Hi!

Wondering if you’ve had a punch biopsy? A punch biopsy can help determine whether you have small fiber neuropathy. I was told, “The most common cause of small fiber neuropathy is diabetes, and even people with prediabetes can experience small fiber neuropathy.”
Small fiber neuropathy is considered a form of peripheral neuropathy because it affects the peripheral nervous system,

I had a puch biopsy at Mayo AZ that came back negative … which then prompted further testing.

In 2017, I experienced toe pins + needles that over days to weeks elevated to my waist. The first neurologist suspected I had peripheral neuropathy. The second neurologist ordered a cervical, thoracic + lumbar spinal MRIs w/ and w/o contrast. At the same time, he ordered AC consult w/ a hematologist to further explore my low normal range B12. (254) as lower range B12 can potentially cause pins + needles/tingling. The thoracic MRI revealed a inactive T7 lesion + I was advised to repeat spinal MRIs in 6-12 mths. The hematologist prescribed a trial of B12 injections + my pins + needles moved back to just my feet. 2 stable MRIs + 2 years of monthly B12 injections later, the pins + needles started creeping back up my legs again. I started experiencing numerous other odd symptoms + consulted specialists of every kind at 3 teaching institutions, including ac3rd neurologist. It wasn’t until a 88° day that I suddenly felt severe difficulty moving my legs. The second neurologist referred me back to the initial neurologist who ordered a punch biopsy which came back negative. Additional testing was done, including a brain MRI add spinal tap w/ results leading to a MS Dx.
I’m so glad that I listened to my inner voice + continued exploring + consulting doctors. Though I’m not happy to have MS, I’m relieved to know what I have + to be receiving treatment.

MS van have wide ranging symptoms … so each person’s symptoms can look totally different, thus making a diagnosis a challenge.

Low B12 can also cause a broad range of symptoms also. Below is an AMAZING YouTube discussing symptoms of low B12.

Hope this info is helpful.