On a long bike ride at the end of May, I noticed a strange sensation on my shins and knuckles. The breeze felt much colder than it should for the actual temperature. I had never felt anything like it and even wondered if I was imagining it. Over the next few days, though, it became apparent that I was not imagining the sensations. Washing my hands in cold tap water felt like I was dipping them in ice water. Pulling frozen fruit or vegetables out of the freezer was painful, causing my fingers to sting for several minutes, like I had just come in from playing in the snow. The sun felt absolutely blazingly hot, inordinately so, like the breeze that was too cool for the true weather conditions. For some reason I had become hypersensitive to temperature.
I also noticed that a little bump or scratch was disproportionately painful and that itches were “itchier” than usual. Other neurological symptoms developed. Over the next several weeks, which included Biking Across Kansas 2015, the symptoms became more pronounced. I didn’t tell anyone at first, but after we returned home from BAK, I made a doctor’s appointment, which led to referrals to a neurologist and a hematologist and to several unpleasant tests. Blood work at the neurologist’s office revealed that my B6 level was high, and the doctor told me to stop immediately all supplements containing B6. Another test indicated probable borderline small fiber peripheral neuropathy (SFN). After extensive testing, the best explanation for the SFN is B6 toxicity.
I feel fortunate because there are many scary things that could cause SFN, and I don’t have them. However, I also initially felt deeply disappointed in myself because I realized that I caused the SFN.
Over the past few years, stress management has been an increasingly difficult struggle for me. I think hormonal changes, job demands, parenting challenges, overstimulation of my introvert sensibilities, grief over the loss of beloved animal companions and perceived relational support circumstances are among the contributing factors. My stress is not extraordinary, and I am well aware that countless people face far tougher challenges, but, for whatever reason, management of my stressors has been a bigger problem in the last several years. I share all this, in part, to progress along the road to recovery that I am paving, but also because I think there is important information in this story that may be able to help others.
During a particularly stressful time in 2013, I Googled “mood support” one evening. I think I was looking for online support, but the natural supplement NOW Foods Mood Support popped up. I saw right away that it was a vegan product and thought, “It’s meant to be!” The product contains St. John’s Wort, Valerian root and B vitamins. I take full responsibility for what happened, but I did clear it with my primary care provider, who deemed it completely safe and encouraged me to take even more, which is a good reminder that we all need to be informed patients and consumers who think for ourselves and listen to our wise instincts. I was also taking a multivitamin at the time, as well as a B12 supplement that contained B6. In addition, I frequently included nutritional yeast, supplemented with B12 and B6, in my smoothies. In the spring of 2015, feeling really overwhelmed and stressed, I doubled my dosage of Mood Support. After my neurological symptoms appeared, I stopped my multivitamin and went back to a regular dose of Mood Support. Although I never suspected B6 as the culprit, I think I had a gut feeling that Mood Support might be involved in some way. I continued to take the regular dose, along with the B12/B6 supplement until the neurologist told me to stop. In retrospect, I can recognize that each reduction in B6 dosage has improved my symptoms. In fact, they are almost gone now. Many types of neuropathy are not reversible, but my internet research indicates that SFN caused by B6 toxicity may be. I go back to the neurologist in December and am encouraged that I will have a complete recovery. I am thankful to have had good medical care that got to the root of the problem before permanent, serious damage had been done.
This is not a condemnation of Mood Support, but a cautionary tale of what can happen when we function from a place of desperation, rather than a place of good sense, reason and compassion for ourselves.
I aspire to translate my level of attentiveness to bodily and environmental cues on the bike to the rest of my life. When the wind conditions change or an obstacle in the road appears, I make adjustments to my body position, level of effort or bike handling. When I plan a fast ride, but the wind is blowing 35 miles per hour, I adjust my expectations. I often remind myself to “take what the road will give me.” That doesn’t mean I am always entirely satisfied with my performance on the bike, but I find that I am satisfied, even quite pleased, more and more often because I have learned from my years of cycling, and I have implemented those lessons to improve my performance—and happiness—on the bike. My challenge is to apply this same strategy to the rest of life, in order to manage my stress more holistically, rather than trying to cover up or wipe out the ramifications of the stress, while simply pressing forward and feeling increasingly overwhelmed.
I take such care to eat a nutritious, compassionate diet, yet I took supplements with abandon because my emotions felt out of control. It is my responsibility to practice the same compassion with myself that I try to practice with all human and nonhuman others. This means knowing when to set and implement boundaries and creating time and space to recharge when I feel overloaded. As an introvert, I need more quiet (even if active, on the bike) downtime than extraverts may need. This is not a character flaw; it is just who I am.
I haven’t solved all my stress management issues, but I am trying hard to pay close attention to my needs and to use my bike, journaling, mantras, quotes, reframing and positive psychology to manage my stress instead of pressing blindly ahead and covering it up. Riding and reading are my two major lifelines to mental and emotional health. Right now, I am immersing myself in positive psychology and happiness literature, and I am feeling the benefits of that. I process much of what I read while I am on my bike.
I wanted to share this experience because I know we are all under stress, and the temptation exists to look for a quick fix so that we can keep plowing forward. I have prided myself on not doing that; however, retrospectively, I recognize that my excessive supplementation was just that.
As my paid work enters a particularly intense period again, while the rest of life keeps on coming, I plan to keep these words from Elizabeth Gilbert visible in the physical spaces I inhabit and in a prominent and readily accessible place in my mind:
You do what you can do, as competently as possible within a reasonable time frame, and then you let it go.
Like a bike ride.
I ride as well as I can while I am on the bike, and then that ride is finished. I move on, let go of any disappointments or frustrations and start fresh on the next ride. I owe the world nothing more than that in the rest of my life. I am one person, trying to do the best I can to make positive contributions where I live and work. I choose to view this experience with SFN and B6 toxicity as a gift and a wake-up call. I refuse to let stress, anxiety or depression suck the life out of my life. I will listen to my body and to my heart and do my best to adjust, based on the cues I receive when I pay attention to how I am feeling and what those feelings may mean.