Thanks, Robin. I have to tell you that 589 isn't great. Right, Mrs. D?
If B12 is not getting to your tissues, other things like homocysteine and methylmalonic acid (blood tests) can be elevated. If you can get your hands on some methylcobalamin sublingual tablets, that would be a very smart thing to do. You might not be getting enough from your diet! Studies have shown that even the meat we consume doesn't have enough B12. I get mine at www.iherb.com
and have since 2000, a year after my B12 deficiency. I like the Jarrow Brand, 5 mg. I take it twice a day. It absorbs (under your tongue) itself into the blood stream and bypasses the GI tract. Some people can't absorb B12 well in the GI tract. The liver is where most B12 is stored and released.
Have you been tested for celiac disease? If not, please do! If you have it, antibodies attack your small intestines, decreasing the absorption of vitamins/minerals. The fact that you have a D deficiency and your B12 is not great is another indicator of an absorption issue.
If you can find a good internist instead of a GP, that's a good idea. No, you don't want to keep doctor hopping all over the place but you need someone who is adept at problem solving!
Pretty much any food can have organic arsenic. Recently, more studies have been done showing that rice products and some apple products have more than acceptable levels (see Consumer Reports on that). It's probably a very remote possibility! I think you should focus on possible autoimmune causes.
GERD and a lack of stomach acid can have similar symptoms. Only a gastroenterologist (a good one) can know the difference. A fairly benign "test" of low or no stomach acid is if you feel better having apple cider vinegar (yuck) with a meal. It acts as a mild acid. But talk to a doctor before trying anything, okay?
If you haven't started a log of symptoms, when they started, how often they happen, etc., it's a great way to organize your thoughts and it can be useful for an internist too.
Yeah, G-B is normally a more progressive disease that starts from the legs and moves upwards. My friend had it.
That's a lot to think about.