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What is a Diplomate? The term "ACVS Diplomate" refers to a veterinarian who has been board certified in veterinary surgery.

Hi Lan, Common symptoms of b12/folate deficiency could be some collection of common non-specific symptoms. Fatigue and tiredness, depression, lots of mysterious aches and pains, excema, dandruff, MCS, allergies, asthma, IBS, sore mouth, sore tongue, canker sores, sores at the corners of mouth, muscle pain. I’ve run across the “moons” on fingernails site. The woman writing it had very serious b12/folate deficiencies. She is sincere. I just don’t know. Those might be the only b12 deficiency symptoms I never had. Out of 400 or so possible symptoms most people never have more than 1/3 to 1/2 of them. Just starting out there is always a first handful of symtpoms. One of the things that distinguishes b12 deficiencies is the dozens of symptoms the doctors are all willing to ignore and tell you they mean nothing. There are at least 5 subdeficiencies involved and what symptoms a person has depends upon which combination of subdeficiencies they have. The very best way to tell is to the supplements. The one thing I am reasonably sure of is that people without deficiency symptoms have no responses. If one puts an Enzymatic Therapy B12 infusion (MeCbl) under a lip for 1-2 hours, 75% of those with a deficiency will have a response before the two hours. If one use a combination of 1 Enzy, and an Anbol Dibencoplex (AdoCbl) capsule emptied between lower lip and gum and at same time as MeCbl under upper lip and retains it the same 2 hours, 85% of thosw with deficiency will likely respond. If an L-methylfolate 800mcg is swallowed 30 minutes before the other two items, approaximately 90% with deficiency will have a response within 2 hours. If a 125mg or larger l-carnitine fumarate is taken on empty stomach with the Metafolin (L-methylfolate) only if a person doesn’t have anxiety,, the repsonse rate for deficiency goes up to 95%. Skin problems, behavoral and emotional and neurological symptoms, sleep disorders, all show up before fatigue which shows up only after a severe worsening of symtpoms. Fatigue is a late arrival. Longitudinal ridges in the nails can be casued by methylation and cell reproduction turning on and off and can happen with stree and illness that put a big demand on the body. My partner developed deep ridges in her big toe toenails from a 2 week international trip that exhausted her and nearly fainted during a performance.


Hi Fredd, i have found ur articles on B12 very informing and helpful i have 3 monthly injections of B12 I do not know my levels as i have never asked, i was recently put on Folic acid tablet, which i have always thought were given to woman trying to conceive or pregnant, i also take vitamin D with calcuim. I still feel very tired to the point where i cud go back to bed after only getting up from bed although i never stay asleep all night . I feel at the moment i am in pain all the time my legs and back and sometimes i cant even dry my hair properly and my arm hurt holding the hairdryer . I also suffer with dizzy spel.s I also have IBS which ive had for years i am due to go back to my doctor I have two sons one has diagnoised autism he is 20 the other one has adhd can u please give me any suggestions that i cud give to my doctor as i feel im just not feeling any better

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View this table:

Table 1. Clinical Characteristics Among Participants With PAD According to Leg Symptom Category

Figure 1 shows associations of leg symptom categories with calf muscle characteristics with adjustment for age, sex, race, BMI, ABI, comorbidities, recruitment cohort, lower extremity revascularization, physical activity, and cigarette smoking. Compared with individuals with PAD and IC, those who were always asymptomatic had lower calf muscle area ( P <0.001), higher calf muscle percent fat ( P <0.001), and lower calf muscle density ( P <0.001) ( Figure 1 ). No other leg symptom group had significantly different muscle characteristics compared with IC after adjustment for multiple comparisons.

Figure 1. Adjusted associations of leg symptom categories with calf muscle characteristics in persons with PAD. Pairwise values shown are in reference to participants with IC symptoms. Results are adjusted for age, sex, race, BMI, comorbidities, ABI, smoking, lower extremity revascularization, recruitment cohort, and blocks walked during the past week. Analyses of calf muscle area also are adjusted for tibia length.

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shows associations of leg symptom categories with peripheral nerve function with adjustment for age, sex, race, BMI, ABI, comorbidities, recruitment cohort, smoking, height, and alcohol use. PAD participants who were always asymptomatic had poorer peroneal nerve amplitude, peroneal NCV, sural nerve amplitude, and sural nerve latency than those with IC. When analyses for NCV were repeated after exclusion of participants with 0 values (ie, after exclusion of participants with no evidence of any nerve activity), peroneal NCV was no longer significantly different between the always asymptomatic and IC groups. No significant differences in upper extremity nerve function were found between the always asymptomatic and IC groups, suggesting that differences in peripheral nerve function were specific to the lower extremities.

View this table:

Table 2. Adjusted Associations of Leg Symptom Categories With Peripheral Nerve Function in Persons With PAD

Figure 2 shows associations of leg symptom categories with lower extremity performance in PAD persons with adjustment for age, sex, race, comorbidities, BMI, smoking, ABI, physical activity, and recruitment cohort. Always asymptomatic PAD participants had significantly poorer performance on the 6-minute walk, usual- and fast-paced 4-m walks, and the Short Physical Performance Battery compared with those with IC ( Figure 2 ). PAD participants with exertional leg pain/carry on had significantly better 6-minute walk performance compared with participants with IC. PAD participants with pain on exertion and rest had significantly slower usual-paced walking speed compared with IC.