So...reaching out to this community not specifically for medical advice but for suggestions on what questions I should be asking my medical team.
I'm a female in her late 40s. I'm a decent and experienced runner - I've broken 3 hours for the marathon and 5:30 for the mile, both after age 40.
For the last ten days, I've been dealing with the following:
*muscle twitching in my legs that gets worse at night as I fall asleep. I've always had benign fasciculation syndrome in my calves after hard workouts, but this is in my quads also, and is noticeable at night.
*a sense of mild vertigo/disorientation that improves after about an hour or so of running
*a feeling of being weak and off balance, especially when running on uneven pavement/downhill. This also improves when running, but only after an hour or so. It's like I'm running on a bosu ball that eventually levels out.
*continuing pressure behind my eyes.
*at first I was also experiencing a migraine aura (no pain), but I took a migraine med and that took care of that.
[notable: these symptoms did start the day after I got my flu shot for this year - I'm not sure if any correlation. I have not had any issue with the flu shot in the past several years.]
The oddest thing is how different my paces are as a run progresses. Until I've been running for an hour or so, I physically cannot run even moderately fast for even a small distance without feeling like I am going to fall on my face. But again, the longer I run the better I feel, the smoother my gait, and the faster the pace available to me. It's like I forget how to run every time, and have to relearn the skill each run.
I don't feel tired at all - my legs are just totally uncoordinated at first. (I do a solid pre-run mobilization routine pre-run, so it's not like I'm rolling out of bed and trying to run).
Background: I have a mild form of ulcerative colitis and also asthma - I'm on Advair, Qvar, and the biologic Xolair to control the asthma, and on oral mesalamine for the ulcerative colitics. I also have a family history of auto-immune and neurologic issues and have Raynauds and chronic migraines myself.
I had very similar symptoms last year, except that I did NOT work out of it and also felt exhausted all the time. At that time, we determined I had a severe folate deficiency (1.7 where below 3.4 is deficient), and I started folic acid supplements, which helped. I am still on those.
I also had some problems with fatigue and feeling short of breath this summer - at that time some bloodwork showed a mild iron deficiency (tsat of 15%), so I went on iron supplements, and that fixed that. Once the tsat was in the normal range and I was feeling better, we cut back the iron supplements to once every 2-3 days to avoid taking too much.
I've been tested a lot - last summer when I had the folate deficiency we ruled out other issues with a sleep study (fine) and a neurology work-up for MS (EMG/nerve conduction and brain MRI with/without contrast - also totally fine).
This summer I had a colonoscopy/upper endoscopy and a abdominal CT scan to see whether I had Crohns (a concern raised because of the folate and iron deficiencies, despite a good diet). Some minor inflammation in the large intestine and lower part of the stomach, but otherwise the only notable thing was that my stomach clears out food very slowly.
Bloodwork has always been good, other than the folate and iron issues, and slightly high vitamin A (which was weird, since I don't supplement that). Even with low folate and/or iron, I've never had any sort of anemia. B12 has always been slightly high (I do supplement that, upon the direction of a doctor). My last round of bloodwork was in August.
I saw my neurologist last week to get a refill of my migraine meds and explain the weakness/dizziness. He had me do some tests in front of him - I was mostly fine but had some trouble balancing with my eyes closed. He scheduled me for a follow-up EMG and also told me to start 200mg of Riboflavin daily plus CoQ10.
I've also reached out to my primary care to see what he thinks I should do, and whether I should come in to see him. When he contacts me, I'm going to ask him if another round of bloodwork is in order - looking at the CBC/CMP and also B-vitamin levels.
I happen to have a follow-up scheduled with my rheumatologist next week, so I'm also going to ask her about this.
My question to this group again is - any other questions I should be asking/steps I should be taking? Neurology and nutrition deficiencies/toxicities is what's at the front of my mind, but not sure if other avenues to pursue. And has anyone else experienced anything like this?
I'm a female in her late 40s. I'm a decent and experienced runner - I've broken 3 hours for the marathon and 5:30 for the mile, both after age 40.
For the last ten days, I've been dealing with the following:
*muscle twitching in my legs that gets worse at night as I fall asleep. I've always had benign fasciculation syndrome in my calves after hard workouts, but this is in my quads also, and is noticeable at night.
*a sense of mild vertigo/disorientation that improves after about an hour or so of running
*a feeling of being weak and off balance, especially when running on uneven pavement/downhill. This also improves when running, but only after an hour or so. It's like I'm running on a bosu ball that eventually levels out.
*continuing pressure behind my eyes.
*at first I was also experiencing a migraine aura (no pain), but I took a migraine med and that took care of that.
[notable: these symptoms did start the day after I got my flu shot for this year - I'm not sure if any correlation. I have not had any issue with the flu shot in the past several years.]
The oddest thing is how different my paces are as a run progresses. Until I've been running for an hour or so, I physically cannot run even moderately fast for even a small distance without feeling like I am going to fall on my face. But again, the longer I run the better I feel, the smoother my gait, and the faster the pace available to me. It's like I forget how to run every time, and have to relearn the skill each run.
I don't feel tired at all - my legs are just totally uncoordinated at first. (I do a solid pre-run mobilization routine pre-run, so it's not like I'm rolling out of bed and trying to run).
Background: I have a mild form of ulcerative colitis and also asthma - I'm on Advair, Qvar, and the biologic Xolair to control the asthma, and on oral mesalamine for the ulcerative colitics. I also have a family history of auto-immune and neurologic issues and have Raynauds and chronic migraines myself.
I had very similar symptoms last year, except that I did NOT work out of it and also felt exhausted all the time. At that time, we determined I had a severe folate deficiency (1.7 where below 3.4 is deficient), and I started folic acid supplements, which helped. I am still on those.
I also had some problems with fatigue and feeling short of breath this summer - at that time some bloodwork showed a mild iron deficiency (tsat of 15%), so I went on iron supplements, and that fixed that. Once the tsat was in the normal range and I was feeling better, we cut back the iron supplements to once every 2-3 days to avoid taking too much.
I've been tested a lot - last summer when I had the folate deficiency we ruled out other issues with a sleep study (fine) and a neurology work-up for MS (EMG/nerve conduction and brain MRI with/without contrast - also totally fine).
This summer I had a colonoscopy/upper endoscopy and a abdominal CT scan to see whether I had Crohns (a concern raised because of the folate and iron deficiencies, despite a good diet). Some minor inflammation in the large intestine and lower part of the stomach, but otherwise the only notable thing was that my stomach clears out food very slowly.
Bloodwork has always been good, other than the folate and iron issues, and slightly high vitamin A (which was weird, since I don't supplement that). Even with low folate and/or iron, I've never had any sort of anemia. B12 has always been slightly high (I do supplement that, upon the direction of a doctor). My last round of bloodwork was in August.
I saw my neurologist last week to get a refill of my migraine meds and explain the weakness/dizziness. He had me do some tests in front of him - I was mostly fine but had some trouble balancing with my eyes closed. He scheduled me for a follow-up EMG and also told me to start 200mg of Riboflavin daily plus CoQ10.
I've also reached out to my primary care to see what he thinks I should do, and whether I should come in to see him. When he contacts me, I'm going to ask him if another round of bloodwork is in order - looking at the CBC/CMP and also B-vitamin levels.
I happen to have a follow-up scheduled with my rheumatologist next week, so I'm also going to ask her about this.
My question to this group again is - any other questions I should be asking/steps I should be taking? Neurology and nutrition deficiencies/toxicities is what's at the front of my mind, but not sure if other avenues to pursue. And has anyone else experienced anything like this?