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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17961
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have been suffering from fatigue, pins and needles, forgetting

Resolved Question:

Hi, I have been suffering from fatigue, pins and needles, forgetting words, for 12 months. For last 5 months I also have had bladder problems and vision problems and headaches. I also frequently have a horrible scrunched up prickly feeling in my head. I have had a ct scan - clear, and blood tests - clear. I have always had glasses/ contact lenses but since my vision deteriorated in November the optician hasn't been able to find a prescription that works. I am waiting for urology apt, neuro apt and MRI scan. I took 2 cocodamol this morning for the first time and this seems to have helped. Any ideas? Thyroid, cfs and ms have been mentioned by docs. I haven't been able to live my normal life for 12 months now. I am working, but not doing my job as well as I should, and unable to do much else except sleep.
Submitted: 11 months ago.
Category: Medical
Expert:  Dr. D. Love replied 11 months ago.
Hello from JustAnswer.What tye of bladder problems have you been experiencing? Bladder infections?Do you know which blood tests were done?
Customer: replied 11 months ago.
Possibly Bladder infections - I had to take 4 courses of antibiotics one after the other to stop them, last one I took was co amoxiclav and this worked. There was a lot of blood in my urine (+3) and white blood cells but clear for infections. Also prior to this I have had incontinence when asleep on 2 occasions a few months ago, and I wake to urinate at night every night now.
Customer: replied 11 months ago.
The blood tests were for thyroid, diabetes, to check if I was fighting something like an infection, blood count, iron and vitamin d. I was low on iron and vitamin d but this has been rectified and I am still not better.
Expert:  Dr. D. Love replied 11 months ago.
Thank you for the additional information. The diagnoses and consultations mentioned by your doctor are appropriate, although they have apparently already checked for thyroid problems with these blood tests. There are several other possibilities that should be considered for further evaluation. It would be appropriate to look for other nutritional deficiencies. Certainly, vitamin B12 deficiency can cause many diffuse symptoms and particularly can cause a variety of neurologic symptoms. It also would be appropriate to check folic acid levels, as that is frequently checked with the vitamin B12 level. Many of your symptoms could be related to a neuropathy, such as the pins and needles sensation and the bladder symptoms, and you have already have most of the blood tests that would be pertinent in that situation, except for the vitamin B12 level. There are other tests that would also be pertinent for the evaluation of a possible neuropathy, such as an EMG or nerve conduction study, but these will be considered by the Neurologist and will depend upon the findings of the neurology examination. It also would be appropriate to consider systemic inflammatory/autoimmune conditions. There are some blood tests that are non-specific measures of inflammation, such as a sed rate and C-reactive protein. There also are specific tests that can look for inflammatory/autoimmune conditions, and the tests that are usually done first are an ANA and a rheumatoid factor. Another consideration when someone has fatigue and various associated symptoms would be if there is a condition that is interfering with sleep, and even if asleep, is interfering with deeper stages of sleep. Sleep apnea is a common condition that affects deeper stages of sleep. Other conditions, such as acid reflux or certain types of chronic pain, may interfere with sleep. I wold typically pursue the evaluation that is already being arranged before considering a sleep study, but if no other cause can be identified, it would be appropriate to consider a sleep study. If I can provide any additional information, please let me know.
Customer: replied 11 months ago.
Thank you for your advice. A lot of my friends say "it's probably just stress" but when I have looked at symptoms of stress, I don't think my symptoms fit. My gp doesn't think it is stress either. Do you think these symptoms could be caused by stress?
Customer: replied 11 months ago.
And the only other thing I could think of is that I have had cysts on my ovaries in the past. Is there any chance a gynaecological issue could cause these symptoms?
Customer: replied 11 months ago.
I am taking a daily multivitamin which has B12 and folic acid in.
Expert:  Dr. D. Love replied 11 months ago.
Stress is a complicated issue. Stress can directly cause many different symptoms, but there is no test to confirm that symptoms are related to stress, so the diagnosis is made by excluding other possible causes of the symptoms. In addition, chronic/recurrent stress will increase the risk of developing most disease processes, and studies of people undergoing significant stress are more likely to develop a major illness. If stress contributes to someone developing a major illness, the evaluation and treatment of that major illness would be the same as for other people developing that same illness without stress contributing to the disease process. We are usually most concerned about the situations in which stress is directly causing symptoms, and that is probably the scenario to which your doctor was referring when saying it is not likely from stress, and I would agree that this is not a common presentation for symptoms directly from stress. But it is possible that stress could be playing a role in a more complicated manner. The people that are deficient in vitamin B12 are usually deficient because they cannot absorb it well. It is an issue of being unable to make a factor in the gut that attaches to the vitamin B12 to facilitate absorption. So eating a diet high in vitamin B12 or taking a supplement with vitamin B12 does not mean that someone could not be vitamin B12 deficient. In people that are vitamin B12 deficient, we will usually give the vitamin B12 by injection to build the level back up. Once the levels are good, we may be able to maintain levels using a very high dose of a supplement, but not a standard dose of a supplement, and we need to monitor levels to assure that it is effective.
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17961
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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Customer: replied 11 months ago.
Thank you - that is a very helpful answer.

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