B12 deficiency or Carpal Tunnel Syndrome?

[Dance_queen]

Hello, this is my first post but I have been reading posts on here, and replies, every day for the last two months, so I have learnt a lot! Thank you!

My main symptom is numbness and tingling in my fingers and thumbs. It started about four months ago and has gradually got worse and worse, so I now have tingling all the time in my middle and index fingers and thumbs on both hands so anything I do with my hands is painful after a while. I wake up in the night often with one or other hand feeling completely numb and I have to sit up and shake the hand or drop it down low to get the blood flowing again. Then I have severe pain in the fingers. I have been wearing wrist braces every night.

I have seen a GP several times but they say my B12 level is in the normal range so won’t prescribe injections. They say the hand symptoms are Carpal Tunnel Syndrome as it is only the two fingers and thumb but I say, so what about all of the other symptoms that started at roughly the same time? Heart palpitations, swollen ankles and muscle aches/fatigue? One actually said, regarding the ankles, ‘it has been warm, a lot of people get swollen ankles when it’s warm’! But not constantly for four months! I have had a 24 hour ECG which was satisfactory, but palpitations that keep you awake at night are not normal I don’t think.

I have been diagnosed with mild anaemia and mild gastritis. My B12 level was 264 ng/L in May, but has risen recently to 500 as I have been taking 1000 ug of Methylcoblamin by tablets for a month. I had one B12 injection in June which a locum prescribed, but only one every three months was prescribed. It helped for a couple of days I think.

My Reticulocyte haemoglobin content is below reference limit at 20.40 10*9/L [25.0 - 105.0] and my Transferrin level is slightly below reference limit. I have a private Active B12 Test to take this week.

So could it be Carpal Tunnel? Or more likely B12 deficiency? Any help would be appreciated. TIA.

[Charlie2024]

Hi, I will be interested to see what others think as I have a similar issue. I've been very lucky in that my GP has agreed to monthly B12 injections as they helped a lot and I can't go the routine 3 months between injections. Most of my symptoms of B12 deficiency have gone or are much better. However, I still have some tingling in some of my fingers and they can go numb during the night or when I hold my phone for any length of time. My GP also thinks this could be carpal tunnel syndrome and will review this in a few weeks. I told the GP initially that I thought it was related to my low B12, and have to say, it's become less severe since starting regular B12 injections but has not fully gone.

[Gambit62 Administrator]

The hand symptoms are certainly consistent with carpal tunnel. It isn't to do with blood flow but is nerves being trapped in a thin corridor of bone and cartilege in the wrist - as such it can respond quite well to wrist posture - keeping the wrist straight means the corridor doesn't get constricted. Wearing a wrist brace at night may also help with keeping the wrist straight whilst you sleep.

Because B12 deficiency affects nerve responses in a couple of ways it may be making the issue a bit worse. B12 is used to maintain the protective sheathe that insulates nerves and is also involved in the process that resets neuro transmitters - the chemicals that transfer signals between cells.

I still have carpal tunnel but I do find - having dealt with my B12 deficiency - that the time it takes for feeling to come back - and the painful period of pins and needles as it does - is much reduced.

[wedgewood]

If ALL your fingers get completely numb , then it isn’t carpal tunnel syndrome . Carpal tunnel syndrome does NOT affect you little finger, and only part of your ring finger .

[Jillymo]

I was diagnosed with carpel tunnel some years ago now with the symptoms you describe. I also have the wrist braces but cant say they did anything to relieve the symptoms ! It is my ring finger and little pinky that are mostly affected. My thumb joints are very painful and as you have said to hold the phone for any length of time becomes unbearable.

I can no longer rest on my elbow because my the arm goes numb and as you say I too wake up with a dead arm and have to shake it. I inject daily but it has made no difference to my symptoms. I also have the swollen ank;es in the heat and 'very painful' feet, I have recently had cortisone injections in them. It is difficult to know what is causing what.

[Sleepybunny]

Hi,

From what I've read (I'm not medically trained) the symptoms of CTS and B12 deficiency can overlap.

B12 deficiency can cause damage to the myelin layer around nerves. Damaged nerves can lead to symptoms such as pain, pins and needles and many other symptoms.

NICE ( National Institute of Health and Care Excellence) guidance on CTS mentions B12 deficiency.

I left detailed replies with links I think you'll find useful in this thread

Help Needed! Have I got Pernicious Anaemia?

healthunlocked.com/pasoc/po...

I have a similar condition "Cubital Tunnel Syndrome" and I wonder if it's partly due to damage from a long period of untreated B12 deficiency showing up more as I get older.

I'm not medically trained just someone who suffered for years from unrecognised and untreated B12 deficiency.

[Cornwaller]

Your untreated b12 serum level at 264 is low and is in the range which could indicated b12 deficiency and this can be confirmed by the presence of b12 deficiency symptoms. You can check your symptoms at B12d.org. carpel tunnel and pins and needles are widely reported as possible b12 deficiency symptoms. Now you have taken b12 supplements your serum levels will be higher as you report. At this point blood tests are probably difficult to interpret.

For reasons which aren't really well understood, many people find that the treatment has to be continuously maintained at a high intensity for the symptoms to abate.

[HeartyGilly]

I was diagnosed with CPS before I was diagnosed with B12 deficiency. But once my B12 deficiency was treated my CPS disappeared and it now only returns when I am due my b12 injection.

[Dance_queen in reply to HeartyGilly]

That’s interesting and gives me hope. Thanks 😊