Beyond trigger points

In a previous column, (My miracle cure), I recounted the success that I have had with trigger point therapy. Now the rest of the story.

Trigger point therapy has been a Godsend for me. It cured overnight the disabling pain that I had in my right leg and also pain in my right hand and wrist that was so bad it was keeping me from sleeping. And yet, after a while, I began to wonder, why was I getting all these trigger points to begin with?

Some people would say that it is just old age creeping up, but further research has indicated that there are certain factors that predispose a person to develop trigger points. Of course the most obvious ones in my case are that I am overweight and have Type II diabetes.

I was diagnosed with diabetes over a decade ago and at first I was able to control my sugar level by weight loss and diet. About two years ago my sugar got out of control and I found I could no longer bring it down to normal levels with diet and exercise alone.

It was then that I started taking a small (500mg daily) dose of Metformin or Glucophage. This was a very effective drug and not only did it bring my blood sugar back to normal but it also helped me lose about 30 pounds in the first six months.

After a year or so, however, the weight started to creep back on, although I am still 15 pounds below where I started. My blood sugar also started to creep back up, but not enough to alarm my doctor (yes I do have one!) who rejected my suggestion that I increase the dose.

A few years ago I was given a thorough nerve conduction test and was told that, like most diabetics, I was showing some signs of mild neuropathy. The classic case of this is when the smaller nerves particularly in the legs slow down or stop working and you lose sensation in your feet. Could my neuropathy be somehow related to the pain in my legs and the formation of trigger points?

Another clue to my unique medical problems, which have baffled a number of doctors, therapists and chiropractors is that I have been a strict vegetarian for almost 40 years. No meat, fish or eggs. The only animal product that I eat is cheese.

I have been repeatedly warned that vegetarians are prone to develop Vitamin B-12 deficiency, but I never really worried about it and have not been much of a Vitamin pill popper. As I continued to suffer recurring muscle and tendon pain and injuries, however, I began to wonder if this could be a factor.

Despite repeated warnings about the dangers of the Internet, I continue to google medical information voraciously. Last week I stumbled upon some information that I had missed in all my research about Metformin. It seems that one of the side effects of the drug is that it interferes with Vitamin B-12 metabolism. Hmmm.

It suddenly occurred to me that I now had two strikes against me. Not only was my mainly vegan diet putting me at risk for a B-12 deficiency, but I was also taking a drug that has been shown to cause that deficiency on its own. I decided it was time to pop a few vitamins.

On Saturday I purchased a B-complex vitamin that contained 100 mcg of B-12. Although this is 1667% of the recommended daily allowance, my reading had indicated that this was really a minimum dosage for someone trying to overcome a B-12 deficiency. Because of the body’s notorious inefficiency in using B-12, many doctors prefer to give B-12 shots at much higher strength.

I’m not ready for that yet, but the preliminary results have been encouraging. Within just a couple of days the pain in my legs and my trigger points has reduced noticeably. While it may be too early to declare victory, I will continue to take the vitamins and see what happens. I may even ask my doctor about it!

By the way, some of the other signs of B-12 deficiency are mental confusion and irritability. Please let me know if you find me less so.

Postscript: It has now been three months since I started taking the B-12 (although I switched to a stronger version that has 1,000 mcg) and the improvement has been amazing. I still need to massage the occasional trigger point for maintenance, but the constant pain in my legs that I suffered through for about 4 months is completely gone!