on it.

Both of those supplements you mentioned contain hyaluronic acid.
http://www.wisegeek.com/what-are-hya...de-effects.htm

Hives is a listed side effect for oral use of this compound.

But one would think they would go away as time passes since you used them.

Many cereals, breads, and pasta products are fortified today, and contain the B vitamins. Not in high amounts however.

I would not really focus on the blood work for the B6... you can look on the net and find many people asking the question about being in the high range for it. This begs the question as to how accurate the range really is. The B12 range which is still used goes way down low to levels (200pg/ml) listed as normal...which will produce neuro symptoms in some people (deficiency). (below 400pg/ml).
So the ranges for other nutrients might also be out of date as well.

Dermagraphia is a common sign of HAE:

http://www.asthmacenter.com/index.ph...nd_angioedema/

This allergy link above explains HAE.

I would look to what you consume daily as food. I gave you the links to histamine foods and releasers. Those can cause itching.
Also MSG in processed foods can be very irritating to some people.

The most common infestation in people today is Candida. You can starve this yeast by not eating alot sugar and carbs. There are tests for it too.

An itchy rash also comes from gluten intolerance and Celiac.
Going gluten free may help you too.