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Timing for a B12, MMA test to hack my fatigue and other weird symptoms?

by (1649)
Updated September 16, 2014 at 8:06 PM
Created April 08, 2013 at 1:43 PM

Hey y'all!

So, here is the thing: About 7-8 months ago I started having tingling extremities. It got to the point where my hands and feet were constantly tingling and kind of numb. I had my regular GP at the time run a B12 serum test which was elevated. I think it was right around 1000. Folate was around 17 or so.. I think the high end range was 30. Anyway, she brushed it off and told me to stop supplementing B12, which I wasn't doing at the time. About 2 months later I moved to a different state and started seeing a Naturopath because the tingling was driving me batty! Due to my history of being a vegetarian for about 15 years, plus many years of excessive alcohol intake and other symptoms including gastro issues, etc, the Naturopath suspected a functional B12 deficiency. He put me on liquid methyl and a folate supp and some supps to fix my gut. Within about 3 weeks the tingling stopped, the gut got better and I thought everything was coming around. That was 2.5 months ago.

Fast forward. About 2 weeks ago I started seeing a new GP who ran a standard blood test just to get a baseline for my health. Everything showed well TSH was 1.0, Vit D 49, Lipids excellent etc. However I had low platelets and high MPV. He said he wants to wait a month and I will retest. During that time I also started getting really, really tired. First I thought it was a resurgence of Shingles that I got last year bc there was some accompanying nerve pain along the original dermatome. Also, just general aches and A RETURN OF THE TINGLING IN EXTREMITIES! Agh!! So, now I'm frustrated. In the past few days I have been trying to increase potassium intake because it is my understanding that supplementing methyl causes potassium to be used rapidly and potassium deficiency also makes people very tired, tingling in extremities, etc. But I have cranked my potassium intake (with food only) to about 4800 for the past few days and I don't really feel much better. I am getting a little dizzy when standing, have constant muscle twitching in the eye and back, and feel like I have been hit by a truck.

So.. should I assume this is still a B12 issue? Should I re-test serum B12 and also MMA? Should I check Potassium levels? Any other thoughts?

Also, if I have been supplementing b12 and folate how long do I need to cease the supplements before testing?

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6709 · May 31, 2013 at 3:40 AM

Just humor me and have your spine checked. Seriously

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1649 · April 10, 2013 at 5:15 PM

Yah, my doc recommended a redraw in a month.. so that should be sometime soon. Since yesterday I discovered through my 23andMe and a lot of legwork that I have the compound hetero mutations for MTHFR which is likely the biggest problem here. With that knowledge I probably won't pursue the MMA testing I originally asked about and just move forward with trying to fix my damaged methyl cycle. Yay. Thanks for your thoughts!

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2043 · April 09, 2013 at 9:20 AM

Sometimes platelets can clump in the tube they were drawn in and give spurious values. Do you know if a manual differential was done or if it was automated? If this was the only time your plts have ever been low and your MPV high I would suggest a redraw to see if the results are the same.

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1649 · April 08, 2013 at 9:47 PM

And yes, every other blood panel I have ever had (and that has been about 4 in the past 2 years) has shown both platelets and mpv in normal range.

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1649 · April 08, 2013 at 9:46 PM

Nope. Unfortunately it is never that simple for me... all of my symptoms are vague and don't line up with clinical presentations. I should mention, when I last tested it was about 2 days before my cycle began.. but I mentioned that as a possible cause to my doctor and he sort of brushed it off as unlikely.

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2043 · April 08, 2013 at 2:18 PM

Do you have any previous platelet levels or MPVs to compare to? Are you bleeding, easily bruising or showing multiple little red spots all over your body (petechiae)?

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1649 · April 08, 2013 at 2:06 PM

No, mean platelet volume was high at 11.4 I think. I don't know the range as it was just marked, High. Platelets were at 119.. again I don't know the specific range for this lab. My potassium level a few weeks ago when tested was 4.4, well within normal. Magnesium would make sense, but I supplement Mag daily.

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4 Answers

75130cc82f02010d7dc815bd9d9717a2
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0 · September 07, 2013 at 2:12 PM

I have similar symptoms. Neuro work up is negative. Will see neuro surgeon because I have alot of cervical myelopathy. My B12 is high and I don't supplement. I am homozygous MTHFR c766t- with other weird methylation issues. I also did a 23andme work up. I have many fasciculations and very dizzy. I will tracking your progress.

8ce8b8fd33944e67dfd6277e7b671815
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327 · September 06, 2013 at 11:13 PM

Dude, those sound like tell tale symptoms of multiple sclerosis, you should really get that checked out by a neuro who specializes in that.

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8255 · April 22, 2013 at 3:13 PM

I assume your blood sugar is ok?

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2043 · April 08, 2013 at 1:52 PM

Do you mean MCV, and not "MPV", and how high was it? Also, how low were your platelets? Did they run an electrolyte panel, what was your potassium level? You may also be low on magnesium, when people do not respond to potassium supplementation their magnesium levels are often low.

1c67bc28f4e44bbb8770b86df0463df3
6709 · May 31, 2013 at 3:40 AM

Just humor me and have your spine checked. Seriously

06bf7b92d77f1ac1d8e3dc9d539d8254
1649 · April 10, 2013 at 5:15 PM

Yah, my doc recommended a redraw in a month.. so that should be sometime soon. Since yesterday I discovered through my 23andMe and a lot of legwork that I have the compound hetero mutations for MTHFR which is likely the biggest problem here. With that knowledge I probably won't pursue the MMA testing I originally asked about and just move forward with trying to fix my damaged methyl cycle. Yay. Thanks for your thoughts!

A3a4696c919e916ec971691559e9c942
2043 · April 09, 2013 at 9:20 AM

Sometimes platelets can clump in the tube they were drawn in and give spurious values. Do you know if a manual differential was done or if it was automated? If this was the only time your plts have ever been low and your MPV high I would suggest a redraw to see if the results are the same.

06bf7b92d77f1ac1d8e3dc9d539d8254
1649 · April 08, 2013 at 9:47 PM

And yes, every other blood panel I have ever had (and that has been about 4 in the past 2 years) has shown both platelets and mpv in normal range.

06bf7b92d77f1ac1d8e3dc9d539d8254
1649 · April 08, 2013 at 9:46 PM

Nope. Unfortunately it is never that simple for me... all of my symptoms are vague and don't line up with clinical presentations. I should mention, when I last tested it was about 2 days before my cycle began.. but I mentioned that as a possible cause to my doctor and he sort of brushed it off as unlikely.

A3a4696c919e916ec971691559e9c942
2043 · April 08, 2013 at 2:18 PM

Do you have any previous platelet levels or MPVs to compare to? Are you bleeding, easily bruising or showing multiple little red spots all over your body (petechiae)?

06bf7b92d77f1ac1d8e3dc9d539d8254
1649 · April 08, 2013 at 2:06 PM

No, mean platelet volume was high at 11.4 I think. I don't know the range as it was just marked, High. Platelets were at 119.. again I don't know the specific range for this lab. My potassium level a few weeks ago when tested was 4.4, well within normal. Magnesium would make sense, but I supplement Mag daily.

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