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Old 01-06-2010, 09:14 PM   #21
Garrett Smith
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Give it a fair shot. Your MD obviously doesn't have a good answer for you at this point.

You should notice the B12 shot pretty quickly.
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Old 01-08-2010, 09:45 AM   #22
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Definitely going to give the ND a shot..

Just received my 2nd B12 shot about half an hour ago. While I can't say I felt a huge change in energy from the 1st one, I have noticed an interesting effect from both of them. Call me crazy but I notice a sense of euphoria, more specifically an opening up of my peripheral vision and an appeciation for colors/patterns around me. Sounds weird and I havent had a chance to google around about others experiences to see if that is something others have reported, but I distinctly noticed it both times.

Sleep seemed the same after 1st one, we'll see how this weekend goes.
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Old 01-08-2010, 11:27 AM   #23
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B12 is going to help you a lot then. Keep it up.
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Old 01-13-2010, 09:27 AM   #24
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Latest:

Nothing new from my MD. We met last Friday to get a B12 shot and talk further, but nothing really came of it. He brought up looking at some sort of androgen topical application but I was resistant and at least had him try to get me in to see an endocrinologist before doing that.

Have had one more ND consultation:
- we ran through a ďbio terrain analysisĒ, which showed a bunch of stuff I wonít get in to here.. nothing super alarming but I think did show I need to drink more water, might need to more o-3s to fight some inflammation, some other kind of neat stuff..
- did a basic urine adrenal function test (not an expensive one) that showed Iím pretty tapped out.. I think the scale was 17-35 for normal, and I came out a 7
- we talked about a few more things, looked at a diet log, and he seemed to agree with my self-diagnosis of having a bad case of leaky gut and adrenal fatigue.. the question is what is/has caused it
- using some of his recommendations Iím focusing on good digestion above all else, trying to think more about my breathing, and supplementing with fish oil / dig enzymes at meals, glutamine + probiotics in morning/before bed, and a tribulus supp 2x day to help with the t-levels..

Might get one more B12 show at end of week. Otherwise going to see how things go for a few weeks. Iíve had a few good sleeps in the last couple days which gives me some hope on that end!

Still feel stumped on the hemoglobin thing though, and unsatisfied with any attempts at researching (or answers from MD/ND) about why it would be low, if I just have a really messed up gut / adrenals.
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Old 01-13-2010, 10:34 AM   #25
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Methylcobalamin injections will help many times more than cyanocobalamin ones.

I'd bet your ND is using methyl and your MD is using cyano. They don't work the same.
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Old 01-13-2010, 01:43 PM   #26
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Well it certainly seems like pernicous anemia would be a good bet for my low hemoglobin.

Garrett (or anyone else), do you know of a good way to explain to my doctor how my serum b12 test result might not be an accurate representation of my true b12 situation?

I know that testing homocysteine and MMA will give a good indication and would like to get them looked at, but this will be a hard sell unless I can rationalize how the his standard serum test could not be a great indicator.

I've done a lot of reading and looking around but I can't seem to find a good answer for what is wrong with the "normal" test.
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Old 01-13-2010, 08:17 PM   #27
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You could offer to pay cash to cover the difference.

Or try using this:
Quote:
Pract Neurol. 2009 Feb;9(1):37-41.
Functional vitamin B12 deficiency.

Turner MR, Talbot K.

Department of Neurology, John Radcliffe Hospital, University of Oxford, Oxford, UK.

We describe a case of functional vitamin B12 deficiency where the repeated measurement of a serum B12 level within the normal range led to delay in the diagnosis of subacute combined degeneration of the spinal cord, and possibly permanent neurological damage as a result. Failure of intracellular transport of B12 by transcobalamin-2 can lead to functional B12 deficiency but with apparently normal serum levels, and is suggested by raised levels of either serum methylmalonic acid or homocysteine, associated with low levels of transcobalamin-2. Such patients may respond to repeated high-dose injections of B12.

PMID: 19151237
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Old 01-14-2010, 06:42 AM   #28
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Thanks. Using "functional b12 deficiency" to look around is very useful.

I'm going to try to nail that down to make sure that is what is going on.

Also as far as root causes I'm going to try to get my ND/MD to take a look at my heavy metals situation.. that might be relevant here. In particular I'm seeing that "mercury can block the methylation cycle and thus induce a functional B12-deficiency":
http://www.ever.ch/medizinwissen/b12hg.php

(not the most reputable reference there but it gives a good explanation)
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Old 01-14-2010, 10:40 AM   #29
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Mercury and lead are the most common toxicity culprits out there, IMO.
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Old 01-15-2010, 08:54 AM   #30
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Had a quick chat with MD. He is not keen on pursuing an MMA or homocysteine test.. I was in a hurry but didnít want to push on this just yet. He makes some good points about my anemia not looking to be of the pernicious type, with my normal MCV. Sending blood work to an endocrinologist but this could take a while to get a follow-up appt. Angle here seems to be that the anemia could be driven by the low t-levels.

One thing I havenít asked/addressed is if my elevated creatinine or low WBC has any relevance.

One more b12 shot today at ND, next step with him is a provocative urinary challenge to check on the mercury/lead.
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