MS or B12?

[NJgirl75]

I am a 36 year old female with no family history of MS. In June 2011 I was diagnosed with B12 deficiency after I become off balanced & inner ear was ruled out. My numbers were 163. My last blood test was in November & came back as 505. I believe I have been deficient for 6 years, this is as far back as I can remember having symptoms that doctors could not explain. I have off & on numbness, tingling, burning, vibrations, etc Everywhere from my legs, feet, hands, back.In Sept, our of nowhere, I had numbness from the rib cage to the hip, right side only that wrapped from the middle of my abdomen to my spine. The numbness went away but I developed horrible back pain that has not gone away.

My neuro did am EMG and lumbar MRI that were normal. Cervical showed possible lesion at the T2. So I underwent MRI for brain, cervical & thoracic spine. Brain showed some lesions that the neuro said looked like those from migraines which I have had since a child. Spinal showed "small T2 hyperintense focus posteriorly toward the right in the cord." and "level of T4-T5 there is a lesion which extends for the craniocaudal length of 5mm. There is also slight thinning of the cord at this level. There is no evidence of cord compression." The T4-5 is where I experience the most pain & a feeling of pressure.

My doctor sounds like he has made up his mind it's MS, he wants a spinal tap but says even if they don't find anything, it doesn't mean anything. I told him that I have researched B12 deficiency & that it can mimic MS because it causes demyelination. He did not want to consider this. I would like your opinion on this matter. I am also thinking of getting a 2nd opinion. I'd also like to know, if this is from the lack of B12, as my numbers are restored, is it possible the lesion in the spine could go away & hopefully the pain with it? I know sometimes if you are deficient too long it can lead to permanent damage.

Thank you very much!

[Certainlysue]

A related discussion, MS and B12 Deficiency was started.

[snowangel122961]

I just reread you post and sure enough you have a lot of symptoms that would lead you to believe you may have MS...please get to yourself to a good doctor.  You can start taking B-12 now and see if that does help..

[snowangel122961]

I have M.S. and the only confirm way to diagnose MS is the spinal tap, and the MRI with contrast.  

I can also say that the deficiency of B-12 goes along with having MS.  We can't store it in our bodies.  I found this out when I became very augmentative with my boss.  My personality changed.  Until my interest ran a full vitamin and mineral test.  Sure enough I had no B-12 in my body.  Now I take it every day and if I miss for a few days, sure enough I remember since I start being not a nice person again.  Find a neurologist, have the test for B-12 and get to the bottom of this.

You didn't say what caused you to think you had MS...I went blind (have my site back thank's to my Ophthalmologist and my neurologist.  Put me in the hospital and pumped me with steroids.  That saved my sight.

good luck

[NJgirl75]

Thank you Dr. Kumar. Unfortunately, these are all initial MRI, no follow ups have been done yet or suggested.

[Shiv Kumar, MD]

Dear NJgirl75,

Diagnosis of MS is based on clinical symptoms, MRI findings and exclusion of other disease which mimic MS. One of them is Vit B12 deficiency. Usually B12 deficiency presents with symptoms of peripheral neuropathy and sensory ataxia. Rarely, it can present with memory problems and psychiatric disorders. Evidence like low levels of B12 and reversal of symptoms after correction would favor Vit B12 deficiency. But normal EMG in Vit B12 deficiency is odd.

One should always consider the possibility of MS when MRI shows features of multifocal demyelination in the spinal cord and brain. If the follow up MRI shows new lesions with contrast enhancement I would say it supports the diagnosis of MS.

So I personally feel if follow up MRI shows new and contrast enhancing T2 hyperintense lesions you have to undergo evaluation for MS and if proved positive should get started on prophylaxis. If not, close observation and follow up by Neurologist is required for excluding the diagnosis of MS.

Hope that this information helps and hope that you will get better soon.

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Best Regards,
Dr Shiva Kumar R