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Old 08-05-2009, 04:57 PM #1
jane30 jane30 is offline
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jccgf, you copied and pasted reasons for b12 deficiencies"-N 2 O exposure can occur iatrogenically (ie, anesthesia)"

could someone explain this quote further to me? i had surgery in may and was put under does this cause a b12 deficiency or create symptoms?

sorry for the confusion, i was just re-reading this great info and came accross this.

jane
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Old 08-05-2009, 06:45 PM #2
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Quote:
Originally Posted by jane30 View Post
jccgf, you copied and pasted reasons for b12 deficiencies"-N 2 O exposure can occur iatrogenically (ie, anesthesia)"

could someone explain this quote further to me? i had surgery in may and was put under does this cause a b12 deficiency or create symptoms?

sorry for the confusion, i was just re-reading this great info and came accross this.

jane
I use Jarrow Brand Methylcobalamin B12, that you put under your tongue. I think it is probably more important to get the methylcobalamin type of B12, rather than cyanocobalmin, rather than whether it is sublingual or not.... at least this is the message I think I've heard from Rose and MrsD. Just found this thread here on B12 by MrsD:
http://neurotalk.psychcentral.com/thread85103.html

Having said that, when I began supplementing I took Nature Made cyanocobalamin, 1000mcg daily, in regular pill form, extended release formula, and my level came up and I improved. I've also heard you shouldn't take extended release either, because you want all the bang for your buck at one time...so to speak... so that the 1-2% will be passively absorbed. Methylcobalamin is thought to work better, and for a few people who have trouble in the 'conversion/transport process' it is imperative that they take the active form. I switched over to methylcobalamin when I learned of it. I usually order from Iherb.com , but I have seen Jarrow brand in some better vitamin stores. I've used just about every brand without great preference (Country Life, Solgar, Natural Factors, Source Naturals).


From what I think I remember, a single use of nitrous oxide during surgery can cause a sudden B12 deficiency situation. I'll try to find more on that.

Quote:
Dr. Kinsella has had a longstanding interest in B12 deficiency and its relationship to nitrous oxide, a general anesthetic in common use in dental offices and hospital operating rooms. A B12 deficiency can be caused by nitrous oxide, also known as laughing gas, by inhibiting the action of B12 when tissue stores are low.
"This becomes a public health problem in the elderly undergoing surgery or dental work who may have undiagnosed and untreated B12 deficiencies. It also occurs among dental personnel and others who repeatedly abuse nitrous oxide for its euphoric effects," he says.
Nitrous oxide abuse in the form of "whippets" or "whippits" occurs among medical personnel, teenagers and young adults who purchase nitrous oxide containers from baking supply stores or use the gas contained in whipped cream dispensers (hence the name), says Kinsella. Thomas and colleagues earlier this year published the case of a young man who abused nitrous oxide and devastating neurological damage to the spinal cord and peripheral nerves. The link to nitrous oxide was recognized and the patient recovered with B12 replacement.
http://www.eurekalert.org/pub_releas...-wfn102704.php
I can probably something better than this, but I'm sitting down to dinner... and this is what google brought me. Also got many hits on pub med by entering nitrous oxide B12 deficiency. Try entering the terms here:http://www.ncbi.nlm.nih.gov/pubmed/
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Last edited by jccgf; 08-05-2009 at 09:59 PM. Reason: adding detail
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Old 08-05-2009, 07:25 PM #3
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From: The Neurological Manifestations of Gastrointestinal Disease by Mark Skeen, MD.
Neurologic Clinics
Volume 20 € Number 1 € February 2002


Quote:
Nitrous oxide, a common inhaled anesthetic used in dental and surgical procedures, inactivates cobalamin by irreversibly oxidizing the cobalt core of methylcobalamin. Numerous reports have documented acute cobalamin deficiency after exposure to nitrous oxide.[79] [141] Symptoms may be subtle or profound manifestations of cerebral or spinal cord dysfunction. [79] [141] Elderly patients with borderline cobalamin deficiency are at high risk for nitrous oxide–induced cobalamin deficiencies. Because cobalamin deficiency has been reported in 7% to 21% of elderly patients, the syndrome of nitrous oxide–induced cobalamin deficiency is likely underrecognized.[79] Elderly patients and those with previous gastric
surgery who develop central nervous system dysfunction after nitrous oxide anesthesia should be evaluated for cobalamin deficiency. Preoperative screening is appropriate for patients considered at high risk for cobalamin deficiencies.
It appears this is a problem when an individual is already borderline cobalamin deficient. But, if the onset of your symptoms seem connected to your surgery... it certainly could have thrown you over the edge if nitrous oxide was used. In any case, the treatment is B12 supplementation.
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Old 08-05-2009, 08:37 PM #4
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Thanks so much for this information!!!

I had wisdom teeth removal at the beginning of May where they put me out. And yes a few weeks after the surgery I started feeling worse. This is when I started searching online. I've been with low ferritin for more than a year, but just recently begged my dr. to test my b12, since developing electric shock like symptoms in my upper back going up into my head.

I will start supplements and see if they help. I will watch my symptoms closely and still try to get her test for other conditions to see if there is something tied to the low ferritin readings and the b12 reading.

I cannot thank you enough for your advice and wealth of information!

jane
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Old 08-05-2009, 09:07 PM #5
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Jane, you're welcome, and good luck!

I sort of come and go here... lately been drawn back by "B12 talk"... if you have any other questions about B12 deficiency or gluten sensitivity that I might be able to help with.. feel free to pm me. I get notifications on pm's but might miss a post.

...and kudos to you for getting online and researching your symptoms, asking for a B12 test, and then doing your own follow up!!! That seems to be what it takes to these days... and thank goodness for the Internet and health forums... the "medical underground" I like to call it!
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Last edited by jccgf; 08-05-2009 at 09:30 PM.
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Old 08-05-2009, 09:18 PM #6
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a big thank you!!!! and yes im soo thankful for forums like these, it really helps sort out so much that is out there!

i will let you know if i have any other questions, but again thanks for posting all this information!

jane
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Old 08-05-2009, 08:40 PM #7
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hi pearl girl,
wow sounds like you have gone through many many symptoms. i hope you are now finding relief. my level is at 296 but from what i read here and elsewhere it's too low.
how long did you have symptoms before being diagnosed? my numbness comes and goes as do the electric shocks, so this is why i wasn't sure if it was connected to vitamin b12 or something like MS.
your level was very low!!, wow i hope you are starting to see improvements! what is your level at now?

jane
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Old 08-06-2009, 12:09 AM #8
pearl girl pearl girl is offline
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Wink B12 levels went up almost immediately

Quote:
Originally Posted by jane30 View Post
hi pearl girl,
wow sounds like you have gone through many many symptoms. i hope you are now finding relief. my level is at 296 but from what i read here and elsewhere it's too low.
how long did you have symptoms before being diagnosed? my numbness comes and goes as do the electric shocks, so this is why i wasn't sure if it was connected to vitamin b12 or something like MS.
your level was very low!!, wow i hope you are starting to see improvements! what is your level at now?

jane
Hello Jane,

Yes, I have had dozens and dozens of symptoms for many years but never put the dots together: on the other hand, neither did several MD's and two neurologists. "Oh, she had serious cervical spine issues. Schedule her for surgery in three days!" ... or ... "She has brain lesions and brain atrophy; send her immediately to the multiple sclerosis neurologist!" ... Yes, both those statements were said by doctors. What literally saved me was the last neurologist who after ruling out MS because of the types of lesions on my brain said, kind of as an afterthought, "Nancy, have you had your B12 checked?" That was in February. I was called by the neurologist's office and told to RUN to a hospital or lab and get a B12 shot because my level was 68. I began reading reading reading. If you can believe this, a fifth doctor had told me the WRONG kind of B12 to take so it was a little while before I started the methyl version and dibencozide. My tests, about 8 weeks apart went like this: 68; 820; 1750 and counting. I'm due for another test later this month. Obviously with such a low level, there was considerable damage done. I'm getting better but it is two steps forward; one step back; over and over. Keep reading and investigating and don't give up until you have the answers you need. There is a light at the end of the tunnel and I'm standing in it right now!
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Old 08-06-2009, 03:08 PM #9
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Hey pearlgirl
That's crazy all that you have gone through!! Have your symptoms gone away now that you have raised your b12 levels or are you still having problems on and off?

Thanks for sharing your story with me! Although I wouldn't wish this on anyone, it is reassuring that I'm not alone in this one!

Jane
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Old 08-06-2009, 08:36 PM #10
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And remember... getting the level up can happen quickly... but healing takes place over months to years if nerves were damaged and need to repair.

Found another reference to nitrous oxide while checking something out for someone else:

http://emedicine.medscape.com/article/1171558-overview

Quote:
Cyanocobalamin (vitamin B 12 ) deficiency
  • About 80% of all cases are due to pernicious anemia, and another 10% are due to achlorhydria. Exposure to nitrous oxide can suddenly precipitate the deficiency, which should be considered in any patient who develops postoperative paresthesias.
  • The disease predominantly affects the spinal cord; therefore, separating the painful sensory and sensorimotor paresthesias of the peripheral neuropathy from the symptoms of spinal cord involvement is difficult.
  • Presentations vary greatly among patients.
  • The symmetric glove-and-stocking paresthesias, or tingling in the distal aspect of the toes, numbness, coldness, a pins-and-needles feeling, and occasional feelings of swelling or constriction, are slowly progressive and insidious. Symptoms progressing up the legs, occasionally affect the fingers, and culminate in weakness and spasticity.
  • In late stages, signs include moderate muscular wasting, optic atrophy, sphincter dysfunction, and mental disturbances. Examples of these disturbances are mild dementia (which is often the first symptom and clinically indistinguishable from other dementias), disorientation, depression, psychosis, and persecutory delusions.
  • The hematologic manifestation of anemia, if present, can cause weakness, light-headedness, vertigo, tinnitus, palpitations, angina, heart failure, cardiomegaly, pallor, tachycardia, and hepatosplenomegaly.
  • GI symptoms include a sore, beefy red tongue and anorexia.
  • If left untreated, the gait becomes ataxic, followed by paraplegia with spasticity and contractures.
  • The subacute combined degeneration that develops results in a severe myelopathy, involving posterior columns and lateral corticospinal tracts, with other manifestations including optic (retrobulbar) neuropathy, sensorimotor polyneuropathy, and dementia.
~

hehehe... the persecutary delusions come from doctors not knowing how to identify and treat B12 deficiency...
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