Vitamin B12 deficiency and small fiber neuropathy

Hello @sallylynn. I noticed your topic and wanted to get you into an existing discussion with others, so you will see I have moved your post here:
- B12 and neuropathy & bloodwork: https://connect.mayoclinic.org/discussion/vitamin-b12-deficiency-and-small-fiber-neuropathy/

Out of curiosity, have you started taking B12 at the advise of your neurologist once you discovered the deficiency?

Try using sublingual B12 and/or sublingual B complex can be purchased at CVS, to see if it makes a difference. Also, have your thyroid levels checked. Check your MMA levels along with RBC and serum folic acid levels. You can have these done without a doctors order at a facility called Any Lab Test.

B12 and neuropathy & bloodwork
Hello. Looking for answers. Any advice would be appreciated. Events: July 26 2023 out of no where I began to get full body tingling, pin & needles, burning sensation with sporadic itch. My skin felt I was sunburned. Sleeping my back felt as if I was lying on sandpaper. Not real severe, but scary. July 27 my ankles were aching & my front of my calves. July 28 went to ER. At this time I was on antibiotic Cefpodoxime proxetil for UTI. Hospital ran labs. They said all looked good. No explanation why my skin was feeling this. It's now been over a month. Symptoms progressed. Went back to ER onn August 24, there ran many labs. The said I have PN and prescribed Gabapentin. I reviewed my labs on My Chart with a fine tooth comb. These are my concerns: My MCHC is above normal range at 37. The normal range is 32-36. My trends are as follows starting from August 24 to June 3: 37, 36, 37, 36, 36. I researched high MCHC (UWH) and it says: High MCH scores are commonly a sign of macrocytic anemia. This condition occurs when the blood cells are too big, which can be a result of not having enough vitamin B12 or folic acid in the body. Although they did a B12 test is was "Borderline", mine was 268. The normal range is 213-816. I am 55 digits to be considered B12 deficient. I have only 2 trends, August 24 at 268 and Sept. 13 2021 at 330. With the information I provided,could I be experiencing neuropathy symptoms from B12 deficiency.

I have been experiencing the same symptoms since last November. Mine also came on suddenly. After numerous tests (MRI, nerve test, bloodwork, etc. ), the only thing found was low B-12 (312). The neurologist said that even though that is technically within the normal range, for neurology, they like to see the number over 400. My numbers have gone up since taking supplements, but I still have flare ups of symptoms. I can live with my symptoms without medication (I do take B-12, B-complex, vitamin D, and magnesium glycinate), but they are worrisome. My personal opinion is that hormones are also playing a role (age 52 and in perimenopause) and that 2 boosters and having covid in a 6-month period (April-October 2022) has put my immune system into overdrive. I have seen several doctors (GP, OBGYN, 2 neurologists, and a cardiologist) and they just do not know. Best wishes to you.

I have concerns myself about B12. As a teen, I used to get weekly B12 shots that counteracted my extreme tiredness. Now docs refuse to give shots and I take a 1000 mcg B12 pill each day. I’m still exhausted everyday. Doctors should listen to us more because we’re in the body with the problems!

Thank you for responding. I had a B12 test August 24. My B12 is 268. Normal range: 213 - 816 pg/mL. Mine is very low in the normal range. I am almost 63 years old, so I am post menopausal. I have next to none estrogen left in my body. However, I refuse to take estrogen in any shape or form. Actually I had a pelvic exam in July, and the doctor could "Visibly" see the thinning of my "V" walls.
I would like to share this with you as to possibly why I got"Out of nowhere" neuropathy symptoms:
***I was using MICONAZLE NITRATE
at the same time my skin sensations occurred.

DRUG CLASS: Miconazole is in a class of antifungal medications called IMIDAZOLES.

IMIDAZOLE side effects: The most common side affect is nausea/vomiting/loss of appetite/headache/hair loss and "PARESTHESIA".

PARESTHESIA symptoms: Burning/prickling sensation felt in hands, arms, legs,feet but can occur in other parts of body. The sensations, which happen WITHOUT WARNING & is usually painless describes as tingling, numbness,skin crawling, itching. In most cases the paresthesia is transient resolving on it's own in a few days, or weeks.In some cases the "Condition" as being persistent, lasting more than 6 months.A small amount of cases, it is permanent.
* This I know as fact,the symptoms described above are 100% exactly what I experienced to the T. I have never experienced in my life paresthesia until July 26, and it was without warning.
**My neuropathy is getting less. Once in awhile now I will get a brief "Itchs" randomly on my body. Just so you know, I told the ER & my Doctor I was actively using Miconazole Nitrate for my yeast infection. I did the research. On July 28, in detail I told ER my symptoms. I told them I was using Miconazole Nitrate suppositories. I told ER on August 24 the day the "Neuropathy" happened, I was using Miconazole Nitrate. No one put it together. Can I say this was the culprit? I am leaning on yes more than no. What are your thoughts? Oh, I am surprised the Hospital didn't advise me to start B12 since my B12 is very low, they said my B12 was fine. I am a measly 56 digits from actually being "Deficient".

That definitely sounds like it may be the culprit. My OBGYN wants me to go on a low dose HRT, but I have not (2 kids in college and it is very expensive, plus there are risks). If I were you, I would at least start taking a B complex. My neurologist said that everyone over 50 should take it. It contains B-12 but at a lower dose. My mom and 3 other women that I know have recently asked for their B-12 levels to be checked (after what I experienced) and their numbers were all lower than mine. They were all told to take B-12. I think as we age and our hormones fluctuate, our B-12 levels are adversely affected. It is also my understanding that your body will excrete any B-12 that you do not need so you don't have to worry about taking too much. I take 1000 mg daily.

At Hospital my Thyroid was normal & my RBC's were in normal range. I think, possibly, I have found the answer for my split second out of nowhere neuropathy . On July 25 in evening, I started my 2nd round of OTC yeast infection as instructed by my Doctor. I used 3 day suppositories. The active ingredient in yeast treatment is MICONAZOLE NITRATE. 2 days ago I was curious what drug class Miconazole Nitrate is. The drug class is the IMIDAZOLES Family. I proceeded to look IMIDAZOLE drug up, and my eyes popped out what I read. This is what I read: The most common side effects are nausea,vomiting, others are hair loss, rashes and PARESTHESIA.
I look up PARESTHESIA. This is what is says: Paresthesia refers to a burning or prickling sensation that is felt in the hands, arms, feet or legs but can occur in other parts of the body. The symptoms, which happen WITHOUT WARNING is usually painless & is describes as TINGLING, NUMBNESS, SKIN CRAWLING, & ITCHING.
In most cases the paresthesia is transient resolving on it's own after a few days or weeks. In some cases the "Condition" is best classified as being persistent (Lasting more than 6 months). For a small number of cases, it is permanent.
* What you just read is 100% what my symptoms were to the T. What are the odds, I have in my system [IMIDAZOLE] which is the class drug for Miconazole Nitrate which can cause Paresthesia. Every single symptom I got, and yes, with out warning. ~ As of current. my "Symptoms" are well, improving. Occasionally I will get an itch. 3 days ago I started B12 500 mg a day once a day. 3 days ago I stopped taking th eGabapentin I was prescribed. Btw, I sent all this information to my doctor. ~ I would like your opinion on this. Have I connected the dots? ~ Thank you so much.~

What is the "our" group's opinion regarding which drug makes you have brain fog the most - pregabalin or gabapentin? I take pregabalin and sure have it pretty bad!!