21 year old ate THIS DIET and it caused BRAIN DAMAGE: Medical Case Report


Hey guys. I’m Siobhan, a 3rd year medical resident. Today I’m gonna be telling you about James. He’s a 21 year old healthy university student, never had any medical issues. He’s active, but he is a bit of a picky eater. Ever since he was a kid, he didn’t like a lot of food textures. And so he ends up just really eating bread, french fries and Cheerios, but without the milk. One day walking home from class, he noticed that his calf was a bit sore and he figured he must have just strained it at the gym. But throughout the week it started getting more painful and swollen and then so painful that he couldn’t even touch it. So he decided to go to the emergency department. After waiting for a few hours, he was finally seen by the emergency doctor. The doctor noticed that his right calf was 4 centimeters bigger than the left one and it was very painful. So he ordered some blood work and an ultrasound of that leg and then James was diagnosed with a deep vein thrombosis: a blood clot in his leg. But why would a 21 year old get a blood clot? The most common thing in a young person who gets any kind of diseases is a genetic cause or genetic predisposition. So they tested him for all the common ones including factor v. Leiden, some antibodies like antiphospholipid antibody and everything came back normal, with the exception of a high MCB. Which just means that your red blood cells are larger than they should be. So he was started on a blood thinner and then sent home with appropriate followup with a thrombosis clinic and they specialize in blood clots. Over the next few months James started to notice that he was having trouble concentrating and his marks were actually starting to slip a bit. Plus he felt like his legs were a bit weaker and then sometimes he would get this numbness and tingling in his feet that would come and go. He didn’t think much of it, but then the symptoms started getting more frequent and he was worried that maybe this had to do with the blood clot. So he went back to the hospital. So there he was back in the emergency department. The emergency doctor found that his legs were actually weaker. They were 4/5 in strength on both sides and you would definitely expect a 21 year old healthy man to have 5/5 strength. Plus he wasn’t able to feel his feet as well as you’d expect. So the emerge doc ordered some bloodwork and then called the neurology team, the specialist in the brain, the spine and the nerves, to come down and assess James. And again his blood work looked good except for those large red blood cells which were even larger than they were 3 months ago when the neurology team came to assess James. They did a ton of different physical exam findings to try to figure out what was wrong. They watched him walking and then they noticed that he was lifting his feet higher than you’d expect off the ground. When they got him to stand with his feet together and close his eyes, he couldn’t keep his balance and was gonna wobble and fall over. And when they were testing his sensation, he couldn’t feel any vibration underneath the level of his knee and they couldn’t get any reflexes from his ankles. Putting all of these little pieces together, the neurologists felt pretty confident that this was a sensory nerve problem. So the nerves that run from the tip of the toes all the way through the spine and up to the brain to tell the brain what position is the foot in. Otherwise your brain actually doesn’t know what’s going on with your foot. Those are the fibers that were having trouble. So right now we’ve got red blood cells that are too big and sensory nerve fibers that aren’t working well. And there are a ton of different things that can cause both of those and we’ve gotta figure out what crossover, what condition can cause both of these signs and symptoms. So now we send off even more blood work. This time zeroing in on what we suspect: low thyroid, low vitamin b12 levels and evidence of chronic alcohol use. And what we find is incredibly low levels of vitamin b12. After waiting for a while, we finally get the results of James’ brain MRI and the results are shocking. His brain actually looks like it’s 40 years older than he is. We can see that there is brain atrophy, which means the brain actually looks smaller than it should, plus there are lesions in the white matter on both sides of the brain. All of this is consistent with severe vitamin b12 deficiency. Plus this explains why he was having so much trouble concentrating at school. It actually explains everything from the blood clot to the nerve problems. B12 is involved in making myelin, which is kind of like insulation that can go over the nerves and help it send signals really quickly over long distances like your leg. And when there’s damage, that’s when you can get the weakness and the sensation changes and that’s actually why James was lifting his feet so high off the ground. Because he wanted to slam it into the ground and actually feel something because the lack of sensation he had. Vitamin b12 is also involved in blood clotting, but it’s a little bit more confusing, so stick with me. So b12 helps to convert one protein into another protein, simple enough. But if you don’t have b12, this conversion doesn’t happen. So you end up with a lot more of this protein over here and that’s called homocysteine. It’s a normal protein, we all have it, it’s amino acid. But at high levels it can put you at risk for having heart attack, stroke and blood clots. So low vitamin b12 caused the blood clot, his decrease in concentration at school, the decreased sensation in his legs, the weakness and of course those large red blood cells. So great, we’ve got a diagnosis! But that’s not enough… We need to know: Why are his b12 levels so low? So there are actually a bunch of different causes of vitamin b12 deficiency. It can be related to absorption or autoimmune diseases, but in James’ case this is most certainly to do with his diet. So vitamin b12 is actually only found in animal products like meat, dairy, eggs. And if you’re not eating those things because either you don’t like them like James or because you’re vegetarian or vegan, it’s super important that you find other ways to get vitamin b12. There are some products where they fortify and put in b12. Or you can take a supplement, but you really want to stay healthy. The crazy thing is that the amount of b12 that’s fortified into different things like cereals is different in different countries based on regulations laws, things like that. So where I am or James is, it’s Canada. And we don’t have any b12 that’s put into cereals like Cheerios, whereas the US and UK hey actually add that in. So if you think about it… If James had actually lived in the US, this might not have happened. So luckily for James, he started getting vitamin b12 injections every day, then every week and then every month and slowly all of his symptoms went away within a couple of years. And since then he’s actually tried to go and seek psychological therapy and see if he could add in some more food into his diet. But despite his best efforts, he just couldn’t bring himself to do that. So he definitely will be on vitamin b12 pretty much forever. So be truthful: Did you think it was gonna be b12 that explained all of his symptoms or were you surprised? Let me know in the comments below or what you thought it was gonna be. Otherwise, I hope that you like this style of video. If you do, don’t forget to subscribe and I’ll be chatting with you in the next video. Bye for now!

100 thoughts on “21 year old ate THIS DIET and it caused BRAIN DAMAGE: Medical Case Report

  1. Being a big fan of Sally Pacholok the symptoms were fairly easy to spot, for those who want to see the award winning film it's here on you tube https://youtu.be/OvMxJ6GRBNQ

  2. He cannot blame anyone else for this but iam very supprised friends and family or his doctor let him do it you are what you eat if you eat a bad diet or smoke drink or do drugs for a long perio and don't exercise it is your choice and your health will be affected badly eventually

  3. i thought it was probably a mentally and physical drain of a poor diet,been watching a lot of kpop idols' diets people try and sometimes really bad stuff happens

  4. This was a great video. I have been a nurse for over 10 yrs and would have thought it was an autoimmune disorder or something related to his diet (since you made a point about the diet in the beginning). Continue with these types of videos. Just hope people don't try and diagnosis themselves.

  5. I am a 38 year old male from the United States. I was an extremely picky eater and ate almost this exact same diet from the age of 4 to my early twenties. The one major difference was that I drank a lot of milk. I can safely say that I never experienced any of these symptoms but I always had a latent fear that I would somehow find out that my eating habits had caused irreparable harm to my health. Thankfully this is not the case, especially since I went through considerable effort to broaden my diet in college. It took years of effort to get to the point I am at today but I think I will always be on the picky end of the eating spectrum. The one thing I will say this did for me was cause me to completely avoid cigarettes as I felt the same way about putting one of them in my mouth as I did most foods.

  6. Interesting thanks – I would suspect if James doesn't improve his diet it's only a matter of time before he winds up deficient in either another vitamin or mineral.

  7. I am a sophmore in highschool and have a ginormous interest in the practice. I love memorizing medical terms, reading books and cases! I have already read so many Anatomy and Physiology books, my friends start to get a little worried! Haha! Anyway, I just want to thank you for your videos! They have been really fun! I love how energetic you are, and you have a beautiful smile! Do you have any suggestions for medical sites with cases, or ways I can gain more hands on experience with still being in high school! Keep uploading!
    -Kaitlyn

  8. I was almost worried that I was gonna get some brain damage from my diet, then I realized that he didn't eat any fruits or vegetables so I'm pretty sure I'm safe

  9. Hey , your videos are really interesting and educational . Maybe if you could make a video talking about how was med school for you , if you struggled a lot ?

  10. I suppose you dont want to offend vegans, because B12 deficiency is mainly a vegan diet problem. But it want start a civil war if we put the blame on junk food, instead of "green" food. Great video nontheless

  11. Thanks for sharing this story! I just had a lecture on cobalamin and its nice to learn more about this vitamin and its importance from another perspective 🙂

  12. My doctor says me and my family don't consume enough vitamin b12 even though we do….. Maybe we don't absorb it right?

  13. Super interesting! I’ve always had a passion for medicine and this is so enlightening to watch ☺️ thank you x

  14. He is probably deficient in a whole lot of stuff. The diseases these deficiencies will ultimately produce have not manifested yet, but… Medical people are taught that diet is not the causes of diseases, they are not taught much at all about nutrition, and what they are taught is probably wrong. After all, diseases are the result of deficiencies of patented drugs, right? (Sarcasm here) Fear, anxiety, body tension are big factors too, not just diet. And exercise is very important. Our butt is there to run, not sit on. But most medical doctors do not address any of this, but they have a pill to sell you, and it probably isn't cheap. up, time to go do some sprints and a few miles. I am nearly 71

  15. The doctor just gave him a blood thinner, but didn't instruct him to change his diet?! What the heck?! Allopathic "doctors" are quacks! Symptom, pill, symptom, pill! Such a brainless system!

  16. I am b12 deficiency i sure do not eat like that I slept a lot over 15 hours I get the shots every 3 weeks I feel so much better

  17. Vegan nutrition: Improperly planned vegan diets may be deficient in vitamin B12, vitamin D, calcium, iodine, iron, zinc and riboflavin (vitamin B2).
    Vegans usually have problems with the B vitamins and Calcium. The Calcium deficiency would definitely case the cramps. Vegetarian diets are
    similar.

  18. Thank you for this Dr. Very informative. Looking forward for more vlogs of case studies like this. Your vlogs are definitely a time-worthy to watch. You’re my new fave vlogger now. God bless you.

  19. Did I think it was going to be B12 deficiency? No. When you’ve mentioned brain atrophy I was convinced it was hyperfacebookia 😉

  20. I didn't think of B12 deficiency right off the bat but I have witnessed this kind of weirdness somewhat frequently in the Neurology clinic. We would normally give patients B12 injections as you recommended and they would typically have this terrific recovery effect. Excellent explanation and demonstration of James case. My mind hungers for these cases as I work my way to your level. Cheers and good luck on the rest of your journey. I look forward to more content on your channel <3

  21. Hey! I think that it's amazing the amount of joy you put in every video. I love seeing your videos!!! And I actually really liked the idea of making videos explaining 1 single case
    Make more please!! Thank youu very much

  22. I was surprised. I have had some, but not all, of the same symptoms and my neurologist tested me for B12. The result of that test was that I am NOT low on B12. I do still supplement B12 on occasion, but it has not reduced my symptoms.

  23. Damn Siobhan…you are so freakin' beautiful..! Yes I have a thing for freckles. I love watching your videos because you give useful information and make it fun😉

  24. If B12 only comes from animal products, I'm a little confused about how vegans actually survive more than a few years on their self-inflicted dietary restrictions. The B12 supplements have to come from somewhere, and if animal products are the only source for B12, then the supplements aren't vegan. Does this mean vegans aren't actually vegan if they live longer than ten years or so?

  25. I love these medical case reports you're doing on this channel, and those differential diagnosis you explained in these vids >_<!
    (Gradually watching and loving all of your vids xD, thank you for making these!)

  26. This reminds me of another case where a 10-month old had learned to crawl, but then stopped crawling and would just lay there. Dr's found that his arms and legs hurt, so they ran tests and suspected bone cancer (even told his parents that). A doctor from India took one look and correctly diagnosed it as scurvy. Turns out the patient only ate goldfish crackers. Doctors in developed countries just don't see malnutrition that often.

  27. Very interesting information. My dad was diagnosed with muscular distrophy at age 55 in the mid 1980's. The VA attributed it to exposure to agent orange in Viet Nam in 1965. It started off with nerve issues in his feet. The mylein sheath were being destroyed gradually. He died at age 78, totally disabled. I am wondering if the ability to absorb vitamin B12 was affected by the chemical exposure. By the way, agent orange was also manufactured by Monsanto, manufactuer of Round Up.

  28. I literally just learned about this in nursing school – as soon as you mentioned all he ate was bread, cheerios and fries I knew it had to be due to a nutritional deficiency!

  29. not surprised since I have B12 deficiency. Doctors never really figured out why because I am young (20 at the time), haven't had gastric surgery and am not vegan/vegetarian so they just put it down to maybe my body not having enough intrinsic factor. I have been on B12 sublingual tablets since and most of my symptoms have gone away.

  30. We literally just learned all about this stuff in my hematology/oncology module and it was so cool being able to see this in an actual patient! Awesome video!

  31. B12 is good for everyone, even if they're marketed towards vegans, almost everyone could use more B12 in their diet unless you eat fish multiple times per day.

  32. does this mean that B12 can affect your nerve signal and reaction time? i eat a normal diet, but i should take in some extra B12

  33. Man medical bills in United State are criminally expensive, totally rip off. You go in a hospital rich , comming out stinkly poor . We live in a fucking rip off society now.

  34. I though it Was a vitamin deficiency I was Thinking more towards vitamin D Not B12 But they both mehmet some of the same symptoms.

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