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Suggest Treatment For Pernicious Anemia
Question: I was diagnosed with pernicious anemia (via shillings test) around 35 years ago. Since that time I have developed chronic uticaria, asthma and hashimoto's disease. My doctor keeps telling me that my bloodwork shows no sign of pernicious anemia. However, when not taking my B12 injections I develop symptons similar to the symptoms of essential tremor. I get terrible tremors in my hands, chin and face and can't write my name at times. This is so embarrasing and scary! Can you tell me if these are all related in some way? I am worried at times that I might even be developing parkinsons because of these tremors.
Brief Answer:
get done vitamin b 12 level.
Detailed Answer:
Hello dear, thanks for your question on HCM.
I can understand your situation and problem.
I want to know which inhaler you are using for asthma, I mean which drug?
I advice you to get done Serum B12 level tested at the time of tremors. If it is normal, then pernicious anemia is not cause for your tremors.
So we need to think other causes. I can think of two reasons in your case.
1. Side effect of inhalers. If your inhaler contains salbutamol or levosalbutamol then possibility of tremors as a side effect of these drugs is high.
2. Hyperthyroidism. Hashimoto's thyroiditis can precipitate in stressful conditions and secrete more thyroid hormones. This excess T3 and T4 can cause tremors. So get done S.TSH and free T3 and T4 for the diagnosis of this.
Let me know your inhaler details, so that I can guide you further.
I will be happy to help you further.
Wish you good health.
Thanks.
get done vitamin b 12 level.
Detailed Answer:
Hello dear, thanks for your question on HCM.
I can understand your situation and problem.
I want to know which inhaler you are using for asthma, I mean which drug?
I advice you to get done Serum B12 level tested at the time of tremors. If it is normal, then pernicious anemia is not cause for your tremors.
So we need to think other causes. I can think of two reasons in your case.
1. Side effect of inhalers. If your inhaler contains salbutamol or levosalbutamol then possibility of tremors as a side effect of these drugs is high.
2. Hyperthyroidism. Hashimoto's thyroiditis can precipitate in stressful conditions and secrete more thyroid hormones. This excess T3 and T4 can cause tremors. So get done S.TSH and free T3 and T4 for the diagnosis of this.
Let me know your inhaler details, so that I can guide you further.
I will be happy to help you further.
Wish you good health.
Thanks.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thank you.. I am on Advair 250 (which I will be giving up soon because of the cost!). I use it at bedtime only. My endocrinologist watches my T3 and T4 and does not think that my hashimotos is causing any tremors.
Brief Answer:
Then consult neurologist.
Detailed Answer:
Hello dear, thanks for your follow up question.
Advair is combination of salmeterol and fluticasone. Salmeterol is LABA (long acting beta 2 agonist) and fluticasone is inhaled corticosteroids (ICS). Both are excellent drugs for asthma. You should continue this.
Less chances of tremors due to these medications
And less chances of thyroid too
So better to consult neurologist and get done clinical examination.
It might be intentional tremors or parkinson's tremors.
For this, detailed neurological examination is needed.
So consult neurologist and discuss all these.
Hope I have solved your query.
If you are not having further queries, please close the conversation and rate the answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health.
Thanks.
Then consult neurologist.
Detailed Answer:
Hello dear, thanks for your follow up question.
Advair is combination of salmeterol and fluticasone. Salmeterol is LABA (long acting beta 2 agonist) and fluticasone is inhaled corticosteroids (ICS). Both are excellent drugs for asthma. You should continue this.
Less chances of tremors due to these medications
And less chances of thyroid too
So better to consult neurologist and get done clinical examination.
It might be intentional tremors or parkinson's tremors.
For this, detailed neurological examination is needed.
So consult neurologist and discuss all these.
Hope I have solved your query.
If you are not having further queries, please close the conversation and rate the answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health.
Thanks.
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Answered by
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