Speculation on a possible cause

[Alchemist]

From the article posted on this site on andropause I have extracted the symptoms that apply.  I have edited down the symptoms to include only those that are known to be tied into methylb12, adenosylb12, methylfolate deficiencies.  There are several hundred additional symptoms centered around skin problems, neurological problems, sleep disorders, reproductive disorders, biochemical and cell abnormalities, mood, personality and other changes.  Many are called "normal" aging.  The earliest 100 symptoms or so are generally written off as "non-specific" and are ignored for decades until blatant disease processes are seen.  For those with shortages from birth for often genetic reasons, there are often a peak of symptoms as puberty sets in and the system is strained.  Low or fluctuating levels of testosterone is common.  Later in life another peak often occurs around 50 and thereafter as the stomach produces less acid and less b12 can be absorbed potentially causing a large drop or fluctuations in testosterone and other hormones.  Additionally these drops of b12/mfolate can also occur as the real vitamins are replaced in the food chain with folic acid and cyanocbl, both inactive forms that are at best only partly effective, 20-50% effective at best.  How we got ourselves into that fix is a long story.

    Lower energy or fatigue;
    Lower sex drive or libido;
    Softer erections, ‘erectile dysfunction’ or loss of morning erections;
    Hot flushes or night sweats. Other non-specific symptoms may include:
    Loss of motivation and self-confidence;
    Feeling sad, depressed or anxious;
    Poor concentration;
    Declining memory;
    Sleep disturbance;
    Increased need for napping; and
    Decreased physical strength.

Increased body weight, especially increased body fat, often around the mid-section or waistline;
Decreased muscle mass and strength and eventual frailty;
Decline in bone strength (measured by a scan) and risk of bone fracture and height loss;
Increased wrinkling (with very low levels of testosterone);
Blood pressure may also be high, although there are many co-factors for high blood pressure; and


Lack of mb12-adb12-methylfolate causes a multitude of biochemical changes and body malfunctions from cell replication/growth abnormalities, abnormal PAP smears, hormone abnormalities (low testosterone), neurotransmitter abnormalities, increased asthma, increased allergies, MCS, lack of ATP generation and increased MMA production, increased HCY, increased histamine, increased inflammation, epithelial abnormalities, endothelial abnormalities, ED, reduced libido, poor quality sperm, no sperm, reproduction failure, neural tube defects, reduced or poor orgasm, autoimmune diseases, poor immune function, IBS, possiibly cancer cause by DNA replication abnormalities, linked to MS, ALS, Autism,  Parkinson's, Alzheimer's, FMS, CFS, hypothyroid, Hashimoto's thyroiditis, possibly Lupus, and many other neurological disorders by low CSF cobalamin levels AND increased MMA and/or HCY levels in the CSF (specific parkers for low adb12, mb12/mfolate/p5p).  This is the short list.



Puberty puts a big stress on those with low b12/folate levels causing increased problems when growth puts large stress on b12/folate levels for several years.  After age 50 stomach acid decreases and absorbtion of b12 from food decreases causing large increase in symptoms, worsening as people age.  As the food levels of cyanocobalamin and folic acid increase over the years 1960 to present, neurological diseases have increased at comparable rates (20 year offset) with the most increase of these associated neurological condtions being over the last 15-20 years.  This period includes far more consumption of fortified foods.  White flour is now fortified with folic acid (USA) and has been for more than a decade now.

In the near future I will post a list of childhood symptoms that point more or less at these b12 and folate deficiencies.  These are not documented by research for the most part and come from case histories of people who have found these vitamins effective against their symptoms.

These nutrients are not a cure for gynecomastia.  They might be able to change the process if they are connected while it is happening or prevent it if used in advance.  However, at this point I am merely speculating and getting ready to gather some data.  So anybody who would like to compare their symptoms to the ones I am going to post, be thinking about childhood symptoms especially for those with onset at puberty.  My son and I both fit the b12/folate deficiencies pattern and the puberty onset of gynecomastia pattern. 

[xelnaga13]

Very confusing hypothesis. Its basically a medical spider web connecting b12 and folate deficiencies to everything from autism to gynecomastia. Vitamin and mineral deficiencies lead to abnormal body function; nothing ground breaking here.

Focusing on gynecomastia for a moment; I believe artificial hormones in plastics and food products are more likely to blame for pubertal onset gynecomastia.

[Alchemist]

Very confusing hypothesis. Its basically a medical spider web connecting b12 and folate deficiencies to everything from autism to gynecomastia. Vitamin and mineral deficiencies lead to abnormal body function; nothing ground breaking here.

Focusing on gynecomastia for a moment; I believe artificial hormones in plastics and food products are more likely to blame for pubertal onset gynecomastia.

Hi Xelnaga,

Focusing on gynecomastia for a moment; I believe artificial hormones in plastics and food products are more likely to blame for pubertal onset gynecomastia.

I and everybody my age or older score a complete zero on "artificial hormones in plastics and food products" for onset prior to 1960.  Also, it doesn't explain the big bump in age related onset of men in their 50s. 

Its basically a medical spider web connecting b12 and folate deficiencies to everything from autism to gynecomastia.

I have been a health care systems analyst since about 1981. Construction of data matrices and their analysis has been part of what I do.

Data matrix might be a more accurate word than "spider web".  It certainly does not account for "everything".

The main cobalamin form used as a vitamin is Cyanocobalamin, a lab mistake that won the Nobel prize in 1948.  It is the official "B12" because of the lab mistake.  The two actual active forms of cobalamin, methylcobalamin and adenosylcobalamin were not identified until 1959.  Mb12 and adb12 are anywhere from 100 to 10,000 times more effective than cyanocobalamin.  The only advantage of cyanocbl is that it is shelf stable indefinitely, like a Twinkie.  Cyanocbl and hydroxycbl (the inactive form used in UK and some other countries, also a Twinkie of the vitamin world, work to some degree on approximately 1/3 of the symptoms that the active forms of cobalamin work on for approximately 2/3 of people.  For the other 1/3 they don't work at all on the studies symptoms.

Methylfolate (Metafolin by Merck)is effective for 100% of people as the folate required for DNA transactions for cell reproduction.  Folic acid works not at all for 20% of people, works very little for another 30% and up to the biological limit of conversion (about 800mcg/day), not necessarily adequate, for 50%.  In some unknown percentage of people folic acid actually blocks at least 10x as much of the active (methylfolate) form. Some people also have the same problem with folinic acid, just recently becoming available as a vitamin and is the natural form of folate in vegetables.
 
Let's look at the matrix for Subacute Combined Degeneration, MS, ALS and Parkinson's.

Subacute combined degeneration has low cerebral spinal fluid and low blood serum cobalamin.  Research since the 90s has indicated that all three of the other three have low cerebral spinal fluid levels of cobalamin (various non-specific analogs of b12) independent of blood serum level.  Further for MS there is elevated homocysteine, a specific marker for low methylb12 and/or low methylfolate and/or low p5p (active form of B6).  For Parkinson's there is biochemical marker of elevated MMA, a specific marker for low adenosylb12 which powers the neurological mitochondria and cause MMA to be formed when there is insufficient adenosylb12.  Latest hypothesis of cause of Parkinson's is neurological damage from 20 years of malfunctioning mitochondria producing MMA instead of ATP.  For ALS both biochemical markers are present; homocysteine and MMA (methylmalonic acid).  Whether there is causality involved in the neurons being damaged by lack of methylb12 and/or adenosylb12 in these diseases is not yet known.  However, lack of methylb12 causes neurological damage.  Lack of adenosylb12 causes neurological damage. Both SCD and MS have demyelination of the nerves as a major feature of the damage they do.  The difference being that SCD happens more symmetrically.  Also, the definition of MS requires that b12 deficiency based on blood serum level not be present.  That exclusion criteria predates the discovery of cerebral deficiency with blood serum levels.

Chronic Fatigue Syndrome (CFS) and Fibromyalgia Syndrome (FMS), and the parent ME, have have 100% of their symptoms as part of the active b12 and active folate deficiency syndromes.  They have the low cerebral spinal fluid cobalamin level but the research hasn't been done yet, that I am aware of, to determine if HCY and/or MMA are present in the CSF.  However, most of the functional symptoms are reversed in months with sufficient quantities of high quality methylb12/adenosylb12 and methylfolate and much of the damage heals within a couple of years.  This is pragmatically demonstrable by thousands of people currently treating themselves in advance of the needed research which is barely beginning.  Eight years ago I was dying and my problems included SCD, FMS and CFS among other things.  I am 95% healed on 175 of 200 symptoms.  I am no longer diagnosable with FMS or CFS but the SCD is only fought to a standstill and about 75% reversed.  I was weeks to months away from diapers in a wheelchair at that time. 

In looking at the andropause article I couldn't help but notice that almost all the symptoms are also b12 deficiency symptoms.  Of course low testosterone is also a b12 deficiency symptom.  The only ones listed that I eliminated from the list above are some things that have not been asked about in the b12 deficiency arena.  However when a FEW men on a Fibromyalgia board start asking about bras for their breasts, it gets my attention.  So I present this as a hypothesis with the intent of gathering information to test the hypothesis if people will offer it.  Yes, it is complicated. An a few short paragraphs are no adequate for laying it all out. If it wasn't it would have been solved already.  Because of the body-shame associated with gynecomastia, almost nobody on an FMS, CFS or b12 deficiency board is going to volunteer it.  And since almost nobody mentions it almost nobody might suspect it could be associated.  Instead a very few guys out of tens to hundreds of thousands mention it which is way below normal incidence.


The above is only touching the surface.  I could go on for another 100 pages or so if you would like to see more of the matrix and discuss it intelligently instead of dismissing it out of hand.

[xelnaga13]

@ Alchemist- You're obviously very schooled in the above subject matter, so take your liberties. I did not mean for my comments to appear dismissive in any way. I would like to have a clear understanding of your position.

For the sake of clarity can we limit the conversation to gyno, andropause, and b12/folate deficiency? Is there anyway you can write it in layman's terms?

Now onto plastic. While I agree plastic contamination does not explain your generation of early onset gyno; it is a possible cause for younger generations.

[xelnaga13]

One more thing ... How do you feel about b12 injections for individuals in their 20's; that have no underlying vitamin deficiencies? Thank you for your time and attention.

[Alchemist]

One more thing ... How do you feel about b12 injections for individuals in their 20's; that have no underlying vitamin deficiencies? Thank you for your time and attention.

Hi Xelnaga,

Over 99% of "b12" injections are cyanocbl or hydroxycbl and are not particularly effective compared to sublingual methylb12 and adenosylb12.  Only certain brands are effective.

Jarrow 5000mcg and 1000 mcg tablets and Enzymatic Therapy B12 infusion methylb12 are the two 5 star brands that are head and shoulders better than any other brands I know of.  Source Naturals Dibencozide (another name for adenosylb12) 10mg and Country Life 3m Dibencozide (has folic acid and is a problem for some people) are the two effectfive brands of this.  If you have a bunch of "non-specific" symptoms then BOTH kinds could each be separately effective.  A 5000mg Jarrow is as effective as a 750-1250mcg subcutaneous injection when held under the upper lip for 45-120 minutes (longer the better).  About 85% of suitably symptomatic persons will have a response to either brand and size of mb12 and/or adb12 within 2 hours.  That increases to 95% with Metafolin swallowed at the same time.  The other 5% need some other additional vitamin or supplement with L-carnitine fumarate, vitamin D3, SAM-e as the most likely.  50% of the population regardless of remembered symptoms will have the 2 hour response and then remember the symptoms the docs have all told them they didn't matter.  Truly asymptomatic people have no response.  If you have a response you NEED these things.  Private message me and I'll tell you where you can get them quickly at a good price and $5 off the first order. 

Injections are only needed for those with low CSF cobalamin levels and normal to high serum levels.  And then they need to be methylb12 injections and many of those are exposed to too much light during mixing by the compounding pharmacy destroying their effectiveness.  Go with the mb12/adb12 sublinguals.  They are far more reliable.

[Alchemist]

@ Alchemist- You're obviously very schooled in the above subject matter, so take your liberties. I did not mean for my comments to appear dismissive in any way. I would like to have a clear understanding of your position.

For the sake of clarity can we limit the conversation to gyno, andropause, and b12/folate deficiency? Is there anyway you can write it in layman's terms?

Now onto plastic. While I agree plastic contamination does not explain your generation of early onset gyno; it is a possible cause for younger generations.

Hi Xelnaga,

For the sake of clarity can we limit the conversation to gyno, andropause, and b12/folate deficiency? Is there anyway you can write it in layman's terms?

For the moment, what you see there is 100% on those subjects.  I've just started researching it.  I don't know that anybody at all in the research community has looked into it in this way.  So I am reading my way through lots of articles trying to find something useful.

[Alchemist]

These are the many of the most frequently seen symptoms in childhood of people later responding to methylb12, adenosylb12 and methylfolate.  These are gathered from case histories as reported by the person and subject to memory errors.  They have been compared to adult symptoms and there are many that are the same.  A few come out of published research on b12 deficiency, FMS and CFS from various sources.  They are all basically the same categories as the adult symptoms; ie immune malfunction, tissue formation malfunction or functional neurological.  As a child neurological damage symptoms and signs are rare.


delayed myelination
failure to thrive
autism
delayed speech
depression
frequent or continuous tonsillitis
frequent strep
frequent pneumonia
frequent long-lasting supposed viral illnesses that linger and linger and linger
everything goes to the lungs for extended periods
headaches
growing pains
skin problems
dandruff
allergies
asthma
continuous swollen glands in neck
low grade fever for years
Night terrors
Prolonged hypnopompic state transitioning from sleep
Prolonged hypnogogic state transitioning to sleep
Sleep paralysis
seizures
coma
nosebleeds
canker sores

[Alchemist]

These are many but not all of the general symptoms, signs and characteristics from adenosylb12, methylb12 and methylfolate deficiencies, body and central nervous system.  While there are a lot of symptoms, over 600 processes are dependent upon these vitamins, they fall into only a few categories; epithelial tissue malfunction, endothelial tissue malfunctions, neurological function and damage, immune, hormone, neurotransmitters, muscles, mitochondria

So "low testosterone", which has a lot of symptoms associated with it, can be the result of low active b12s  and methylfolate.  I have seen a lot of reference to Celiac disease as being commonly found with hypogonadism leading to gynecomastia and also as a b12 deficiency symptom.

As many of these symptoms or characteristics are non-specific having many possible causes, b12/folate are implicated especially when there are symptoms present across several bodily systems.  So one of the hallmark triads is "beef-red burning tongue", abnormal fatigue and any of a wide variety of neurological symptoms.  Also, people rarely have just one symptom and yet that is where it starts out.  Which symptoms people have is highly specific to their body.  Also this combines at least 5 specific deficiency syndromes including body-adensylb12, CNS-adenosylb12, body-methylb12, CNS-methylb12 and methylfolate plus many other cofactors which may be lacking distinguishing which symptoms a person may have.



mouth sensitive to hot and cold
sore burning tongue
beef-red tongue, possibly smoother than normal
sore mouth, no infection or apparant reason
teeth sensitive to hot and cold
canker sores
dry mouth
excessive thirst
burning bladder (no UTI)
painful urgency (no UTI)
burning urethra (no UTI)

burning muscle pain
accumulating muscle pains following exertion
sore muscles throughout body
lack of muscle recovery after exercise
exercise does not build muscle
extremely sore neck muscles reversing normal curvature of neck
exercise deblitates for up to a week, making things much worse
painfully tight, stiff muscles, especially legs and arms
frequent muscle spasms anywhere in body
muscle pain especially around attachment points to bones
Eighteen severely tender muscle spots of FMS
Widespread muscle pain responding to NSAID
Bursitis
Joint pain
Pain in weight bearing joints
morning joint stiffness


sick stomach
nausea
stomach not emptying
bloating
frequent vomiting
acid regurgitation
dyspepsia
flatulence
altered bowel habits
abdominal pain
loss of appetite for meat, fish, eggs, dairy, the only b12 contining foods, nutrient specific anorexia
intermittent constipation
intermittant diarrhea
irritable bowel syndrome
Crohns disease (direction of causality if any not established)
Celiac disease (direction of causality if any not established) - gluten sensitivity
Dairy sensitivity - beyond lactose intolerance
sores, ulcers and lesions along entire GI tract or any part
anorexia
Bullimia
weight loss
weight gain

reduced libido - loss of sexual desire
loss of orgasmic intensity
unsatisfying orgasms
inability to orgasm
loss and/or change of genital sensations
burning genital skin sensation
unable to feel aroused
numb genital skin
low sex hormones

MEN
low testosterone
erectile disfunction
low sperm count
poor sperm motility
Poor sperm quality
no sperm


WOMEN
low testosterone
low estrogen
post partum depression
post partum psychosis
False positive pap smears
menstrual symptoms
Frequent miscarriage
PMS
Chronic yeast infections
onset of menopause - unexpected

paleness
rapid heart rate
heart arythymias
shortness of breath
heart palpitations
weak pulse
congestive heart failure
arteriosclerosis

Widespread pain throughout body
Hypothyroid (direction of causality if any not established)
Hasimoto's Thyroiditis, affected during active phase, appears to be deficiency result

High homocysteine
High urinary MMA

dizziness - even unable to walk
vertigo

Confusion
Disorientation
Difficulty in word finding
irritable
depression
SAD - Seasonal Affective Disorder
mental slowing
personality changes
chronic malaise
poor concentration
Difficulty assimilating new information
Reduced task completion
moodiness
tiredness
mood swings
memory loss
listlessness
impaired connection to others
mentally fuzzy, foggy, brainfog
inappropriate anger
rage
psychosis, including many of the most florid psychosis seen in literature, megoblastic madness
Alzheimer's
delirium
dementia
paranoia
delusions
hallucinations - multisensory
anxiety or tension
nervousness
mania
panic attacks
Hypersensitivity to touch
Hypersensitivity to odors
Hypersensitivity to tastes
Hypersensitivity to clothing texture
Hypersensitivity to chemicals
Hypersensitivity to body malfunctions, symtoms
Hypersensitivity to sounds and noises
Hypersensitivity to light and visual stimuli
Hypersensitivity to blood sugar changes
Hypersensitivity to internal metabolic changes
Hypersensitivity to temperature changes
 
mild to extremely severe fatigue
continuous extremely severe fatigue
easy fatiguability
severe abnormal muscle fatigue up to and including apparent paralysis leading to death
weakness

sleep disorders
non restorative sleep
lack of dreaming
Night terrors
Prolonged hypnogogic state transitioning to sleep
Sleep paralysis

alteration of touch all over body, normal touch can be unpleasant and painful
alterations and loss of taste
taste hallucinations
smell hallucinations
sound hallucinations
visual hallucinations
metallic taste
alterations and loss of smell
loss of smell and taste of strawberries specifically
loss or alteration of smell and taste of potato chips specifically
roughening and increased raspiness of voice, mb12 can smooth in mid word
blurring of vision - can be sudden onset and sudden return
dimmed vision - usually not noticed going into it because change can be very slow or present for life
Visual impairment can be seen; ophthalmological exam may show bilateral visual loss
optic atophy
centrocecal scotomata
hypersensitivity/intolerance to bright light
Slow to adapt to night vision
Night blindness
tearing
redness of eyes
Age Related Macular Degneration
Optic neuritis
diminished hearing - gradual onset or present for life, sudden return possible
tinnitus - ringing in ears
always feeling cold
low body temperature
intolerance to loud sounds
intolerance to multiple sounds

Brainstem or cerebellar signs or even reversible (with mb12) coma may occur
neural tube defect
mother of child with neural tube defect
demyelinated areas on nerves
subacute combined degeneration
axonial degeneration of spinal cord
unsteadiness of gait
ataxic gait, particularly in dark
positive Romberg
positive Lhermittes

neuropathies, many types
progressive bilateral neuropathies
demyelination of nerves - white spots on nerves on MRIs
loss of detail and sensual aspects of touch all over body
paresthesias anywhere in body - tingling, pins and needles, etc
paresthesias in one left foot only
paresthesias in one right foot only
paresthesias in one left leg only
paresthesias in one right leg only
paresthesias in one left hand only
paresthesias in one right hand only
paresthesias in one left arm only
paresthesias in one right arm only
paresthesias in both feet - cobwebs, hairs etc
paresthesias in both feet - burning, cold,  wet, etc
paresthesias in both feet -  tingling,painnful tingling, etc
paresthesias in both feet - pain - mild to seveere or acute, shallow to deep, etc
paresthesias in both feet -  numbness in skin, etc
paresthesias in both feet - numbness in muscles, etc
paresthesias in both legs - cobwebs, hairs etc
paresthesias in both legs- burning, cold,  wet, etc
paresthesias in both legs -  tingling,painnful tingling, etc
paresthesias in both feet - pain - mild to seveere or acute, shallow to deep, etc
paresthesias in both legs-  numbness in skin, etc
paresthesias in both legs - numbness in muscles, etc
paresthesias in both legs - burning, tingling, cobwebs, wet, hair, pain, numbness, etc
paresthesias in both hands - burning, tingling, cobwebs, wet, hairs, pain, numbness, etc
paresthesias in both arms - burning, tingling, cobwebs, wet, hairs, pain, numbness, etc
Loss of position sense is 1 of 2 most common abnormality (or vibration sense)
Loss of vibration sense is 1 of 2 most common abnormality (or position sense)
Loss of motor control over some or all of toes
Loss of motor control over part or all of feet
Loss of sense of joint position
hands feel gloved with loss of sensitivity - glove anesthesia
feet feel socked by loss of sensitivity - stocking anesthesia
glove and stocking anesthesia
trembling
neuropathic bladder
unable to release bladder, mild to severe
unable to fully empty the bladder
urinary incontenance - occasionally to frequently
fecal incontinance - occasionally to frequently
sudden electric like shocks/pains shooting down arms, body, legs shooting down from neck movement
sudden "ice pick" pain
standing with eyes closed, a slight nudge or bump causes loss of balance
most patients have signs of both spinal cord and peripheral nerve involvement

The effect on reflexes is quite variable
Motor impairment may range from only mild clumsiness to a spastic paraplegia
clumsiness
slowed nerve impulses
decreased reflexes
difficulty swallowing
brisk reflexes
decreased deep tendon reflex
toes turn up instead of down in reflex to sole stimulation
Positive bilateral Babinski reflex
Foot Drop
tripping over toes
injuring toes catching top of toes on floor
general feeling of weakness
drowsy
 
suspicious
apathetic
rapid and unpredictable emotional changes
limbs feel stiff


impaired white blood cell response
poor resistance to infections
easy bruising
pronounced anemia
macrocytic anemia
megablastic anemia
pernicious anemia
decreased blood clotting
low hematocrit
MCV > 93   first warning,
MCV > 97   alert
MCV > 100  outright macrocytosis
MCV > 105  urgently needs treatment, severe problem


elevated MCH (Mean Corpuscular Hemoglobin)
elevated LDH
big fat red cells (when said this way usually with happy or healthy modifying it completely misinterpreting results of MCV
platelet disfunction, low count
white cell changes, low count
hypersegmented neutrophils

headaches
inflamed epithelial tissues - mucous membranes, skin, GI, vaginal, lungs
inflamed endothelial tissues - lining of veins and arteries
mucous becomes thick, jellied and sticky
asthma
chronic cough that mimics asthma but isn't
chronic sinus congestion
dermatitis herpetiformis, chronic intensely burning itching rash
frequent infected follicles or acne type lesions all over body
chronic infections, many varieties possible
Seborrheic dermatitis
dandruff
eczema
dermatitis
skin on face, hands, feet, turns brown or yellow if anemia occurs
poor hair condition
thin nails
transverse ridges on nails, can happen as healing starts
splits/sores at corners of mouth -angular cheilitis
Hyperhidrosis - excessive sweating

Bariatric surgery
Dilantin and some other medications
Relatives, grandparant, parent, sibling, child, grandchild ever needing b12 shots or supplement
coma
seizures
brain atrophy with ileal tuberculosis preventing b12 absorbtion
Intestinal parasites
Intestinal bacterial overgrowrth
Low CSF cobalamin
Elevated CSF MMA
Elevated CSF Hcy
Low blood serum level
Elevated uMMA
Elevated blood serum Hcy


Starting AS INFANT OR CHILD

delayed myelination
failure to thrive
autism
delayed speech
depression
frequent or continuous toncilitis
frequent strep
frequent pneumonia
frequent longlasting supposed viral illnesses that linger and linger and linger
everything goes to the lungs for extended periods
headaches
growing pains
skin problems
dandruff
allergies
asthma
continuous swolen glands in neck
low grade fever for years
Night terrors
Prolonged hypnopompic state transitioning from sleep
Prolonged hypnagogic state transitioning to sleep
Sleep paralysis
seizures
coma
nosebleeds
FREQUENT DIAGNOSES OR OTHER PROVIDER BEHAVIOR

FMS
CFS
ME
ED
IBS
Sub-acute combined degeneration
Low Testosterone
Fertility Problems, male and female
Sleep Disorders
Neural Tube Defects
Peripheral Neuropathy
Polyneuropathy
Autonomic neuropathy
Conversion Disorder
Hypochondria
"TOO many symptoms to be believable"
Liar
Alcoholic suspected of  non-drinker or genuine light drinker
Removed from Practice for knowing to much
Its All In Your Head   -  IAIYH
Removed from practice for insisting that there is REALLY something wrong instead of IAIYH
Alzheimer's