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What Causes Lethargy, Increased Sleep And Dizziness?
Question: Background
Well,it all started in the year 2011 3years back where i used to feel Dizzy often(once in 2 months) and i thot it might be due to dehydration or my stomach is empty.
i used to rest for a while and the dizziness would disappear
As the days passed i felt unsteady and my balance was affected i could not stand straight but my body used to keep shaking/jerking
my unsteadiness turned worst that it was very hard for me to sit before the computer even when i sit i used to have unsteadiness.or gait problem.
Ive seen different doctors like CMC hospital ,st Johns etc etc they said its vertigo and i have problem with my inner ear which affected my balance.
i lost all the hope and i got married in 2013 December jus 10months back,after which i started feeling tingling sensation all over My body
with severe fatigue and weak, i couldnt even go alone anywhere as the tingling turned worst and i got scared and started devaloping fear and nervousness.
i went to a small clinic and their Doc said to test B12 and i found that it was 350 and doc said this is the causeand gave me b12 shots for a week and left it
i felt better my balance problem started to improve and i forgot about it as i felt better but never knew nor the Doc said that i should take the supplements.
And after 2 months again i felt very weak and tinglish
i went to Manipal hospital and there the Doc diagnoised that my vitb12 was jus 220 and my vitamin D was 14..
he started the below medicines and i started them on Aug 23rd
*****************************************************************
Rejunuron 500mcg injection for 6 weeks weekly once
Arachitol 6lakhs for vit d deficiency for 6 weeks aweekly once
and along with the below supplements for 3 months
BECOSULES Z capsule in the morning after breakfast (which has 15mcg of b12)
Shelcal 500mg in the Afternoon after lunch (250IU of Vit D)
Pregalin Sr 75 in the night after dinner
For sure i can feel much improvement in my balance and i started feeling better
but pregalin tablet is tossing me upside down
i started these medicines 2months back and pregalin tablet makes me drowsy fatigue feeling weak,
i feel that i shoould have 10hrs sleep or else i cant manage the next day
i feel so nervous and panic, andmy legs and palms feel so weak
is this a side effect of pregalin? and since doc prescribed for 3months can i stop the medicine now cos its been 2 months im taking.
pregalin makes me drowsy and sleepy and i feel lethargic with tingling sensation and nervousness.
And will all the above symptoms disappear ?? and how long it would take for the below symptoms caused due to vit b12 deficiency or pregalin to disappear?
And also is there any good b12 supplement that i can use like higher doses since in becosules Z amount of b12 is jus 15mscg.
like any imported Supplement of 1000mcg that in can use?
Please advise
the symptoms drives me crazy i cant be as normal person
Well,it all started in the year 2011 3years back where i used to feel Dizzy often(once in 2 months) and i thot it might be due to dehydration or my stomach is empty.
i used to rest for a while and the dizziness would disappear
As the days passed i felt unsteady and my balance was affected i could not stand straight but my body used to keep shaking/jerking
my unsteadiness turned worst that it was very hard for me to sit before the computer even when i sit i used to have unsteadiness.or gait problem.
Ive seen different doctors like CMC hospital ,st Johns etc etc they said its vertigo and i have problem with my inner ear which affected my balance.
i lost all the hope and i got married in 2013 December jus 10months back,after which i started feeling tingling sensation all over My body
with severe fatigue and weak, i couldnt even go alone anywhere as the tingling turned worst and i got scared and started devaloping fear and nervousness.
i went to a small clinic and their Doc said to test B12 and i found that it was 350 and doc said this is the causeand gave me b12 shots for a week and left it
i felt better my balance problem started to improve and i forgot about it as i felt better but never knew nor the Doc said that i should take the supplements.
And after 2 months again i felt very weak and tinglish
i went to Manipal hospital and there the Doc diagnoised that my vitb12 was jus 220 and my vitamin D was 14..
he started the below medicines and i started them on Aug 23rd
*****************************************************************
Rejunuron 500mcg injection for 6 weeks weekly once
Arachitol 6lakhs for vit d deficiency for 6 weeks aweekly once
and along with the below supplements for 3 months
BECOSULES Z capsule in the morning after breakfast (which has 15mcg of b12)
Shelcal 500mg in the Afternoon after lunch (250IU of Vit D)
Pregalin Sr 75 in the night after dinner
For sure i can feel much improvement in my balance and i started feeling better
but pregalin tablet is tossing me upside down
i started these medicines 2months back and pregalin tablet makes me drowsy fatigue feeling weak,
i feel that i shoould have 10hrs sleep or else i cant manage the next day
i feel so nervous and panic, andmy legs and palms feel so weak
is this a side effect of pregalin? and since doc prescribed for 3months can i stop the medicine now cos its been 2 months im taking.
pregalin makes me drowsy and sleepy and i feel lethargic with tingling sensation and nervousness.
And will all the above symptoms disappear ?? and how long it would take for the below symptoms caused due to vit b12 deficiency or pregalin to disappear?
And also is there any good b12 supplement that i can use like higher doses since in becosules Z amount of b12 is jus 15mscg.
like any imported Supplement of 1000mcg that in can use?
Please advise
the symptoms drives me crazy i cant be as normal person
Brief Answer:
Treatment plan changes needed.
Detailed Answer:
Hello there.
I am Dr.Senduran,general physician hope to answer your query.
I have gone through the history carefully..
In my opinion,both pregabalin SR,ineffective vitamin B12 replacement therapy could be the reason for the symptoms you are experiencing.
Especially lethargy,increased sleep,dizziness is common with pregabalin..
If I am your treating physician,would advise you initially to taper the dose of pregabalin gradually over weeks as 50 mg,then 25 mg.Abrupt cessation of drug can cause symtoms of CNS excitation like mental confusion, seizures,agitation etc and should be avoided.
Also I would advice you to recheck the vitamin B12 level once again.Depending on the report,parenteral therapy may be restarted with maintenance dose to replenish the B12 levels in the body mainly in liver if levels on the lower side.Or else oral therapy with dosage of 500mcg to 1000 mcg would be needed if levels on the upper normal border in your case.The B12 replacement therapy should be continued for atleast 3 - 6 months which is based on the clinical recovery and also the lab values.
Mega strength vitamin B12 tablets are less available in XXXXXXX .There are brands like Health aid megastrength 1000mcg(should be available),Rugby(cyanocobalamin 500mcg) etc.
You need not be worried .The symptoms should resolve gradually with proper treatment. I would advice you to discuss this with your treating doctor in order to effectively manage the situation.
You can also encourage animal food products like liver,kidney,meat etc if you are a non-vegeterian.
Hope this information helps you.If any questions, don't hesitate to ask.
Wish you speedy recovery and good health.
Take care.
Treatment plan changes needed.
Detailed Answer:
Hello there.
I am Dr.Senduran,general physician hope to answer your query.
I have gone through the history carefully..
In my opinion,both pregabalin SR,ineffective vitamin B12 replacement therapy could be the reason for the symptoms you are experiencing.
Especially lethargy,increased sleep,dizziness is common with pregabalin..
If I am your treating physician,would advise you initially to taper the dose of pregabalin gradually over weeks as 50 mg,then 25 mg.Abrupt cessation of drug can cause symtoms of CNS excitation like mental confusion, seizures,agitation etc and should be avoided.
Also I would advice you to recheck the vitamin B12 level once again.Depending on the report,parenteral therapy may be restarted with maintenance dose to replenish the B12 levels in the body mainly in liver if levels on the lower side.Or else oral therapy with dosage of 500mcg to 1000 mcg would be needed if levels on the upper normal border in your case.The B12 replacement therapy should be continued for atleast 3 - 6 months which is based on the clinical recovery and also the lab values.
Mega strength vitamin B12 tablets are less available in XXXXXXX .There are brands like Health aid megastrength 1000mcg(should be available),Rugby(cyanocobalamin 500mcg) etc.
You need not be worried .The symptoms should resolve gradually with proper treatment. I would advice you to discuss this with your treating doctor in order to effectively manage the situation.
You can also encourage animal food products like liver,kidney,meat etc if you are a non-vegeterian.
Hope this information helps you.If any questions, don't hesitate to ask.
Wish you speedy recovery and good health.
Take care.
Above answer was peer-reviewed by :
Dr. Raju A.T
Thanks or your reply.. Well the mega strength from health aid would be a cynaide form and not methyl .. Now a days everyone prefers methylcobalamin . I have a friend in UK who can get this b12 supplement from health aid. But would this be effective as it's a cynaide form?
Or do you recommend and other good methyl supplements?
If the current symptoms are due to pregabalin and since hardly another one month to go to complete the course,after stopping taking pregabalin will the symptoms of dizziness lethargic go away?
And if the other symptoms like tingling, nervousness, unsteadiness are due to vit b12 ,are these are reversible ? If so how long it will take
Today I'll get my b12 again..
Or do you recommend and other good methyl supplements?
If the current symptoms are due to pregabalin and since hardly another one month to go to complete the course,after stopping taking pregabalin will the symptoms of dizziness lethargic go away?
And if the other symptoms like tingling, nervousness, unsteadiness are due to vit b12 ,are these are reversible ? If so how long it will take
Today I'll get my b12 again..
Brief Answer:
B12 deficiency symptoms are reversible
Detailed Answer:
Hello again,
Both cyanocobalamin and methylcobalamin should work fine.Most of the OTC supplements contain cyanocobalamin as its active ingredient and is inexpensive.So i would prefer my patients initially with those.But if you ask about effectiveness in therapy,i too would give little more preference to methyl supplement.You can go for mecobalamin( USA brand) and in XXXXXXX please check the availability of neuromin tablet 500mcg at your place.
As you gradually taper the dosage of pregabalin,lethargy and drowsiness should starts to improve.
Complete B12 replacement therapy depends on progress of serum B12 lab values and clinical symptoms.
With effective replacement,the symptoms of B12 deficiency gradually gets better within 2-3 months of therapy and for complete replenishment may need maintenance therapy up to 4-6 months.This duration however varies with various factors like tolerance,maintenance dose etc.
Hope this answers your query.Take care.
B12 deficiency symptoms are reversible
Detailed Answer:
Hello again,
Both cyanocobalamin and methylcobalamin should work fine.Most of the OTC supplements contain cyanocobalamin as its active ingredient and is inexpensive.So i would prefer my patients initially with those.But if you ask about effectiveness in therapy,i too would give little more preference to methyl supplement.You can go for mecobalamin( USA brand) and in XXXXXXX please check the availability of neuromin tablet 500mcg at your place.
As you gradually taper the dosage of pregabalin,lethargy and drowsiness should starts to improve.
Complete B12 replacement therapy depends on progress of serum B12 lab values and clinical symptoms.
With effective replacement,the symptoms of B12 deficiency gradually gets better within 2-3 months of therapy and for complete replenishment may need maintenance therapy up to 4-6 months.This duration however varies with various factors like tolerance,maintenance dose etc.
Hope this answers your query.Take care.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thanks.. I plan to buy
Jarrow Formulas methyl b12 1000mcg lemon flavour supplement hope this should be good. It's US brand.
Please advise
And also I've mentioned that my Vit D also which is very low just 14
Any comment on this?
Is shelcal 500mg is okay which has 250IU of d3 vit. And also weekly 4 times I stand in the sun for half an hr. In the afternoon between 12-3 .
Thanks for the comments on pregalin.
Will pregalin cause anxiety/panic simply for no reason?
Since now taking one tablet . Can I take half tab from today and slowly after that I'll take once in 2 days and than stop. Is that fine ?
Jarrow Formulas methyl b12 1000mcg lemon flavour supplement hope this should be good. It's US brand.
Please advise
And also I've mentioned that my Vit D also which is very low just 14
Any comment on this?
Is shelcal 500mg is okay which has 250IU of d3 vit. And also weekly 4 times I stand in the sun for half an hr. In the afternoon between 12-3 .
Thanks for the comments on pregalin.
Will pregalin cause anxiety/panic simply for no reason?
Since now taking one tablet . Can I take half tab from today and slowly after that I'll take once in 2 days and than stop. Is that fine ?
Brief Answer:
After getting opinion from your treating doctor..
Detailed Answer:
Hello again,
Yes, Sub lingual formulation like Jarrow's formula would be a better option to try. As oral tablet's bioavailability is less due to its inadequate absorption and first pass metabolism. However I would advise you to get a 500mcg to avoid overdose and would be easy to increase or decrease the frequency on the basis of outcome.
Regarding Shelcal D 500, no need to change at present especially when you are planning to taper down dosage of pregabalin. You can check your serum calcium, vitamin D levels after a month and revise the regimen if needed. Encourage dairy products like cheese in diet, better to stand in morning sun too.
Pregabalin is associated rarely with CNS symptoms like other medications acting on the CNS. But with appropriate usage, these are preventable.
If I am your treating physician, would advice to titrate your full present daily dose of 75mg to three divided doses of plain pregabalin plain tablet 25 mg(thrice a day) for initial 2 days. This is because, you are on sustained release tablets(which works slowly throughout the day) which is not advisable to break and consume. Hope you understand my point.
I would strongly suggest you to discuss above with your treating doctor and decide further about any alteration in the management. You can also send me once you get B12 report.
Hope this information helps you.
If any concern, reply back Or else close this discussion and rate it please.
After getting opinion from your treating doctor..
Detailed Answer:
Hello again,
Yes, Sub lingual formulation like Jarrow's formula would be a better option to try. As oral tablet's bioavailability is less due to its inadequate absorption and first pass metabolism. However I would advise you to get a 500mcg to avoid overdose and would be easy to increase or decrease the frequency on the basis of outcome.
Regarding Shelcal D 500, no need to change at present especially when you are planning to taper down dosage of pregabalin. You can check your serum calcium, vitamin D levels after a month and revise the regimen if needed. Encourage dairy products like cheese in diet, better to stand in morning sun too.
Pregabalin is associated rarely with CNS symptoms like other medications acting on the CNS. But with appropriate usage, these are preventable.
If I am your treating physician, would advice to titrate your full present daily dose of 75mg to three divided doses of plain pregabalin plain tablet 25 mg(thrice a day) for initial 2 days. This is because, you are on sustained release tablets(which works slowly throughout the day) which is not advisable to break and consume. Hope you understand my point.
I would strongly suggest you to discuss above with your treating doctor and decide further about any alteration in the management. You can also send me once you get B12 report.
Hope this information helps you.
If any concern, reply back Or else close this discussion and rate it please.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
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