Debilitating fatigue. Nerve pain. No appetite. Weight gain while eating less. Muscle stiffness. Weakness. Tachycardia. Low grade fevers. Dizziness. Mouth ulcers. High CRP. Monocytosis.

It was looking grim; I improved for a while after starting treatment for ADH, but then started to deteriorate again. Rapidly. I feared that it was leukemia, lupus, or some other serious condition that had been raging alongside the ADH.

I was having trouble getting into the car and soon, even sitting upright for more than a few minutes was becoming extremely painful. I managed to drag myself to a few appointments and several vials of my blood were sent for testing. I anxiously awaited to see if I had leukemia or autoimmune markers. I returned to my genetic counselor and was tested for several conditions that could affect my immune system. Thankfully, they were negative - but I had a lot of inflammation.

What was going on?

I went to a different clinic for an exam, just to get a different perspective on it. She suspected a vitamin D deficiency - she was correct! I saw a hematologist next and he did some further exams and tests.

Much like the nephrologists I've seen, Dr. Dracula walked in, read my chart and very casually said, "Oh you're recovering from so many infections and antibiotics and have vitamin deficiencies too." I was stunned by how fast he was able to figure it out, but I'd need to process everything after the appointment was over. In that moment, I just sat silently with my mouth open behind my mask as he described my treatment plan.

After a few days of vitamin D supplements and a vitamin B12 injection, I finally began to improve again. The swelling started to decrease, as well as the symptoms. He estimated that with rest and vitamin supplementation, I should return to normal levels and get rid of the swelling and other bothersome symptoms in a few months.

Symptoms

A few relatives have lupus or general autoimmune conditions, which didn't help my anxiety. The combination of symptoms from vitamin D deficiency and vitamin B12 deficiency had produced a near perfect syndrome that mimicked lupus.

Vitamin D deficiency symptoms

Including:

• Fatigue

• Difficulty sleeping

• Depression

• Muscle weakness

• Getting sick more easily

• Bone pain and achiness

• Hair loss

• Loss of appetite

• Pale skin

• Wounds slow to heal

• Muscle pain

• Unexplained weight gain

Many of these symptoms are common lupus symptoms too, but with the addition of vitamin B12 deficiency symptoms, it was the perfect imitator.

Vitamin B12 deficiency symptoms

Including:

• Fatigue

• Lethargy

• Pale yellow tint to skin

• Mouth ulcers

• Brain fog

• Pins and needles sensations (nerve pain)

• Sore and red tongue

• Irritability

• Blurred vision

• Issues with memory and concentration

Comparison to lupus

Now, let's look at the symptoms of lupus compared with vitamin D and B12 deficiencies; the main symptoms of lupus are listed and if that is also a symptom of vitamin D or B12 deficiencies, it's marked with a symbol:

Note that lupus symptoms vary based on the affected organs; I wasn't able to list every symptom of each, but this has some of the most common ones.

Treatments

Thankfully the treatment of vitamin deficiencies is fairly straightforward: supplementation of the vitamin(s). Vitamin D is supplemented with a pill or chew/gummy. If the deficiency is dangerously low, you'll begin with a weekly megadose of vitamin D before switching to a daily supplement.

Vitamin B12 supplements might be more intimidated: they're injections that you administer yourself (or with someone's help at home). Luckily, I'm not afraid of needles - but, I know many people are. If you're unable to administer it yourself and don't know anyone who can, you might be able to ask your pharmacist or other healthcare providers for help.

You begin with weekly injections before switching to a monthly injection. The dosage and length of treatment will depend on the severity of the deficiency. There are also oral supplements for milder deficiencies.

And sometimes after just a couple of days, you'll start to feel better! I started improving after a couple of days and have finally started to get rid of swelling!

It's weird to feel like I'm improving again, but I like this weirdness…