[48F] With tingling in extremities and headache

Patient Description

A 48-year-old female presents with tingling in her fingers and feet for the past two days, described as pins and needles, worsening at night, and lasting for hours. The tingling developed gradually without associated numbness or muscle weakness. She also reports fatigue, an acne breakout, and a frontal headache, aching in nature, rated 6/10 in intensity, and relieved by sleep. The headache has been present for two days without visual changes, nausea, or vomiting, but she notes feeling off balance and clumsy. The patient has been vegan for the past year without taking vitamin B12 supplements. She is currently taking Vyvanse 70 mg daily with food and has no known drug allergies. No recent infections, illnesses, or changes in medication or diet apart from the vegan diet.

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Arora's Assessment

What might be happening

Based on your symptoms, here are some possible explanations:

  • Vitamin B12 Deficiency: Tingling in the fingers and feet, fatigue, and balance issues can be signs of a vitamin B12 deficiency, which is common in vegan diets without supplementation. B12 is crucial for nerve health and energy levels.

    • Treatment typically involves dietary changes or B12 supplements. Blood tests can confirm the deficiency.
  • Medication Side Effects: Vyvanse can sometimes cause headaches and fatigue. It's important to discuss these symptoms with your doctor to see if they might be related to your medication.

    • Adjusting the dosage or timing of your medication might help.
  • Tension Headaches: These are common and can cause aching pain in the front of the head. Stress or poor posture might contribute.

    • Over-the-counter pain relief and stress management techniques can be helpful.

What you can do

  1. Consult a Doctor: It's important to discuss your symptoms with a healthcare provider. They can perform tests to check for vitamin deficiencies or other issues.
  2. Consider B12 Supplements: As a vegan, you might benefit from taking a B12 supplement. Discuss this with your doctor.
  3. Monitor Symptoms: Use MDandMe to journal your symptoms, track any changes, and share this information with your healthcare provider.
  4. Lifestyle Adjustments: Ensure you're eating a balanced diet, staying hydrated, and managing stress. Gentle exercise might also help with balance and fatigue.

What you should look out for

  • Worsening Symptoms: If your tingling, balance issues, or headaches worsen, seek medical attention.
  • New Symptoms: Watch for any new symptoms like severe weakness, vision changes, or confusion, and contact a healthcare provider if they occur.

Remember, this information is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and treatment plan.

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2 mo ago


People Also Ask


What are the common symptoms of vitamin B12 deficiency?

Common symptoms of vitamin B12 deficiency include tingling or numbness in the hands and feet, fatigue, weakness, balance problems, and cognitive disturbances. It can also lead to anemia and neurological issues if left untreated.


Can a vegan diet lead to vitamin B12 deficiency?

Yes, a vegan diet can lead to vitamin B12 deficiency because B12 is primarily found in animal products. Vegans are advised to take B12 supplements or consume fortified foods to meet their nutritional needs.


What are the potential side effects of Vyvanse?

Potential side effects of Vyvanse include decreased appetite, dry mouth, insomnia, increased heart rate, anxiety, and headaches. It's important to discuss any side effects with a healthcare provider to determine if adjustments are needed.


How can tension headaches be managed effectively?

Tension headaches can be managed with over-the-counter pain relievers, stress management techniques, regular exercise, proper posture, and ensuring adequate hydration and sleep. If headaches persist, consulting a healthcare provider is recommended.


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