I have lived with chronic migraines most if my life

Patient

Q: Ihave lived with chronic migraines (most if my life) and more recently I've been having sleeping issues aa well. I can fall asleep but wake up many tines a night. Sleep aids do not seem to help, nor does going to bed early and keeping a routine. I had several surgeries (7 in a year) a few years ago on my hand and my body seems to never have recovered fully. I amso had mono about 4 months ago as an adult. In addition to the sleep issues, I now have a very bad caae of restless leg sybdrome. In the past frew months, Ive started getting tingling in my feet and hands. Last weekend during a short boat ride with family, my hands and face were prickly and numb feeling all day and I have been really weak and lathargic wver since. My eyes seem to bbe having difficulty focusing too. I have been taking a D supplement for many months and my doctor put me on a potassium supplement, but Im not seeing improvement. Any ideas on what the problem might be? Thanks!

Doctor

A:   Hello,

As mentioned you are having sleep issues with tingling and numbness, with blurred vision and lethargy. These symptoms complex can occur due to plenty of causes but the commonest ones are:
Deficiency of B12
Depression.

Both these causes can lead to the mentioned set of symptoms. The first one can be easily identified by a blood test and can be confirmed. Later supplementation is also easy.
The other mentioned illness, depression can also lead to the stated symptoms and can be treated with Escitalopram or Duloxetine. If the B12 levels come normal, it would be wise to meet a psychiatrist.

Hope this helps.
IN case if you have any further query, do let me know.
Regards

Comments / Follow Ups

Patient: Thank you for your feedback. I am taking Duloxetine for anxiety and have been for a couple of years. My physician has mentioned my B12 level being low in the past, but not this last round. I will have to ask about it again. The D and potassium were mentioned, but not B. I haven't seen much change with the D and potassium though.
Doctor: Hello
I would suggest that B12 levels would be more specific as compared to Vit D and Potassium. Do insist for B12 estimation in your next visit and if low, then it needs to be corrected.
Regards

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