I'm going in for my first annual physical since my PN diagnosis. What tests should I order to find out about deficiencies?

I was thinking about these:
B12
B6
D3
Magnesium
Sodium (they always do this)

others??

Thanks.

B12 yes, get your # result

B6 yes, (will show elevated if you are on vits), typically only useful if reading shows very low---as that indicates neuropathy

D3 yes, get your # result

magnesium is only useful in very low and very high readings. Anything in between does not reflect your status much. Serum reading for magnesium is not accurate, but intracellular may be like from Acu-cell.

Sodium and potassium are in the general electrolyte screen.

zinc/copper ratio, can be useful too.

I believe there is a test for thiamine B1.

You could request heavy metals screen, for arsenic and lead.
Heavy metal toxicity can cause PN.

for prediabetes and hypoglycemia... HbA1C and fasting insulin can be revealing.

Thanks, mrsD. I think I understand this.

I assume it is not necessary for me to stop taking all supplements before the day of the test in order to get a "true" baseline reading. Correct?

If you want a "true" reading... you have to stop some of them.

B12 stop at least 5 days.
B6 stop at least 5 days.

Vit D Since many do not show fast gains with this it may not
affect results much.

I'd stop the magnesium too.

Traditional blood work from doctors measures serum levels.

Better tests are available, but many doctors don't use them.
Acu-cell is one example.

this website explains it:
http://www.acu-cell.com/

Basically serum levels don't reflect what is going on much in the body. Very low or very high show either deficiency or over use or some failure in the body to activate (as in B6).

For example on PubMed are many papers reporting "normal" magnesium levels in patients who then get supplemental treatment for migraine, with extra, who respond. At so called normal levels they have migraine (indicating a need).

I have Small Fiber Neuropathy. Is there some way to know -- by test, perhaps -- whether the disease has invaded and/or is affecting my autonomic nervous system and vital organs? Should I assume that, by definition, my autonomic nervous system and vital organs are affected, or will be affected?

Not always. I don't have any autonomic symptoms and I've had PN over 30 yrs.

The ones with severe damage, from drugs, or autoimmune issues seem to get the autonomic effects. Long standing diabetics too. But it appears variable among patients.

You know not all diabetics get PN either, or if they do not always severely.
Not all diabetics progress with kidney or heart damage either. A recent study showed that certain genes predispose diabetics to faster deterioration than others.

There may be some genetic reason for the variability of PN among different people.

There are tests for autonomic PN...but usually you need to show symptoms to a doctor for that evaluation. They won't do them for just sensory symptoms as a rule.

Thanks so much, mrsD.

I might as well post this, talking about worrying about autonomic PN....I'm reading this thread because I'm interested in the supplement testing too, thanks, will ask about most of those.

I've got SFPN and have wondered about autonomic too, glad to read your posts, Mrs. D. I've had PN for 11 yrs from being pre-diabetic found in a GTT, very important to check, and who knows how long I have been PD...

BUT, when my Dr. did an EKG b/c it had been 18 yrs since last one, there was a little something different on it and he had tests run on me. Did echo-cardiogram and stress tests and my heart is in great shape! I was so glad to find this out, it turns out that my EKG is normal when it looks like it did...it had been that way the last time too, 18 yrs ago, different Dr. but this Doc had said he thought I might have an enlarged heart and that was not said before, so....I went along with the testing. But I was glad to know everything was so good and that means major blood vessels are not blocked or narrowed either. So like Mrs. D says, just b/c we have SFPN or diabetes, it does not mean something else is going to happen. My great-grandmother, great-aunt, and my uncle all had diabetes and all lived to old age and I don't think any had autonomic ailments. Only my great-grand had "sensitive feet" and they weren't bad like mine. My dad remembered making something to hold the bedcovers off her feet when he was a boy.