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Months of the same symptoms- MS, deficiency, thyroid or something else?

Hi- 24 yr. old female currently seeing my Dr. trying to figure out whats wrong. I have posted here before but now my symptoms are still worrying me.

I have been getting a lot of muscle twitches, short bubbly twitching feelings in all parts of my body everyday. Legs arms fingers hands anything even eyes and mouth which hasnt gone away since pre summer 2018...This has been this way for months.

I also have had a tingling left heel of my foot which feels like “buzzing” that comes and goes, sometimes all day sometimes not at all sometimes it goes away if i stand or move a certain way, or sometimes its just permanent. Also short crawling sensations on my nose and scalp. These all come and go and will last seconds- but the buzzing in my left heel is multiple times a day. Seems to be worse when i’m anxious about it. I brought up that I was worried this could be MS but none of my doctors seem to think so. My new doctor didnt rule it out completely but didnt seem super concerned.

I’m going for an EMG on my foot and i’m very concerned. Here are my blood test results-

my b12 - 421 pg/ml  
standard range-200 - 1,100 pg/mL

my magnesium- 2.0 pg/ml
standard range: 1.5 - 2.5 mg/dL

my Free T4- 0.9 ng/dl

my TSH - 4.62 mIU/L (dr said was minimally elevated but prob is nothing?)

i had more done but i thought these would be the most relevant to share.

I want to add i had chemotherapy 6 ago that is known to cause nerve damage but im not sure this late in remission. please someone help i’m feeling very lost and confused and yes i also see a counseler for anxiety. Looking for any insight please
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987762 tn?1331027953
Hi again, i'm really sorry to hear your still dealing with these issues, i am pleased to hear you are seeing a counsellor cause it will help in the long run, it can take years to understand how to deescalate your anxiety and understand your triggers, so hang in there!

You've not mentioned if you've considered and discussed  with your dr or counsellor trying M/H medication and or cognitive behavioural therapy to help stabilise your anxiety......if you haven't i would highly recommend you seriously consider consulting with a psychiatrist to see if those types of treatment options would be in your best interest....

I can't tell you much of anything about those blood test results to me there's nothing standing out, you could try posting the results of all your blood tests in the thyroid community, they're definitely more up to date on what to be looking for overall and what tests you might need etc

Hope that helps.......JJ

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hi thank you for answering again :) still in the process of trying meds possibly! i’m curious to see if these symptoms bother me less once my
anxiety is completley gone.
symptom wise i don’t know if these are MS related or not? i also noticed i went into a hot tub tonight and after the foot buzzing was way more noticeable. is it even worth doing the emg or should i push for an mri? my mom says she experiences twitches ans tingles for years and she does not have MS. i feel like people assume i’m exaggerating but the symptoms are so real and bother me daily lol
The symptoms wouldn't be MS related because of the way lesion damage presents and further develops over time, the pattern you've been described experiencing isn't the same as what a neurological condition like MS does.

I think you are overly hyper aware of every little thing your body does and once something registers in your mind it gets worse and worse because the sensation gets stuck in you head and your anxiety escalates and the more you keep focusing on the sensation, tingle, twitch, buzz, twinge etc

It probably is in your best interest to get your anxiety under control before you put your self through further medical tests, anxiety is a known cause of the types of issues and pattern you've been experiencing, anxiety manifesting physical symptoms are definitely real!

Keep in mind that anxiety definitely escalates the more attention you give to something and as the anxiety builds and builds the more convinced you become that something is seriously wrong and the more you'll be compelled to self check, google symptoms, research conditions, seek advice, consult dr's, repeat or get different tests etc etc causing you to continually repeat the very set of behaviours that feeds your anxiety.

The longer you are stuck in a cycle of health related anxiety, the harder it is to get out of it with out an individualised treatment plan, eg a combination of medication and cognitive behavioural therapy, etc Fight the medical condition you know to be true (health anxiety)  and once you understand your anxiety triggers, what you need to do to deescalate, what helps you keep your anxiety under control day to day etc you will be in a much better emotional position to cope with the bad, and the good things that happen in your life.

Hope that helps.....JJ
I think my therapist now is hesitant to refer me to a psychiatrist for meds but I agree that a combination therapy would be best.

also, thats good to hear. I figured since I keep getting tingling in different spots that if i did have a disease that would be it “progressing” but also i could be misunderstanding what MS symptoms actually are. I was getting rem/nystagmus eye movements when i closed my eyes this morning trying to sleep. literally they would move side to side only while my eyes were clothes, which of course induced me to panic, them when i calmed down it seemed to get better. but when i googled nystagamus/optic neuritis  all MS things come up so i panicked more.
Googling is the last thing you should be doing when you are dealing with health related anxiety because it usually escalates anxiety instead of providing reassurance. With health related anxiety the more you google and research symptoms or the condition you're become focused on, the more likely you are to over look any information or explanation that challenges your anxious thoughts, misinterpret and jump to conclusions to understand meaning, experience additional symptoms which are 'similar' to what you've been reading about etc etc etc

Symptom progression-remittance when M/H is the causation is basically the reflection of the anxious head space, attention escalating anxiety and distraction deescalating anxiety etc the types of symptoms are typically sensory, perception of weakness etc and the symptom pattern is typically random, move around from one location to another, situation specific, rapidly multiply, predominantly bilateral or in all peripheral limbs, lasts second to a few minutes etc

IF what you experienced was something medically significant like involuntary-uncontrolled acquired 'Nystagmus' it wouldn't of been able to immediately stop with opening your eyes and changing visual focus from inside your eyelids, wouldn't improve or stop because of a calm-er state of mind...

Hope that helps......JJ
thank you! yes i agree that the nystagmus i *thought* i had was false. i think i was just in sheer panic. my eyes are fine now, it took a few nights of calming down and rest to realize that. i just really cannot get over my foot that buzzes day in and day out. currently woke me up. reading some of my old posts i complained of muscle weakness and twitches all the way back to the summer even maybe before. my doctor wants me to go for an emg for the tingling but i agree it will cause me a lot of stress if i have to go further - MRI ect. My brain just cannot accept that this could be anything but MS. :( I’m going to have a therapy session soon but i feel im driving everyone nuts.
The only way to know if you don't have MS is to get an MRI. Everyone presents differently with every disease, so it's impossible for anyone to say that you do not have MS without and MRI. Diagnosis can't be made over the internet. I got an MRI for MS when I had similar symptoms plus others. It was negative at the time. I have now developed new symptoms and I will be requesting a follow up MRI to rule out that I do not now have MS. If you want to rule out that MS is definitely not the cause of your symptoms, you too will need to get an MRI.

That being said, you are hypothyroid with that high TSH and hypo can cause strange nerve sensations. If the cause is an autoimmune disease called Hashimoto's (most common cause of hypo and is commonly undiagnosed because people forget to run the tests), and this autoimmune disease will also give you all kinds of strange symptoms. Someone with a normal thyroid will have TSH under 2.0. Once TSH starts to rise above that level that indicates that thyroid hormone production is slowing down. In the US most labs have TSH lab ranges that cut off at 4.0. Anything above that level is for sure hypo. Forget about your doctor saying that it's "minimally elevated" and is probably nothing. It's ELEVATED. Elevated is elevated, and elevated means slow thyroid plain and simple.

What is the lab range of your FT4? 0.9 sound very low, but it depends on the lab range. With your TSH being as high as it is, I'd expect a low FT4, but what about your FT3? Did you doctor forget to test the other thyroid hormone, the active one, FT3? It works in conjunction with your T4. T4 converts into T3, and T3 is the active, usable hormone.

Along with your high TSH and what appears to be low FT3, plus the missing FT3, those numbers give need to test for thyroid autoimmune Hashimoto's. This is done by testing two thyroid antibodies. Did your doctor also test antibodies TG and TPO?

It could be that your symptoms are just from untreated hypothyroidism, which could also be undiagnosed and untreated Hashimoto's, or your symptoms could be from something completely different. For sure your thyroid is too slow with those numbers.
Interesting.. okay I will bring this up at my follow up. I had chemotherapy and radiation to my neck and chest which is known to cause thyroid issues in the future. My old doctor who ran those tests seemed so not concerned but i thought it was weird myself. Also i read 400 for b12 is considered low in other places but he didnt think so. Im terrified to get an MRI because i am truly almost convinced i have MS. But i do have horrible healthy anxiety as you can see in my above comments. Chemo also does cause strange sensations but not this far out from it usually.
ok so i checked, m TSH third gen went from 4.62 to 3.71 the following test which is in range i guess. The standard says 4.50. FREE T4 says 0.9 standard range being 0.8. These are the only things he tested me
for. And the retest showed it went back down. So i’m confused
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