What mayn be causing multiple symptoms such as fatigue,nausea,numbness,dizziness?

Patient

Q: I've been having multiple symptoms within the past 6 months and am not sure if they can all be related but I just feel that I know something is not right and I'm feeling frustrated. It all started with a pain in my upper left rib cage that I also felt in my back. I also had a numb tingling feeling starting in my chest all the way down my leg on the left side. I went to the doctor and he diagnosed it with inflammation in my rib and said it would go away on it's own. The pain went away within a week however the numbness continued in my leg for a few months. I went back and was referred to a neurologist. He did some tests and an MRI on my spine but found no results. Around this time I started experiencing dizziness, loss of balance, extreme fatigue, and nausea. Lately I've been feeling pressure in my chest when I breath at times. And today am feeling pressure in the left side of my head and face that feels like liquid is inside. Any suggestions would be helpful! Thank you!!

Doctor

A:   It seems that previously you had an intercostal neuritis that went away, then you are having fatigue, dizziness, nausea, balance problems, possibly you should be checked for anemia and Vitamin B12 deficiency. Vitamin B12 deficiency can have a number of possible causes. Typically it occurs in people whose digestive systems do not adequately absorb the vitamin from the foods they eat, excessive alcohol consumption, long term use of acid-reducing medications, atrophic gastritis, conditions that affect the small intestine, vegetarians. A deficiency of vitamin B12 can lead to vitamin B12 deficiency anemia. A mild deficiency may cause only mild, if any, symptoms, similar to those that you described, but as the anemia worsens it may causes symptoms such as: rapid heart beating, pale skin, stomach upset, weight loss, sore tongue, weakness, tiredness, light-headed, diarrhea or constipation and nerve problems. For some people, B12 supplementation may be necessary for life. If a diet lacking in animal products is the cause, the doctor will recommend dietary changes along with supplementation of vitamin B12 by injection or tablet. For most people, treatment resolves the anemia; however, any nerve damage that has occurred as a result of the deficiency could be permanent. I suggest that you talk to your doctor about get some blood test done to rule out anemia and also check Vitamin B12 levels.

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