So, I've been a long time reader of paleohacks, but this is my first question, and I've got a long backstory, apologies in advance...
I developed stomach problems in college after a bout with a parasite (dientamoeba I think) and plenty of drinking. After I graduated my brother (a doc) suggested I try prilosec OTC, which helped A LOT. So I stayed on it for about 3 years, and the heartburn started to slowly come back, until one day I had a bout of light headedness, cold sweat, and what seemed like heart palpitations so I went to the ER but they found nothing, and the ER doc suspected esophagitis.
So I got an endoscopy, everything looked good, GI suggested doubling prilosec dosage to 40 mg, which I did for a about week but felt gross so I went back down to 20 mg. Then a friend suggested the paleo diet, which helped enormously. I also learned I was Vitamin D deficient (21 ng/ml), and went on 3k IU for six months and got my levels up (34 ng/ml), after which I quit cold turkey cause I was getting bad muscle twitches all over and magnesium supplements weren't helping, plus I don't seem to tolerate mag supplements well (I was using natural calm).
That was about 2 years ago, and I've been off of prilosec for just about that whole time. I've yo-yo'ed on the diet for the last few years, and had several bouts of heartburn, including another bout of burning with light headedness and cold sweat this last summer, after which I quit all alcohol and caffeine for good (although I don't drink that much anymore anyway). I went to see a cardiologist and got a halter monitor and did a stress echo test, everything fine. But I also did a tilt table test which was positive (passed out after fifteen minutes), which the doc told me was neurocardiogenic syncope (although I've never passed out in a real life situation before, so I was skeptical and thought I might just be dehydrated).
Anyway, here's the question: the heartburn has been getting better since the summer going back on a strict paleo diet, but over the last two months I've developed very minor dizziness, the twitching has come back (like fireworks going off all over my calves), and I've got some minor pain / tingling / burning / numbness in my left hand and foot and around my left eye. I'm seeing a neurologist next week, but I'm also wondering if anyone has any ideas about GERD being related to peripheral neuropathy? I'm also somewhat concerned about any possible vitamin / mineral deficiencies since being due to either the prilosec from a few years back, or a VLC diet (like thiamine)? I'm thinking I'm going to try thiamine, magnesium glycinate, and increase overall veggies and fish oil, and I'm praying I don't have MS.
Any thoughts or ideas would be very appreciated. Thanks!
So, I have experienced everything that you are describing. It has been a long road for me to figure out what is going on, but I have finally nailed it and am working toward recovery. Hopefully my story will resonate with you and give you a framework.
I was veg/vegan for about 13 years. During that time I was also a very heavy drinker.. for about 8 years. I always had "stomach problems," since I was a kid. They were on and off and seemed to only pop up when stressed. About 5 years ago (while still vegan) I started to get bouts of weird dizziness. It wasn't vertigo.. it was more like the floor was moving under my feet. The doctor also thought I had neurocardiogenic syncope. Which was silly considering I never passed out. The only thing that helped was electrolytes. I was likely just dehydrated because I partied so much and ate so little. About 4 years ago I started eating meat, cheese, dairy, eggs, etc. I felt much better in many aspects, but it seems that once you start to get healthier thats when health problems emerge.
Since adopting meat in the Paleo style diet the dizziness has gone away, BUT I did continue to party and stress and etc up until about 6 months ago. Not quite as often or as heavy, but I was still sort of undoing all the good I was doing by eating really well and working out with the heavy drinking. ANYWAY. About 5 months ago I started to get numbness and tingling in hands and feet, ear ringing, etc. Also the heartburn I have had on and off for years started to get worse. So, I went to my doc who said I was just stressed.. She ran blood tests including B12 for the tingling which came back slightly elevated. She brushed it off.
So, then about 2 weeks ago I finally went to see a functional medicine doctor. I am one of those people that is never sick and feel good, but am unwell.. if that makes sense? The doc ran blood panel and just by interpreting the results he read me like a book. Basically I have gastritis (likely caused or worsened by the alcohol), I also have a bacterial overgrowth of the small intestine. Because of this I have intense heartburn, IBS like symptoms when stressed, etc. Additionally, because the intestinal lining is inflamed and likely a bit damaged I have an issuing with absorption and conversion of key nutrients like B12, D and Iron. So, my B12 was slightly elevated bc I have a functional deficiency meaning that the enzymatic process required for the conversion of B is all jacked bc of my gastritis. Also, I have been supplementing 6000 IUs of D just to maintain a level of 38. So, there must be a D problem as well. Lastly, I am mildly anemic despite eating lots of animal products because of the inflamed intestinal lining.
So, no GERD is not causing the neuropathy, but the symptoms are all interconnected. I would guess that the over drinking caused some damage to ur stomach lining which in turn caused an issue with nutrient absorption which in turn has caused the neuropathy. Maybe its B12, maybe D, maybe magnesium... maybe all. I would also add that that many years of acid reducers has probably not helped, but likely further damaged the stomach and done a number on your acid production.
I would suggest seeing the neuro if it is going to make you feel better, but you are likely better suited finding a functional med type doc and having them help. When a reg doctor runs blood tests they use ranges that are established by ALL of the population... so that is from really unhealthy to healthy people. Functional docs use ranges that are essentially indicative of perfect health. Where your doc will tell you everything is normal, a functional doc will see glaring issues.
If you are unable to see a functional doc I would have a reg doc run a b12 test. Althouhg serum b12 is generally not that useful as it only shows stored B12, not B12 that is actually being utilized.. at least it is a starting point. I would then start trying to heal the gut. Try cutting out Prilosec all together and using Betaine HCL. You can read Chris Kresser's post on how to implement. http://chriskresser.com/get-rid-of-heartburn-and-gerd-forever-in-three-simple-steps I would also use digestive enzymes with every meal, eat a lot of fermented type foods such as kefir, kimchi, sauerkraut, etc. Don't take probiotics.. as they often do more harm than good. You want to add those after you have started to heal.
Additionally it might be helpful to get a stool test like a Metametrix profile to see if there are any huge issues. Lastly, I would try supps of b12, sublingual. You want the methyl form. Just see if that helps. As far as magnesium try chelated kind.. and try multiple forms until you find one that you can tolerate. Continue the D and maybe up the dosage. Sometimes it helps to get D from fish oil with D so that the D is emulsified and therefore able to be absorbed by those with damaged guts.
Oh, and the obvious... cut out the toxic foods that are damaging you. There is a good explanation of what that means here:http://perfecthealthdiet.com/2010/07/ulcerative-colitis-a-devastating-gut-disease/
I hope that helps!
Muscle twitching is not a symptom of neuropathy or MS and neither is the transient symptoms, as I understand it. You can ask for an EMG for confirmation. Ask your Neurologist to run a test for PNH syndromes, specifically anti-VGKC antibodies. The success rate is only ~50% for this test. A good Neurologist knows how to reproduce the twitches at the visit but there aren't many like that. The good news is that these problems are VERY common and almost always benign. I'm sure that's not much consolation for your problems. In the mean time, check out the aboutbfs.com forums for more advice.
These same problems can also cause digestive problems by the way. I had similar problems (in fact, I'm twitching right now) and found Domperidone to be most effective in the end. The PPIs only work for short periods of time. You can ask GI for a gastric emptying test. Note that the US is the only country in the world which doesn't permit the sale of this drug and your GI probably doesn't know about it. They might recommend Reglan, Erythromycin, and an H2 blocker, which are all ok in the short term.
I'd also suggest elevating the head of your bed at night, get tested for sleep apnea even if symptom free, going on a strict gluten free diet, and doing the Paleo autoimmune protocol (no nuts, dairy, wheat, etc). Good luck!
Although I think the other responses are great I just want to add a couple of suggestions of my own:
1) Good that you are off Prilosec. You might want to go on a low carb diet (<60 grams/day) to see if your GERD is caused by SIBO. If it is you should experience relief within a few days.
2) Get tested for H. pylori. It can also be a cause of GERD but it can also cause a wide diversity of symptoms. Hopefully you were tested when you had an endoscopy. But it won't cost much to get a blood test to rule it out, just to be 100% sure.
3) Yes, it is important you see a doctor about your nerve twitches. Try to ensure your doctor rules out any obvious nutritional imbalance; I should think a simple blood test would do. Could GERD cause a nutritional imbalance? Of course, but there might be other factors involved. Good medical advice is needed.