Family doctor: Sudden-onset fatigue calls for full physical

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Q: I have not seen anything in your column about fatigue.

I am a 77-year-old male. Last year I was jogging, but six months ago I had to stop because I just don't have the "get up and go" that I used to have. My health checked out fine, and the doctor gave me a booster shot of vitamin B-12, but it didn't help me at all.

Others have told me that I need a daily vitamin. There are so many on the market today that I don't know which brand or strength is best.

A: A daily multivitamin may be all you need. I recommend you use one of the better-known brands. They may be a little more expensive than other brands, but they often have better quality control.

Centrum or One-A-Day should offer you both the quality and variety you need. You may wish to shop around to find the best price.

I also urge you to have a full physical exam, including a review of any medications you are taking, as well as testing for anemia, diabetes, congestive heart failure, vitamin deficiencies and more.

Fatigue is a common symptom of many disorders. Because yours came on suddenly, I worry about potentially serious causes.

If everything checks out normal, it is then time to look at your diet, lifestyle, exercise, sleep habits and stressors. These can be benign causes of fatigue and, fortunately, are easily correctable with minor changes, such as a more balanced diet, increasing exercise and reducing stress.

Start by adding the daily multivitamin, followed by an appointment with your primary-care physician.

LEG CRAMPS

Q: I, like many of your readers, have bad leg cramps. While I do not have a solution to prevent them (soap doesn't work for me), I do have something that stops them.

It is an over-the-counter medication called Leg Cramps. I purchase mine at Walgreens, but I am sure it is available in more places. They stop the pain within 60 seconds or so, and, if the cramp returns, I simply take another one. I hope this helps your readers.

A: I have had no experience with this product, which is made with quinine, but I am passing it on to my readers.

I ask that anyone with Leg Cramps experience (either good or bad) write to me with their results. I will put the answers in a future column. Thanks for writing.

Write to Dr. Gott c/o United Media, 200 Madison Ave., 4th fl., New York, NY 10016.

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Abstract purpose of vitamin B12 deficiency diseases of the nervous system caused by the disease characteristics, clinical type. Methods 15 cases of vitamin B12 deficiency in patients with clinical data reviewed. Results of vitamin B12 deficiency in patients with symptoms of the nervous system mainly for the physically feeling very deep feeling of decline, ataxia and spastic Qingtan, early often misdiagnosed, the pathological changes of myelin is missing, the site can demyelinating Central nervous system, can also peripheral nervous system. Conclusion of vitamin B12 deficiency caused by the nervous system demyelinating diseases in addition to the spinal cord, can cause big white matter, brain stem and peripheral nerve demyelination change.

Key words: vitamin B12 deficiency, nerve degeneration

Vitamin B12 deficiency can cause nervous system disease, central nervous system and peripheral nervous system may be involved, clinical performance for the two-leg cramps and Qingtan, deep feeling of decline, ataxia, neurological disorders, such as around 1 . As the involvement of different positions, clinical performance is not the same. In recent years by now, I treated 15 cases of vitamin B12 deficiency caused diseases of the nervous system of the cases were reviewed as follows.

1 clinical data

11 general information on vitamin B12 deficiency in 15 patients, aged 36 to 78 years, an average of 57.8 years old, both males and the course of three months to 7 years, an average of 19.9 months. Past history of drinking two cases, Manxingweibing history of five cases, subtotal gastrectomy in 1 case. Clinical manifestations of the nine cases of spinal cord injury, decreased performance for memory and orientation of the obstacles to the two cases of brain lesions, peripheral nerve damage for the performance of the four cases.

12 auxiliary examination of serum concentrations of vitamin B12 to reduce the 13 cases, increased to two cases (attendance are taking vitamin B12), under the double-limb evoked potential (SEP) showed that six cases of abnormal limb on the two-SEP show abnormal case. MRI revealed spinal cord signal uneven six cases, the first CT scan showed that brain atrophy three cases, two cases of white matter degeneration.

2 discussion

The classic vitamin B12 deficiency caused by the nervous system disease refers to the spinal cord of the joint sub-acute (SCD), spinal cord lesions accumulated after the main cable, the cable side and peripheral nerve. When the white matter and serious nerve can be involved. In our observation of 15 patients found that vitamin B12 deficiency in the nervous system of patients with the performance of each, of which the first symptom to both lower extremities unable to walk with seven cases of instability, stamping on the cotton flu are two cases, only a memory decline Cases, limb numbness, four cases, double the limbs evoked potential (SEP) showed that six cases of abnormal limb on the two-SEP show abnormal case. Cervical spinal cord MRI revealed disc 2 to 7 with one case of spinal stenosis, 6 to cervical disc degeneration chest 5, 7 to chest a neck, chest 2

Additional information:

From www.cantonrep.com:
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