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Original Message ----- From: Rodney G. , DC @grou ps.com Sent: Thursday, April 02, 2009 7:42 PMSubject: vague paresthesiasHi all:53 year old male, 10+ years of bilateral foot "numbish" feelings. Denies diabetes, has had workups apparently. Fingers have been tingling lately, and has been waking after 2 hours sleep with chin and "sides" tingling. No known exposures to heavy metals, toxic chemicals. No noted back or neck pain. I didn't ask about family history.I just did a phone consult, he called requesting an MRI to find out what was wrong and I told him it would be multiple areas and that he may want to consult a

neurologist first. Any ideas or referral recommendations?Thanks!Rod , DCTillamook Natural Health Center

Rod:

If he is a 53 year old male living in the Northwest I would be sure to rule out Multiple Sclerosis. Up to 90% of patients with MS with present with some degree of parestesia. If I was going to do any imaging I would like to se the brain, and the spinal cord in the cervical region.

Other important diagnoses to consider are hypothyroidism (order TSH and free T4 to start) and B12 deficiency (alcohol use/abuse? diet? history of medications which block the absorption of B vitamins). We all think of diabetes when considering foot numbness but there are many other conditions which present with bilateral paresthesia. Additionally some latent infections will also have numbness.

Hope that helps. Keep us posted.

Sincerely:

Dr. J Chlebowski

923 NE Couch St

Portland, Oregon

Drchrischlebowski.com

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