Objective: There is extensive literature on the clinical characteristics of vitamin B12 deficiency, but limited research of hypercobalaminemia and its effect on the body. The purpose of this case is to discuss the possibility of peripheral neuropathy and muscle twitches presenting as the clinical manifestation of hypercobalaminemia.
Clinical Features: A 49-year-old female patient presented to chiropractic clinic after having an extensive workup of paresthesia in her arms, legs, and upper back. Multiple MRIs did not reveal a clinical explanation for her symptoms. All lab work was reported as normal and serum B12 levels were significantly elevated but were not concerning as B12 is a water-soluble vitamin.
Intervention and Outcome: Collaborative care between a chiropractor and primary care physician resulted in monitoring of B12 levels. The patient was advised to discontinue the use of supplements with B12 and stop the consumption of energy drinks with B12. She was also advised to consume a diet lower in B12. Serum B12 levels were monitored over 13 months and as levels in the blood decreased, symptoms improved.
Conclusion: There is evidence in this case to support hypercobalaminemia is correlated with paresthesias and muscle spasms throughout the body.
Author keywords: Vitamin B12; Hypercobalaminemia; Chiropractic
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