vitamin b12 defiency and neuromuscular disease

[denise-s]

Hello, My father is 72 years old and has been complaining of leg weakness for approx. 2 1/2 years. His B12 level was 107 2 years ago  and is 111 now. He has seen a neurologist at Pittsburgh  hospital who performed an EMG. This doctor states that my dad is possible ALS.  He also has a positive ANA (40 dils, homogenous)
esr (35) and CPK  levels  of 600 for two years.  He was given B12 injections at one per month and told to followup in 3 months with  his neurologist.  Other than the weakness in his knees, he does not have any other symptoms of als.His doctor stated that the only way to completely dx als is to rule out everything else.
My question is two-fold. First, is his dosage correct to stop neurologic problems due to B12 deficiency?  Second, at one time the neurologist mentioned muscle biopsy to rule out poly myositis. Should he have a muscle bx? My father has an appointment at CCF in january.   I am concerned that if he isn't receiving the proper dosage of B12 he may not stop the neurolgic problems. Thankyou very much for answering these questions.

[missesther]

A related discussion, b12 deficiency was started.

[keys]

im not a doctor , my dear friend recently had similair problems had problems, has your dad been checked for b1 defiency if not , that can cause weakness in the lower body, my dear friend  at 73 was misdiagnosed with als and it was  Beri beri which is  a b1 defiency,it  can be caused  by alcohol intake , diuretics  , certain meds, and just  an insufficient intake of b1 or change in metabolism. if he hasnt been checked its a simple thing to get  done and treatment is simple,  some of the first symptoms are weakness in the lower body knees and ankles, fatigue or irratability. .about 25% i read of all alcholics have  it.  but it can be caused by other reasons and the older one gets the more sensitive thier  metabolism can be even  with just moderate drinking or medications .
the progression of the disease left unchecked  is terrible.

[CCF-Neuro-M.D.-CS]

Without examining your father I cannot tell you if his symptoms are related to B12 deficiency. A level of 111 is low (although I would need to see the labs normal values) and need to be replenished. Injections of B12 can be administered up to 2 times per week depending on the clinical scenario. Unfortunately without seeing your father I cannot make recommendations regarding treatment or other diagnositic studies. I would encourage you to speak with the doctor and ask him/her if they believe the B12 is causing his symptoms. Sorry I could not be of more help. If you would like to be seen earlier at the Clinic, I would encourage you to call the appointment office (216-444-5559) and ask about the cancellation list. Good luck.