Diary of Unknown Symptoms

Mystery of the Internal Vibration

Entry for June 16, 2006

What is folate?

Folic acid, also called folate or folacin, is a B-complex vitamin most publicized for its importance in pregnancy and prevention of pregnancy defects.

Folic acid is one of the most chemically complicated vitamins, with a three-part structure that puts special demands on the body’s metabolism. The three primary components of folic acid are called PABA, glutamic acid, and pteridine. (Two of these components, glutamic acid and pteridine, help explain the technical chemical name for folate, namely pteroylmonoglutamate.)

As complex as this vitamin is in its structure, it is equally as complicated in its interaction with the human body. For example, most foods do not contain folic acid in the exact form described above, and enzymes inside the intestine have to chemically alter food forms of folate in order for this vitamin to be absorbed. Even when the body is operating at full efficiency, only about 50% of ingested food folate can be absorbed.

What is the function of folate?

Red blood cell formation and circulation support

One of folate’s key functions as a vitamin is to allow for complete development of red blood cells. These cells help carry oxygen around the body. When folic acid is deficient, the red bloods cannot form properly, and continue to grow without dividing. This condition is called macrocytic anemia, and one of its most common causes is folic acid deficiency.

In addition to its support of red blood cell formation, folate also helps maintain healthy circulation of the blood throughout the body by preventing build-up of a substance called homocysteine. A high serum homocysteine level (called hyperhomocysteinemia) is associated with increased risk of cardiovascular disease, and low intake of folate is a key risk factor for hyperhomocysteinemia. Increased intake of folic acid, particularly by men, has repeatedly been suggested as a simply way to lower risk of cardiovascular disease by preventing build-up of homocysteine in the blood. Preliminary research also suggests that high homocysteine levels can lead to the deterioration of dopamine-producing brain cells and may therefore contribute to the development of Parkinson’s disease. Therefore, folate deficiency may have an important relationship to neurological health.

Research is now confirming a link between blood levels of folate and not only cardiovascular disease, but dementias, including Alzheimer’s disease.

One of the most recent studies, which was published in the July 2004 issue of the American Journal of Clinical Nutrition evaluated 228 subjects. In those whose blood levels of folate were lowest, the risk for mild cognitive impairment was more than tripled, and risk of dementia increased almost four fold. Homocysteine, a potentially harmful product of cellular metabolism that is converted into other useful compounds by folate, along with vitamin B6 and B 12, was also linked to dementia and Alzheimer’s disease. Individuals whose homocysteine levels were elevated had a 4.3 (more than four fold) increased risk of dementia and a 3.7 (almost four fold) increased risk of Alzheimer’s disease.(June 30, 2004)

Research teams in the Netherlands and the U.S. have confirmed that low levels of folic acid in the diet significantly increases risk of osteporosis-related bone fractures due to the resulting increase in homocysteine levels. Homocysteine has already been linked to damage to the arteries and atherosclerosis, plus increased risk of dementia in the elderly. Now, in a study that appeared in the May 2004 issue of the New England Journal of Medicine, researchers at the Eramus Medical Center, Rotterdam, Holland, and another team in Boston have confirmed that individuals with the highest levels of homocysteine have a much higher risk of osteoporotic fracture.

In the Rotterdam study, which included 2,406 subjects aged 55 years or older, those with the highest homocysteine levels, whether men or women, almost doubled their risk of fracture. The Boston team found that risk of hip fracture nearly quadrupled in men and doubled in women in the top 25% of homocysteine levels. Both groups found that folic acid reduced the risk of osteoporotic fractures by reducing high levels of homocysteine.

What factors might contribute to a deficiency of folate?

In addition to poor dietary intake of folate itself, deficient intake of other B vitamins can contribute to folate deficiency. These vitamins include B1, B2, and B3 which are all involved in folate recycling. Poor protein intake can cause deficiency of folate binding protein which is needed for optimal absorption of folate from the intestine, and can also be related to an insufficient supply of glycine and serine, the amino acids that directly participate in metabolic recycling of folate. Excessive intake of alcohol, smoking, and heavy coffee drinking can also contribute to folate deficiency.

How do other nutrients interact with folate?

Vitamins B1, B2, and B3 must be present in adequate amounts to enable folic acid to undergo metabolic recycling in the body. Excessive amounts of folic acid, however, can hide a vitamin B12 deficiency, by masking blood-related symptoms.

How is folate-deficiency anemia diagnosed?

Folate-deficiency anemia may be suspected from general findings from a complete medical history and physical examination. In addition, several blood tests can be performed to confirm the diagnosis. If the anemia is thought to be caused by a problem in the digestive tract, a barium study of the digestive system may be performed. Folate deficiency does not usually produce neurological problems; B12 deficiency does. Folate and B12 deficiency can be present at the same time. If B12 deficiency is treated with folate by mistake, the symptoms of anemia may lessen, but the neurological problems can become worse.

Natural forms of folic acid:

orange juice
oranges
romaine lettuce
spinach
liver
rice
barley
sprouts
wheat germ
soy beans
green, leafy vegetables
beans
peanuts
broccoli
asparagus
peas
lentils
wheat germ
chick peas (garbanzo beans)

How do I know if I’m deficent in folate? Untill I started eating healthy recently, the only thing I had on a semi-regular basis was romaine lettuce. I’m sure wheatgrass is a good substitute for the green, leafy vegetables.

What are deficiency symptoms for folate?

Because of its link with the nervous system, folate deficiency can be associated with irritability, mental fatigue, forgetfulness, confusion, depression, and insomnia. The connections between folate, circulation, and red blood cell status make folate deficiency a possible cause of general or muscular fatigue. The role of folate in protecting the lining of body cavities means that folate deficiency can also result in intestinal tract symptoms (like diarrhea) or mouth-related symptoms like gingivitis or periodontal disease.

So folate helps maintain healthy circulation of the blood throughout the body by preventing build-up of a substance called homocysteine which can lead to a higher risk of coronary heart disease, stroke and peripheral vascular disease.

Another one of my “weird” symptoms is when I hold my hands over my head for more than ten seconds. I start to feel a mild numbing sensation down the length of my arms and I’m sure it’s due to a lack of blood circulation.

I think I’ve proven that I do have circulation issues so maybe I’m deficient in folic acid too. Beriberi sounds very serious and if it’s what I have then I should get a blood test to confirm it. On the way home I’ll drop into the walk in clinic and see if I can convince the doctor for a blood test. At the very least, I will be able to rule out if it comes up negative.

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June 16, 2006 Posted by | Health | , , , , , , | Leave a comment

Entry for June 15, 2006

Nervous System Support

Vitamin B1 also plays a key role in support of the nervous system, where it permits healthy development of the fat-like coverings which surround most nerves (called myelin sheaths). In the absence of vitamin B1, these coverings can degenerate or become damaged. Pain, prickly sensations, and nerve deadening are nerve-related symptoms that can result from vitamin B1 deficiency.
 
A second type of connection between vitamin B1 and the nervous system involves its role in the production of the messaging molecule acetylcholine. This molecule, called a neurotransmitter, is used by the nervous system to relay messages between the nerves and muscles. Acetylcholine cannot be produced without adequate supplies of vitamin B1. Because acetylcholine is used by the nervous system to ensure proper muscle tone in the heart, deficiency of B1 can also result in compromised heart function.
 
Deficiency Symptoms
What are deficiency symptoms for vitamin B1?
Because of its ability to disrupt the body’s energy production, one of the first symptoms of vitamin B1 deficiency is loss of appetite (called anorexia) that reflects the body’s listlessness and malaise.
 
Inability of the nervous system to ensure proper muscle tone in the GI tract can lead to indigestion or constipation, and muscle tenderness, particularly in the calf muscles.
Other symptoms related to nerve dysfunction are commonly associated with thiamin deficiency, since the myelin sheaths wrapping the nerves cannot be correctly made without adequate thiamin. These nerve-related symptoms include “pins and needles” sensations or numbness, especially in the legs.
 
Toxicity Symptoms

What are toxicity symptoms for vitamin B1? Even at extremely high doses of 500 milligrams per day, vitamin B1 intake does not appear to carry a risk of toxicity. This vitamin is often supplemented in high doses during treatment of maple sugar urine disease (MSUD), and may be given intravenously in treatment of alcoholism; these clinical circumstances have provided a broad basis for determining the low risk of toxicity associated with increased intake of thiamin. In its most recent 1998 recommendations for intake of B-complex vitamins, the Institute of Medicine at the National Academy of Sciences did not establish a Tolerable Upper Limit (UL) for intake of vitamin B1
 
Nutrient Interactions

How do other nutrients interact with vitamin B1? No B-complex vitamin is more dependent on its fellow B vitamins than thiamin. Absorption of thiamin into the body requires adequate supplies of vitamins B6, B12, and folic acid. A deficiency in vitamin B12 can increase loss of thiamin in the urine, and vitamin B6 also appears to help regulate distribution of thiamin throughout the body.  If folic acid is deficient in the cells, then it causes an indirect thiamine deficiency because thiamine is present but cannot be activated.
 
Maybe it’s time to research folic acid.

June 16, 2006 Posted by | Health | , , , | Leave a comment

Entry for June 15, 2006

Beriberi – this is caused by thiamin deficiency and affects the cardiovascular, muscular, gastrointestinal and nervous systems. As well as the above symptoms, a person with ‘dry’ beriberi may have: nerve degeneration, nervous tingling throughout the body, poor arm and leg coordination, and deep pain in the calf muscles. Symptoms of ‘wet’ beriberi include: an enlarged heart, heart failure and severe oedema (swelling).

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Beriberi causes different symptoms in different people. One form, called dry beriberi, causes nerve and muscle abnormalities. Symptoms include a prickling (pins-and-needles) sensation in the toes, a burning sensation in the feet that is particularly severe at night, and pain, weakness, and wasting (atrophy) of muscles in the legs.

Brain abnormalities due to vitamin B1 deficiency occur primarily in alcoholics. Brain abnormalities may develop when a chronic vitamin B1 deficiency is suddenly worsened by a rapid, substantial decrease in the vitamin B1 level (which can be caused by an alcoholic binge) or by a sudden increase in vitamin B1 requirements (which may occur when an undernourished alcoholic is fed intravenously).

Prognosis:

Wet beriberi: Improvement is observed in the first 6-24 hours after thiamin administration.

Cyanosis disappears, Heart rate reduces, Respiratory rate reduces. Diuresis and reduction in heart size may be apparent within 1-2 days.

In cases of dry beriberi and Korsakoff psychosis, the complete resolution of the neurologic symptoms can take several months.

oh great…the complete resolution of the neurologic symptoms can take several months. Well I’ve waited this long. Maybe I’ll think about getting a test done to prove this diagnosis once and for all.

One study on human starvation found that in thiamine vitamin B. deficiency, symptoms such as lack of well being, anxiety, hysteria, depression, and loss of appetite preceded any clinical evidence of beriberi. Other studies using the Minnesota Multiphasic Personal Index (MMPI) have also demonstrated that adverse behavioral changes precede physical findings in thiamine deficiency. Indeed, thiamine treatment—as much as 300 mg—is used to treat Wernicke’s encephalopathy (cerebral beriberi), an acute brain disorder whose early stages are characterized by mental confusion, an inability to think of words, and fabrication of “facts” (Winter and Winter, 1988).

Confusion, forgetfulness, and irritability—symptoms often diagnosed as Alzheimer’s disease—may actually be an easily treated vitamin B deficiency. Untreated, the deficiency can lead to irreversible spinal cord degeneration, other neurologic problems, and serious anemias. If your patient is a vegetarian, such a deficiency may result from inadequate compensation for a lack of red meat. Elderly patients may be deficient owing to malabsorption of the vitamin. A B 2 deficiency can be diagnosed with a blood or urine test. Once detected, a monthly intramuscular B2 injection is recommended.

June 15, 2006 Posted by | Health | , | Leave a comment

Entry for June 15, 2006

Dear Dr. Google…

I’ve been taking high doses of niacin for over a month and although there is some improvement, I still have the mysterious internal tremor and low stomach acid. I forgot to take my acidophilus this morning and I had the head pinching. It disappeared when I took the acidophilus so something is obviously still wrong. Maybe it’s not a niacin deficiency at all? I have nervous system symptoms that are effected by diet. It has to be a nutritional deficiency, I just don’t know what kind.

With the Iridology charts and the deep lines at the top of my iris suggesting something effecting the cerebrum part of my brain, I start looking up symptoms with the cerebrum. With iridology some practitioners feel they can diagnose severe disease well before symptoms present themselves. So let’s see what I find out. I start reading about a whole bunch of scary neurological disorders and nothing matches my symptoms. It has to be a nutritional deficiency.

I start googling vitamin deficiencies and I look up every one. A, B, C, D, E, K etc. After reading them all and not finding anything as a possible match, I decide search for vitamins deficiencies that can effect the brain or more importantly, the cerebrum. This time I come across a more detailed decription of a Vitamin B1 (Thiamin) deficiency.

Vitamin B1 Deficiency

Vitamin B1 (thiamin) deficiency may result from a deficiency in the diet. People whose diet consists mainly of polished (refined) white rice are at risk of vitamin B1 deficiency, because polishing removes almost all of the vitamins. Alcoholics, who often substitute alcohol for food, are at high risk of developing this deficiency.

Symptoms

Early symptoms are vague. They include fatigue, irritability, memory impairment, loss of appetite, sleep disturbances, abdominal discomfort, and weight loss. Eventually, a severe vitamin B1 deficiency (beriberi) may develop, characterized by nerve, heart, and brain abnormalities.

Brain abnormalities due to vitamin B1 deficiency occur primarily in alcoholics. Brain abnormalities may develop when a chronic vitamin B1 deficiency is suddenly worsened by a rapid, substantial decrease in the vitamin B1 level (which can be caused by an alcoholic binge) or by a sudden increase in vitamin B1 requirements (which may occur when an undernourished alcoholic is fed intravenously).

Diagnosis and Treatment

The diagnosis is based on symptoms. Tests to confirm the diagnosis are not readily available. All forms of the deficiency are treated with vitamin B1 supplements.

A balanced diet containing all essential nutrients will prevent a thiamine deficiency and the development of beriberi. People who consume large quantities of junk food like soda, pretzels, chips, candy, and high carbohydrate foods made with unenriched flours may be deficient in thiamine and other vital nutrients. They may need to take vitamin supplements and should improve their diets. Usually there are other deficiencies in the B vitamins that will also need treatment.

Excess thiamine is excreted by the body in the urine, and negative reactions to too much thiamine are rare. Thiamine is unstable in alkali solutions, so it should not be taken with antacids or barbiturates.

Thiamine should be taken daily, with the dose depending on the severity of the disease. Additional supplements of B vitamins, a multivitamin and mineral complex, and Vitamin C are also recommended. Other alternative therapies may help relieve the person’s symptoms after the thiamine deficiency is corrected.

So maybe I had multiple B vitamin deficiencies? Another web site talks about how a B1 deficiency can lead to a disease called Beriberi :

Beriberi – this is caused by thiamin deficiency and affects the cardiovascular, muscular, gastrointestinal and nervous systems. As well as the above symptoms, a person with ‘dry’ beriberi may have: nerve degeneration, nervous tingling throughout the body, poor arm and leg coordination, and deep pain in the calf muscles. Symptoms of ‘wet’ beriberi include: an enlarged heart, heart failure and severe oedema (swelling).

Thiamine Deficiency And Dependency

The coenzyme thiamine pyrophosphate, the active form of thiamine (vitamin B1), participates in carbohydrate metabolism through decarboxylation of -keto acids. Thiamine also acts as coenzyme to the apoenzyme transketolase in the pentose monophosphate pathway for glucose. Deficiency causes beriberi with peripheral neurologic, cerebral, cardiovascular, and GI manifestations.

Another site lists another set of symptoms:

Deficiency Symptoms: Depression, constipation, impaired growth in children, shortness of breath, numbness of hands and feet, weakness, fatigue, nervousness, sensitivity to noise, loss of appetite.

Inhibits Absorption: Tobacco, stress, fever, coffee, alcohol, surgery, raw clams

Enhances Absorption: B-complex, sulfur, manganese, niacin, B-2, folic acid, C, E

And then another says one of the Neurologic signs is a….TREMOR.

Pathophysiology
Nutritional disease results from Thiamine deficiency

Symptoms : Weakness, irritability, Nausea, Vomiting, Burning feet, Pruritus

Signs

Neurologic: Tremor, Diminished reflexes in lower limbs, Muscle atrophy

Cardiac: Congestive Heart Failure, Pedal Edema , Pleural Effusions

And yet another:

The following systems are most affected by beriberi:

Gastrointestinal system

When the cells of the smooth muscles in the digestive system and glands do not get enough energy from glucose, they are unable to produce more glucose from the normal digestion of food. There is a loss of appetite, indigestion, severe constipation, and a lack of hydrochloric acid in the stomach.

Nervous System

Glucose is essential for the central nervous system to function normally. Early deficiency symptoms are fatigue, irritability, and poor memory. If the deficiency continues, there is damage to the peripheral nerves that causes loss of sensation and muscle weakness, which is called peripheral neuropathy. The legs are most affected. The toes feel numb and the feet have a burning sensation; the leg muscles become sore and the calf muscles cramp. The individual walks unsteadily and has difficulty getting up from a squatting position. Eventually, the muscles shrink (atrophy) and there is a loss of reflexes in the knees and feet; the feet may hang limp (footdrop).

Cardiovascular system

There is a rapid heartbeat and sweating. Eventually the heart muscle weakens. Because the smooth muscle in the blood vessels is affected, the arteries and veins relax, causing swelling, known as edema, in the legs.

Musculoskeletal system

There is widespread muscle pain caused by the lack of TPP in the muscle tissue.

A thiamin deficiency also produces Warnicke-Korsakoff syndrome, sometimes called cerebral beriberi, a disorder of the central nervous system.

Muscles shrink (atrophy) and there is a loss of reflexes in the knees and feet? Could this explain my Plantar Fasciitis? A B1 deficiency is linked to the Gastrointestinal system and the Nervous System. The two things I have symptoms for. The two things I’ve been telling the doctors about and now I have a link to the cerebrum.

What is Wernicke-Korsakoff syndrome?

Wernicke-Korsakoff syndrome (WKS) is a neurological disorder. Wernicke’s Encephalopathy and Korsakoff’s Psychosis are the acute and chronic phases, respectively, of the same disease. Wernicke-Korsakoff syndrome is a combination of  Korsakoff’s syndrome which constitutes confusion, aphonia and confabulation and Wernicke’s encephalopathy which is nystagmus, opthalmoplegia, coma and, if untreated, death. It is also known as cerebral beriberi, which is beriberi (thiamine deficiency disease) in the brain. This results from severe acute deficiency of thiamine superimposed on a chronic deficiency. Usually found in malnourished chronic alcoholics.

Korsakoff’s syndrome, with symptoms of severe anterograde and retrograde amnesia, is caused by damage to mammillary bodies and other brain regions due to deficiency of thiamine. This is most often caused by chronic alcoholism, though other conditions including severe malnutrition, have been known to cause it. An association of Gayet-Wernicke and Korsakoff’ syndromes frequently observed in alcoholic, nutritionally deficient patients with the Gayet-Wernicke syndrome. Patients develop symptoms of the Korsakoff syndrome, mainly amnesia with a tendency to confabulate with or without polyneuropathy.

I don’t think I’ve gotten to the point of the Wernicke-Korsakoff syndrome so it appears what I could have is a B1 deficiency that may led to it. Scary stuff…and it’s starting to make a bit more sense.

I’ve had this very weird feeling in my head almost from the time when the other symptoms started happening around July 2005. If I tilted my head back and kept it there for 5-10 seconds, when I try to bring it back, my head has a heavy sluggishness feeling. Almost like the fluid trying to balance itself. It dosen’t happen all of the time and I didn’t quite know how to explain it so I never mentioned it. The Cerebellum is the part of the brain below the back of the cerebrum and it regulates balance, posture, movement, and muscle coordination.

Down to Shoppers Drug Mart to pick up 100 mg of B1 suppliment.

June 15, 2006 Posted by | Health | , , , , , , , , , , , , | Leave a comment

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