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Suggest Treatment For Dizziness, Tremors And Tingling Sensation

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Posted on Tue, 7 Oct 2014
Question: Im a male of 28years and i was struggling with unsteady gait-24/7/dizzy(dizziness-rarely) for past 3years however i have been to different doctors/hospitals took several medications/exercises ,big hospitals like CMC,but unfortunately no one was able to identify the exact root cause,lately in April 2014 i had a serious illness like tremors and tingling sensations palpitations,strong intense fear, and i was admitted for a day and the DOC said m Anaemic and after which i went to a small very small clinic their the Doc said to check Vitamin b12 and he found that vit b12 was very low it was 367, and he gave me shots for a week(5injections) and after that i started to eat all greens,milks etc etc m a non veg guy,and surprisingly my unsteady gait started to improve and tingling/tremors all started to dissapear,and after 4months now jus 3weeks back again i felt fatigue extremely fatigue very weak and tingling sensation,i went to the doc in manipal he asked me to check my vit b12 and Vit D and CBC And CRP test,
i have done all and below are the values
01), vit b12 - 220
02)Vit d- 14
3)CRP -4.9

and he prescribed me
-Rejuneuron-500mcg injections for 6 weeks ,weekly once for vitb12
-Arachitol 6lakhs injection for Vit D
And prescriped Tablets for 3months
Becozules tablet -1-0-0
shelcal 500mg- 0-1-0
Pregalin sr 75mg - 0-0-1
Could you please tell me how long it will take for me to get cured and will my unsteady gait be cured (ataxia)
doctor
Answered by Dr. Suresh Heijebu (1 hour later)
Brief Answer:
3-5 months is needed for recovery

Detailed Answer:
Hi sir,
I have carefully read your query and understand your concern.

Going by your symptoms of ataxia and abnormal sensory symptoms,it can be clearly attributed to a specific syndrome of vitamin b12 deficiency called SUB ACUTE COMBINED DEGENERATION OF CORD.

You seem to have low levels of vit D and b12 along with elevated levels of CRP.

You are currently receiving an excellent treatment for your condition.
Its just perfect and will hasten your recovery.

It may take 3-5 months from here on for complete recovery and cure of your ataxia.

This can be monitored by periodic assessment of serum MMA/methyl malonic acid levels.Their levels are good indicators of CLINICAL recovery.

Consume diet rich in potassium and b12 like eggs,meat and soya beans.

Methionine rich foods like asparagus and mushrooms can help to improve ataxia quite quickly.

I hope this info is helpful to you
Thank you
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Suresh Heijebu (13 minutes later)
Thank you for your reply. Well m jus curious to knw if my CRP levels are high what does that indicate. And when you say MMA levels how do I monitor that? And do you think if I have b12 absorption problem? If so taking tablets like becosules would benefit? And should I take these medications life long. And since I had ataxia for 3 years can this condition be completely reversed now? I went through a lot of stress in my personal life , so would stress deplete my b12 levels!?? And m a married person can I plan for a kid at these conditions?
doctor
Answered by Dr. Suresh Heijebu (6 hours later)
Brief Answer:
Potential cure possible

Detailed Answer:
Hi SIR,
Welcome back,

let me clarify all your doubts once for all.

Sub acute cord degeneration is an absolutely a reversible condition in early stages.

The feature of you responding excellently to injections of vit b12 with resolution of your symptoms to a large extent is a very favourable sign which indicates potential cure.

Elevated CRP is secondary to deficiency in b12 which leads to elevated MMA and homocysteine.

These intermediate products lead to elevated CRP.

This CRP come down to normal levels once B12 deficiency is corrected completely.

Measurement of MMA is a blood test is a better indicator of b12 replenishment than serum b12 levels.

This is a blood test and can be done at any sophisticated medical laboratories.

I do not think you have any absorption problems with B12 AS PER YOUR CLINICAL HISTORY unless you had any autoimmune disease or gastric surgery.

But in case you a need a confirmation of this ,you can undergo SChling's test done at your local laboratories.

Becosules are no where concerned with your b12 deficiency or absorption.

These drugs need not be taken for life long.
A b12 supplementation of 1-2 yrs is just more than adequate for the rest of your life provided you regularly consume animal foods.

This condition is potentially reversible even now ,but it take sometime.

Stress do not contribute any deficiency of B12.

I advice you to have your kids once after this treatment schedule is completed.
Ideal time period would be after 2 years from now once you completely recover.

I hope this info is helpful to you ,
Thank you


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Suresh Heijebu (10 hours later)
Thanks for your reply, we'll m really struggling a lot lot , it's been 25 days I state the treatment and already 4 injections are over another 2 to go, but the improvement is very little . Will it take time to recover, from morning I feel extreme fatigue can't even stand so weak I feel with slight tingling sensation. M really wondering if the injections are working. Please let me knw if the symptoms will come and go now? Before getting stable.? Can lots of masturbation deplete b12? My haemoglobin was 11.5 before the treatment now it's 13.4 . What's the reason that I feel extremely fatigue, I feel my hands and legs don have life in them
doctor
Answered by Dr. Suresh Heijebu (1 hour later)
Brief Answer:
1000 mcg of B12 IS NEEDED

Detailed Answer:
HI, XXXXXXX

I understand your concern.

The feelings of extreme fatigue and loss of strength in the arms can point to coexistent both neurological and non neurological effects of SCD of spinal cord.

The reason for this would be coexistent, undetected hematological abnormalities in the blood.

Symptoms will be fluctuating in course and it takes time to initiate nerve repair and conduction.

Hence the symptoms can come and go before getting stabilized.

For a speed onset of recovery advice inj b12 1000 mcg daily im for 5 days followed by Inj B12 1000 mcg once a week for 5 weeks then followed by 1000 mcg once a month for life.

This is the standard protocol of management.

1000mcg daily yields a daily absorption of 10mcg of B12 which exceeds the 2mcg recommended daily allowance.

I strongly recommend you to take Inj Methylcobalamin which is the standard, stable and active form of B12.

Your current B12 dosage is insufficient. Hence response may be delayed.

Since anemia can be a complication with this vitamin deficiency a 6 month course of oral iron plus folic acid supplementation (tab conviron forte) is strongly needed even though you have normal HB%.

This treatment corrects any unnoticed coexistent hematological abnormalities in SCD.

NOTE: all the mentioned drugs above should be taken only under strict medical supervision of your doctor.

Masturbation in no circumstances can deplete Vit B12 levels.

I hope this info is helpful to you,
Thank you

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
Answered by
Dr.
Dr. Suresh Heijebu

Psychiatrist

Practicing since :2010

Answered : 3646 Questions

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Suggest Treatment For Dizziness, Tremors And Tingling Sensation

Brief Answer: 3-5 months is needed for recovery Detailed Answer: Hi sir, I have carefully read your query and understand your concern. Going by your symptoms of ataxia and abnormal sensory symptoms,it can be clearly attributed to a specific syndrome of vitamin b12 deficiency called SUB ACUTE COMBINED DEGENERATION OF CORD. You seem to have low levels of vit D and b12 along with elevated levels of CRP. You are currently receiving an excellent treatment for your condition. Its just perfect and will hasten your recovery. It may take 3-5 months from here on for complete recovery and cure of your ataxia. This can be monitored by periodic assessment of serum MMA/methyl malonic acid levels.Their levels are good indicators of CLINICAL recovery. Consume diet rich in potassium and b12 like eggs,meat and soya beans. Methionine rich foods like asparagus and mushrooms can help to improve ataxia quite quickly. I hope this info is helpful to you Thank you