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Delayed and irregular period. Suffered postnatal depression, have anxiety issues. Why do I have rapid heart rate and weakness?

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General & Family Physician
Practicing since : 2004
Answered : 1722 Questions
I am 32, weight 11s9lb, height 5ft5".
I went to the docs the other day as I have not had a period since Feb 11th, one before that was start of Dec and they have been fairly irregular through the last yr.
Was always regular before. I am not pregnant, the doc found a bladder infection though.

I had period like cramps a week ago and thought I would be coming on and I had shooting cramping pains down my legs and into my calves for 3 hours. The next day still no period.

The dr mentioned that a blood test a couple of yrs ago showed low vitb12 but I was not told of this at the time as it was borderline. She has sent me for FBC and blood tests which I had done today. Since then I checked out symptoms of Vit b12 def and it is like a light went on in my head! There are so many things I have been treated for seperately or that I have suffered in silence with as I had just put them down to life or just ignored them.
I have been thinking back over the past few years and have clocked up a lot of symptoms.

I have at various times throughout the past decade suffered blackouts and was sent for a CT scan, nothing found and put down to stress.

I suffered badly with postnatal depression after both my children, 11 years ago and 6 yrs ago. I suffer with panic attacks and extreme anxiety issues still. I put that down to stress as I run my own business. I can be extremely irratible and volatile in my emotions which I hate.

I had a cholecystectomy 3 yrs ago (even though there was only 1 small gallstone on the scan which the consultant could not understand was causing me so much pain and I was of slim build and did not have a fatty diet) the procedure went perfectly well.

About 12 months ago I had an attack of very rapid heartrate, the ambulance came and monitored me they said the heartrate was very fast and I had very low blood sugar (although I had eaten only an hour before it started - I was only sitting down watching TV when the attack came on), I was taken to casualty by the paramedics, whilst waiting to be seen the heartrate slowed right down and the Dr then told me it was just down to Atrophic Gastritis or a panic attack. (I know it was NOT a panic attack as I have suffered them and I was very relaxed and comfortable at the time) I very occassionally have palpitations from time to time.

I suffer badly with heartburn, indegestion and gas, and often feel bloated throughout the day.

I find it hard to switch off and suffer insomnia or get incredibly tired very quickly, my body aches most days. I always have very cold hands and feet, often get foot and big toe cramps and incredibly itchy shins.

Recently I have felt spaced out when working - like I have just gone "inside my head" and zoned out in a cocoon type place - it feels very trippy. Have also had tingling at base of neck. I often suffer with headaches - but I always have.

I get stiff and sore neck and bad back - but have put it down to stooping over working (I am a cake artist so do a lot of this)

I have trouble finishing sentences and sometimes forget words for things. I have become incredibly forgetful.

I feel unfit, I always walk and wii fit a lot, recently at a new gym I went on the cross trainer next to my sister who is 3 stone heavier than me and we are as active as each other, I was out of breath and had to stop within 5 mins, she did the full 20 mins. I also get out of breath going up 2 flights of stairs.

I can no longer tolerate alcohol - (i have never been a big drinker anyway) but now 1 small glass of wine can make me feel like I had 3 bottles of it the following morning. It makes me feel extremely nauseous.

Should I tell my doctor all these symptoms - could this be Pernicious Anemia/Vitb12 def related?

What if the test comes back as borderline/normal again? Should I push for more tests? I feel so relieved that all these things could be attributed to one thing as I have alway s felt like I moan all the time to my husband about aches/pains/tiredness/depression/anxiety that he gets fed up of it.

I am a go getter and a very driven person by nature, please help me to get back that spark I feel has gone!!
Posted Tue, 22 May 2012 in Blood Disorders
Answered by Dr. Chakravarthy Mazumdar 6 hours later

I understand that you are facing a multitude of health issues and trying to find out the best reason for the same. Most often it is not right to draw a single diagnosis with all the symptoms that you have. One cause for a long time can lead to further complications if undetected and treated. So the sequence of the problems from the earliest to the latest is to be probed with good history and necessary tests to determine the first reason and a cycle of reasons. Sometimes there are more than one reason.

Since your questions and thoughts are mainly about the Serum B12 levels and symptoms that the person exhibits along with high risk factors. The symptoms that you expressed here are related to it. The tests that were done earlier determined borderline deficiency. As you were taking a course of medications for long time and there are few gut problems there is a possibility for risk of Vit B12 deficiency. You are just displaying neurological symptoms similar to the ones that occur in mild Vit B12 deficiency. Muscle cramps, memory loss, shock like pains along the thighs are few.

Generally, serum vitamin B12 can be broken down into 3 values:
Likely vitamin B12 deficiency: <148 picomols/L (<200 picograms/mL); we generally start empirical treatment without waiting.

Possible vitamin B12 deficiency: 148 to 258 picomols/L (201 to 350 picograms/mL); An astute physician further probes with the use of tissue deficiency markers such as homocysteine, methylmalonic acid (MMA), and holotranscobalamin.
Unlikely vitamin B12 deficiency: >258 picomols/L (>350 picograms/mL).

You were complaining not able to exercise for long which can be anemia. A full blood count with peripheral smear is useful to determine whether there is evidence of macrocytosis (increased RBC size) and XXXXXXX anaemia, leukopenia (low WBC), or thrombocytopenia (low platelet count). This suggests a more severe and prolonged vitamin B12 deficiency.

Once the Vitamin B12 deficiency is confirmed we can find out the reason for it like Pernicious anemia with Intrinsic factor levels in the blood and anti parietal cell antibody.

I think your treating doctor should start the Vitamin B12 supplements which will not harm you even if you are not deficient.

Finally I suggest a check for thyroid hormone levels, a consult with Psychiatrist should be of great help too.

Hope this helps.
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