Doctors Story

Even physicians have been misdiagnosed with other neurological disorders when the real diagnosis was vitamin B12 deficiency. In 2004, David Carr, M.D., a local pediatrician in Orlando, Florida, began having paresthesias and balance problems which he himself thought may be MS. In 2005, he became very ill.

Carr was misdiagnosed with olivopontocerebellar atrophy (OPCA) or multisystem atrophy at age fifty-five. He lost fifty pounds, lost his vision, and gradually deteriorated to the point where he could not eat or walk. His sister, who trains guide dogs, says, "On his 'death bed' at Shands Hospital in Gainesville, Florida, the doctor discovered that it was pernicious anemia, vitamin B12 deficiency." Dr. Carr was told by his doctors that he would probably gain his sight back, but he may never walk again. Fortunately, with the help of physical therapy, forearm crutches, and a specially trained balance dog, Dr. Carr did regain the ability to walk, but he still suffers from neurologic disability caused by chronic untreated B12 deficiency.22

Dr. Carr relays that the so-called "best neurologist in Florida" mis-diagnosed him and told him he was dying and to go into hospice care. Multisystem atrophy is a rare neurological disorder characterized by a combination of parkinsonism, cerebellar and pyramidal signs, and autonomic dysfunction. His friend, a psychologist, carried him to the hospital where a geriatric psychiatrist correctly determined that he was severely B12 deficient (serum B12 54 pg/ml). In 2010 (five years later), Dr. Carr still suffers from the result of late diagnosed B12 deficiency and needs forearm crutches to ambulate.

Similarly, we advocate comprehensive B12 testing in all patients diagnosed with Guillain-Barré, chronic immune demyelinating polyneuropathy (CIDP), seizure disorders, ALS, CBG, and Parkinson's type disorders.

George, a fifty-two-year-old male, came into the ER with an injured right foot. Wheelchair-bound due to symptoms of MS, George could get up to shave and go to the bathroom, and that's what he'd been doing when he fell and broke his foot. His legs were very weak, and he walked with a spastic gait when he moved from his wheelchair to a regular chair. He complained of chronic mid-back pain and told the ER staff that in addition to his MS (diagnosed eighteen months earlier), he suffered from depression, bipolar disorder, spinal stenosis, an irritable bowel, and neuralgia.

George's history raised red flags, leading the ER doctor to look for additional evidence of deficiency. George's blood tests showed enlarged red blood cells, and his MMA came back elevated. The latter clearly indicated B12 deficiency, particularly after the doctor ruled out other likely causes of high serum MMA, such as impaired kidney function. Interestingly, George had high serum Bn levels, possibly because other doctors—mistaking his symptoms for effects of alcoholism—occasionally gave him intravenous fluids containing vitamins.

The ER doctor called George's primary care doctor one week later, after receiving all of George's results, and explained that the findings indicated that B12 deficiency was causing or exacerbating George's symptoms. George's doctor was grateful for the information, saying, "I owe you one."

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