B12 Deficiency and Polysensory Neuropathy

[ridgway]

  
  I explained in a number of posts about a diagnosis of Polysensory Neuropathy which was originally attributed to a toxic reaction to Quinolones.  Since I have had almost every test to rule out other major causes, ( connective tissue, sjorgens, lupus, ms, malignancies, toxins, etc)
  I thought a test for B12 Deficiency/ Folic Acid Screen  might be in order, although not one of my doctors thought this needed to be done.
    I was wondering if you would agree based on the following.  I have had gastro problems for 15  years, a hereditary thing that no one ever had investigated that seems more like Irritable bowell? who knows , none of my doctors seemed concerned about it. . But it makes me wonder if B12 levels might be suspect where the Gastro problem might effect levels.  I'm just wondering if the following symptoms can be caused by B12 deficiency.
  l. Hair becomming dry and brittle in texture followed by hair loss
  2.Skin papules that resemble small acnes perhaps that are colorless
  3.An escalation from Paresthesias in the face and skin eruption at the onset to Polysensory Neuropathy diagnosis 3 months later.
  4. Runs and loose stools.
  Given the long term effects of a possible B12 deficiency I think it's a good idea just to check.
  I know polysensory Neuropathy is a sign but what about the hair, skin, and stools?
  If you could let me know I'd really appreciate it,  and which tests are the most accurate in detecting B12 deficiency?  If Polsensory Neuropathy hails from B12 deficiency is this possible to improve with B12 injections?
  Thank you again for your wonderful  source of information.  It helps more than you will ever know.
  

[CCF Neuro MD MJD]

B12 does cause a neuropathy and affects the spine as well - the sensory loss is primarily of vibration and position sense on exam.  Your doctor may feel that you don't have that pattern, but if you've been tested for all  that you mention, I would think you might have been tested for B12 deficiency as well.
The major effects of B12 deficiency besides the Neurologic problems are Anemia and GI Problems (like diarrhea) - the tongue can be smooth and beefy.  The skin is pale but does not usually cause the skin problems you mentioned unless accompanied by other vitamin deficiencies.  The acne and hair problems are not typical for B12 deficiency either.
It seems reasonable to ask your physician again if he'd like to check for B12 deficiency - you don't have any obvious risks though. Deficiency is either caused from the stomach's inability to secrete a factor important in absorption or the distal small intestine's ability to absorb it.  The way to check is with a simple B12 level - If suspicion is high, tests for Methymalonic Acid and Homocystine, which are more sensitive to early B12 loss can be helpful.
Hope this is of help. Remember this information is for educational purposes only and does not substitute for a doctor's direct evaluation.