perapherial neuropathy and low b12????

Hi all,

My doctors have said that I have low B12 (225) and that is what is causing my numbness, tingling and burning in my feet, legs, hands and arms.  More on my left side than right.  I have been taking the B12 shots for 4 months now and last week my neuropathy issues got worse!  Neuro Dr. said take the shot 1x a week for a month instead of 1x a month and my primary dr prescribed neurontin to ease the burning.  

My question is does this all seem normal?  I mean, my levels are not below normal but are low so can I have the issues that I have with that?  Everything that I read on PN says I have more than just normal PN since I get the burning with it and now it is spreading/getting worse while being treated?  I have also started taking an antidepresant because of the stress from all this.  Should I just go with what the Dr's are saying or find 2 new dr's and start over?  T

Thank you!!!

[Dr Sharma]

Hello dear, a warm welcome  to you on Medhelp. I can understand your present dilemma. The normal vitamin B12 range is 150-350 pg/mL, deficiency with overt deficiency symptoms manifest with less than 100pg/ml levels. Since your levels were within normal range to begin with and you have been receiving vitamin shots also, your doctor may need to investigate whether the vitamin is getting absorbed. Schilling test is indicated. You also need to be checked for other possible causes for this peripheral neuropathy. These could be infections, metabolic problems like diabetes, traumatic injuries. A thyroid hormone levels assay also would be needed.

Gabapentin would help relieve nerve related symptoms and neuropathic pain.
You are welcome with any further clarifications.
Wish you all the best.

[Red_Star]

"Many B12 deficient people have so-called “normal” levels of B12.

Yet it is well-established in the scientific literature that people with B12 levels between 200 pg/mL and 350 pg/mL – levels considered “normal” in the U.S. – have clear B12 deficiency symptoms. Experts who specialize in the diagnosis and treatment of B12 deficiency, like Sally Pacholok R.N. and Jeffery Stewart D.O., suggest treating all patients that are symptomatic and have B12 levels less than 450 pg/mL. They also recommend treating patients with normal B12, but elevated urinary methylmalonic acid (MMA), homocysteine and/or holotranscobalamin (other markers of B12 deficiency).

In Japan and Europe, the lower limit for B12 is between 500-550 pg/mL, the level associated with psychological and behavioral manifestations such as cognitive decline, dementia and memory loss." - B12 deficiency: a silent epidemic with serious consequences - by Chris Kresser

Just to clarify, the B12 reference range goes up to 900pg/mL or 1100pg/mL depending on the lab.  I hope you don't have permanent nerve damage however B12 serum at 225pg/mL it is very possible.  Have you had your B12 levels retested yet to see if your B12 serum levels are improving?

[momma2494]

Thank you for your responses.  I have asked both doctors to retest my levels to see if it is improving and they don't seem to think it is needed at this time.  I just don't understand why they are "blowing me off" with my symptoms getting worse.  I think I am going to just call another doctor and see waht they say.