Posts Tagged ‘B12’

For a couple of months I had been experiencing pain on my right side, under my ribs, wrapping around to my back.  I had an ultrasound done at 34 weeks to investigate, as my symptoms sounded like gall bladder disease / gall stones.  Everything looked normal except for a “1.0 cm right subscapular echogenic area, likely representing a liver hemangioma.” Well, that is where my pain is, however, the report noted that “No cause for patient’s pain is identified.”

From what I’ve read on the internet, other people have experienced pain there, mimicking gall stones, only to be told it’s a liver hemangioma, and that it shouldn’t be causing pain. Several people also noted that they have IBS (irritable bowel syndrome), which I have been told I have due to years of constipation and bloating (basically since birth).

Recently, in January 2010, I started getting other weird symptoms like numbness and tingling. After 6 months of seeing 8 different doctors, including the emergency room at the hospital, an endocrinologist (I have Graves disease), a neurologist (for the numbness & tingling), and a rheumatologist (who told me it was fribromyalgia, which it isn’t), I was finally diagnosed with vitamin B12 deficiency (it was 115 at the time), low calcium (hypocalcemia), and low ferritin (anemia). The current hypothesis is malabsorption and I go to see a gastroenterologist in February, and I’m getting an MRI just to rule out anything else (Jan 2012 – completed – came back clean.)

So, after 3 months of supplements with vitamins I find I still have malabsorption issues (diarrhea), despite many pills a day:

  • 2 mg+ Calcium
  • 4 IU vitamin D
  • 1-2 Iron pills a day (Palifer/Euro Fer)
  • Vitamin C (I take with iron, and now with each meal as I read it can help with malabsorption)
  • B12 (sublinguals and injections)
  • prenatal vitamin
  • B complex vitamin
  • 1 magnesium pill

I suspect that my history with IBS could be caused by low stomach acid (hypochlorhydria ). It is interesting that the low vitamins happened less than 2 years after my Graves disease diagnosis, which makes me wonder if any of it is autoimmune. Pernicious anemia (low b12) can be caused by an autoimmune disorder, but doesn’t explain the low calcium.  Updated Jan 2012 – I feel fairly certain it’s adrenal fatigiue/insufficiency

So, until I have this baby (less than 4 weeks to go!), and until I see a gastroenterologist (3.5 months from now), I just have to keep taking vitamins, ignore the pain under my right ribs, and hope that it’s all treatable in January!

I know a scope of my stomach and colon is likely in my future, but if it produces the cause of my symptoms (hopefully, all benign), then I’ll be happy. However, I am disappointed that it is taking so long to diagnose. It’s already been 9 months since the onset of my symptoms and it will be over a year before I see the gastroenterologist (it took 3 months of supplements not making much of a difference, and even then, I had to ASK to see one).

Note: my Graves Disease has been perfect throughout pregnancy. I take a pill at breakfast (50 mg), and another pill at bedtime (50 mg). I will let you know if it flares up after birth, but so far, so good!

Post-Birth update

About a week after birth my calcium levels seem to be off. I feel very hypocalcemic, however, I’m taking more calcium than ever (up to 4,000 mg / day). My lips are tingling and my muscles get crampy. However, I’m prone to constipation right now – well, large, firm stools right now, which is odd because I’ve had fibrous, slimy bowel movements leading up to birth, despite the calcium and iron I’m taking.

Update: Jan 2013

Still have constant flank pain in this region. Kidneys look okay. Think this might be the source of all my problems – liver cyst.

Liver cysts are usually asymptomatic, and most people having them are unaware about their condition. It is found that less than 5 percent of people with hepatic cysts develop noticeable symptoms. Also, the benign sacs don’t affect the normal functioning of liver. When the cysts grows larger to about 7 cm, or if there is bleeding inside the cysts, then only they cause symptoms. Bleeding into the cysts is characterized by sudden pain in the upper right abdomen. Symptoms associated with hepatic cysts include the following.Upper abdominal swelling and discomfort
Abdominal pain
Nauseated feeling
Eruption of the cysts
Digestive problems
Shoulder pain
Liver enlargement
Blockage of bile ducts
Infection of the bile ducts

Diagnosis and Treatment

Diagnosis of liver cysts is done when a patient undergoes a CT (Computed Tomography) scan or an ultrasound procedure of the abdomen. Usually, they are detected incidentally, while doing imaging tests for other abdominal problems. If required, examination of a sample of fluid from the cysts, biopsy of the affected tissues and blood test (for parasitic infection cases) is conducted. It is common that an individual has more than one cyst in the liver tissues and rarely, there are multiple cysts.

Since liver cysts don’t disturb the normal functioning of the body, there are no significant treatment methods. In case, the cysts are big enough (for example more than 3 cm), it is advisable to go for a follow-up abdominal imaging to check the growth of cysts. People go for treatment of liver cysts only after they experience discomfort symptoms that disturb their normal routine. Treatment for the same is done by aspiration and/or surgical removal of the cysts.

Of the two available treatment methods, removal of the cysts via laparoscopic surgery is a more reliable intervention. Simple aspiration of the cysts is not recommended, as fluid tends to fill up the cysts after some time. In the surgery, 2-3 small excisions are made in the abdomen. With the help of laparoscope, a large part of the affected tissues including the cyst wall is removed, and the incisions sites are sutured. Laparoscopic surgery is also recommended, if the cysts prevent normal flow of bile juice to the small intestine.

This minimally invasive procedure requires 1-2 days hospital stay. Usually, candidates achieve full recovery within 2 weeks after the surgery. As the liver regenerates on its own, it recuperates successfully. In case, the cysts are infected, then treatment may include administration of antibiotics and other prescribed medications along with excision of the tissues and cysts. For people who have participated surgery for hepatic cyst treatment, recurrence rate is very low (almost negligible).

To conclude with, no specific treatment is needed for asymptomatic liver cysts. However, one should be aware about the complications of liver cysts, such as infection, jaundice (yellowing of the skin and sclera), bleeding into cyst (causing pain) and disturbance of the flow of bile juice. If anybody suspects that he/she has liver cysts, it is recommended to consult and seek advice from a physician so as to get proper medical attention. Except for the mild discomfort cases, hepatic cysts do not pose risks for liver cancer and liver failure.
Read more at Buzzle: http://www.buzzle.com/articles/liver-cysts.html


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So, I’m not sure how long I’ve had pernicious anemia, but my weird symptoms started in January.  I wasn’t tested for b12 deficiency until June! I was diagnosed with fibromyalgia by a rheumatologist (no blood test, told me tight muscles and insomnia were fibromyalgia), a neurologist didn’t know what I had (and didn’t do a blood test), and my family doctor thought I was anxious and a hypochondriac.

I am writing about it because I researched my symptoms obsessively for months and never came across a detailed description of what I was feeling. I always came across those overly vague and generalized pages that didn’t sound like what I was going through. No one mentions the veins, but they were one of my first signs!

Note: autoimmune diseases and thyroid disease put us at increased risk for B12 deficiency! If you feel tingly or “different” it might be worth it to ask your doctor to test your levels. 300-400 is borderline and you should start supplementing. Under 300 will cause symptoms and you should be treated immediately. If you’ve lost blood or had surgery, make sure you’re tested for B12 and anemia right away, symptoms or no symptoms. I also now think I have adrenal insufficiency! Too much cortisol (from stress) causes vasoconstriction, which can lead to numbness. Too little cortisol (adrenal insufficiency) causes widespread vasodialtion!

When my family doctor finally tested my levels, my B12 level was 115, I was severely anemic with extremely low ferritin, and hypocalcemic. After 2 weeks of supplementation, these were my blood results (green numbers are better than the red ones):

  • Calcium: 2.15 up from 2.08 (2.15-2.60)
  • B12: 215 up from 115 PMOL/L  after B12 injection (>200, although most recommend over 400)
  • Anemic (low iron),
    • hemoglobin: 113 down from  117 G/L (115-165)
    • hematocrit:  0.33 down from 0.38 L/L (0.37-0.47) &
    • RBC count: 3.46 down from 3.7 (3,8-5.8)
    • Ferritin: 13 up from 10 (11-145 UG/L)
    • MCH: 32.6 up from 31.6 (27-32) (macrocytic)
  • Low Albumin 34 down from 36.0 G/l (35-50)
  • Low Creatine: 52 up from 46 UMOL/L (60-115)
  • High ESR (inflammation): 20 down from 34 MM/H (0-12)

My main symptoms were numbness and tingling. However, some of my own weirder symptoms included:

  1. I actually think the weird sleep patterns were my first sign. I would wake up every night at 3am. Eventually I wouldn’t be able to nap despite extreme fatigue and would wake up a thousand times at night. Currently, I get hot flashes and sweating at night – I’ve always been cold at night so this is totally new.
  2. Tinnitus: I would read before bed and would often notice ringing in my ears
  3. Mild incontinence. Sudden urges to pee with mild “leaking”, even before the tingling started.
  4. Suddenly, I had right-sided numbness and tingling and muscle spasms. First my right thigh, then my right jaw, with tight spots on my right neck, left trapezius, and right side of my middle back. I wasn’t in much pain at first. It was mostly numbness
  5. Bright blue, tender, swollen veins throughout body, especially chest, thighs, hands and feet. This was one of my first signs that started around the same time as the numbness. Perhaps related to elevated homocysteine levels caused by low B12. (Big, blue, tender veins)
  6. Diarrhea that came and went in bouts (of weeks or months). The first two months of symptoms I had watery stools every day.
  7. Complex/silent/hemiplegic migraines – a wave of numbness in my face, thigh, or stomach for 15 minutes to 2 hours. During this time the area would be very heat/cold sensitive. After it was over I would have a wave of chills and severe headache and fatigue.
  8. I would often crash at 7pm at night. I never really slept soundly, but would lay in a comatose-like state. At night I would wake up a million times and never felt comfortable.
  9. I had achy hips and sciatica-like symptoms. At one point I had “heavy leg syndrome”. A massage of my numb thigh made my whole leg ache for 2 days. I shoveled the driveway and got severe sciatica symptoms – pain down my right leg and it felt like the circulation was poor.
  10. Finally, I had numbness and tingling on both sides of my body (after 2 months of mostly right-sided symptoms). My upper arms and hip/thigh regions were the worst. At times it felt like I had ties around my shoulders cutting off circulation in my upper arms, although my lower arms and hands were fine!  It also felt like tight bands of muscle or nerves running down my upper arm.  My hips and legs were often tingly. Again, it almost felt like circulation problems and I kept researching “vein inflammation” (mostly because my veins were big, blue and tender from the outset)
  11. During this time I also had severe photosensitivity, with wavy peripheral vision. Sometimes I would close my eyes and still see the waves.  I still need to wear sunglasses even on overcast days. My eyes were very bloodshot. Driving at night-time, I noticed that street lights and car lights looked like flares (almost like when you have too much chlorine in your eyes from swimming).
  12. My feet are always tender in the morning and it takes a while for them to feel normal. They can feel swollen, burning, or just tender.
  13. My symptoms are worse at rest. The second I stop moving, everything seizes up. Night time is the worst. Tingling, restless legs, crawling sensations down my arms and legs. Fatigue. Heart palpitations.
  14. Edema: The areas where I had severe nerve inflammation would be mildly swollen. My upper arms were a little jiggly, like they were full of water. My legs would feel weird to bend because they were swollen and it really brought out the cellulite in my upper thighs. I also noticed it in my right jaw, where I often got severe pain and tightness. I have read this could be caused by iron-deficiency anemia, which often occurs with B12 deficiency.
  15. I got floaters in my vision
  16. L’hermitte’s sign: an electrical zap feeling, like you’ve been electrocuted (which is supposedly really rare, but my mom gets it too)
  17. Muscle fatigue. Maybe it’s the nerve inflammation or the anemia, but my arms would tire blow-drying my hair and stairs were difficult to climb (easily fatigued, not really weak).
  18. Severe heart palpitations and sudden weakness/light-headedness for apparently no reason. Sometimes it was so severe I felt I could hardly breath despite laying down.
  19. My mom has also had balance issues and vertigo, as well as brain fog (forgot her own phone number once and couldn’t remember how to get home from work on another occasion)
  20. Dry mouth: My lips were peeling and I often felt like my mouth was dehydrated
  21. Course, dry hair that started to fall out.
  22. Tight calves. I also had muscle cramps in my calves at night. I became hypocalcemic, which I’m sure contributed to this!
  23. Heartburn and acid reflux. This started of mildly and got worse.
  24. Weird muscle spasms in my sleep that would wake me up. They wouldn’t be the really painful calf cramps, these were more spastic.
  25. As my B12 came into the 200 levels, my numbness and tingling moved from my core (upper arms, spine, hips) down to the lower half of of my arms and hands, and my calves and feet, which hadn’t really been affected before the first B12 shot.
  26. Hives: While I didn’t have this symptoms myself, I have read that it is related to B12 and have a friend with both low B12 and occasional outbreaks of hives. (updated 2012 – I got hives!  Not sure if it’s related to low b12, but started getting them several months after this post)
  27. Severely dry hair and hands.
  28. Bloating in the tummy area after stress – like seriously jiggly, like I was retaining a bucket of water. Would wake up with a flat stomach but after the slightest stress, would bloat again! Weird.


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Originally published on May 21, 2010:

Okay, I just had a bath and I noticed that the veins in my legs, particularly my thighs, are more blue and pronounced. I had noticed this with my pregnancy (which I lost in December, 2009) and it never seemed to go away. It looks like it got worse recently. Hmm, can’t find any information on the web about this correlation, but I have a hard time finding another cause for it! I remember reading something about increase blood volume in Graves patients,  which could put a strain on one’s veins,…hmm, surprises around every corner with this disease. No shorts this summer!

To read more about the onset and how confusing it was, click here:

I now think the cause was my cortisol levels (adrenal surge and then adrenal insufficiency). Too much cortisol causes vasoconstriction. Too little, or adrenal insufficiency, causes widespread vasodilation!

Note that after the flare up I had bright, blue and slightly swollen veins, which were also tender to touch (felt bruised ) in my thighs, chest, hands and feet. All doctors said they were nothing to worry about because there was no redness or bulging. I knew it was not normal. I also noticed mild swelling in these areas too. My ring finger would often be too swollen to wear my ring (this has never happened before).

Updated June 29, 2011

Unbelievable, but I now think I have officially solved the mystery of the big, blue veins! B12 deficiency and anemia!  I got a call from my doctor yesterday telling me that the results of my last blood test showed that I am:

  • B12 deficient
  • Anemic (low ferritin, low hemoglobin, macrocytic)
  • hypocalcemia

From what I’ve read, some people get big, blue veins when they’re anemic (B12 specifically, which results in anemia). I have swelling in my arms, face, legs, stomach, back, ankles… Apparently, when blood levels are low in protein (hemoglobin?), some process of osmosis draws fluids from your muscles – resulting in swelling, or edema. My upper arms felt heavy, watery, jiggly.  I don’t know how I could have these symptoms for 6 months, and be 5 months pregnant and not have this diagnosed sooner. I had read all about I didn’t bring it up to the doctor because this seemed like a first line of defence answer – simple blood test could have ruled it out months ago. They tested for lupus but not this?!

Update July 24, 2011

Blue veins are a by-product of b12 deficiency, which leads to an increase in homocysteine levels.
Tingling? B12 deficiency symptoms commonly ignored by doctors

Vitamin B12 assists circulatory lowering concentrations of homocysteine. Homocysteine is a naturally occurring amino acid. When homocysteine levels build up in the bloodstream, they interfere with the methylation reactions that remove toxic levels of homocysteine. High homocysteine levels hurt the heart. Some scientists even believe that high homocysteine levels may be even more damaging than high cholesterol levels.

High homocysteine levels decrease vascular elasticity, resulting in veins losing their elasticity, making it harder for them to dilate, and damaging their inner lining – leading to atherosclerotic plaques (cholesterol, collegen, and calcium).

Result: puts you at risk for coronary artery disease, heart attacks, strokes, “mini strokes” (transient eschemic attacks, or TIAs), blood clots (pulmonary embolism, deep vein thrombosis), carotid and renal artery stenosis (narrowing), or aneurysms (ballooning of damaged blood vessels). It also promotes abnormal blood clotting.


  • high doses of B vitamins: folate, B6 and B12.
  • Vitamin B12 helps the body convert harmful homocysteine into harmless methionine.

When vitamin B 12 goes through its own methylation reaction it becomes methylcobalamin. This form of B12 is superior to other forms of the item in that it does not have to be activated before it starts its work.

Methylcobalamin is a super nutrient for the brain. It protects the brain from the ill effects of aspartame, glutamate, and nitric oxide. It also saves the brain form the damaging effects of poor circulation and hypoglycemia.

Glutamate and nitric oxide toxicity are hallmarks of both Parkinson’s and Alzheimer’s disease. Poor circulation and the resulting low levels of oxygenation is a chronic problem after heart attack or stroke. Low blood sugar is a constant risk in well-treated diabetes.

Methylcobalamin also protects myelin, the “insulation” for cells throughout the central nervous system. Degeneration of the myelin layer is implicated in most cases of memory loss and progressive diseases like multiple sclerosis, Lou Gehrig’s disease (amyotrophic lateral sclerosis), and degeneration of the spinal cord. The information on vitamin B12 recently discovered by French scientists is that the methylcobalamin form of the nutrient promotes regeneration of the insulating myelin and slows the progression of these diseases.



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January 2011: So when my right thigh felt a little numb, I attributed it to the long walk in the snow I did the night before. “Must have a muscle spasm” I thought.  When the next day I got numbness in my face (twitching of the muscle between my jaw and eyes with a knot/hard ball on the jaw), yes, momentary panic, and then, “I have a really big knot in my back, leading to my neck. That must be it.”  When the symptoms continued overnight and I awoke with my entire right side feeling tingly, I freaked and went to the emergency room. Autoimmune disorders run in my family. I have a cousin with MS and to be honest, it is my biggest fear.


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