In a medical case that highlighted the limits of modern imaging, Dr Sudhir Kumar, a neurologist at Apollo Hospitals, Hyderabad, shared how a simple dietary deficiency — not a brain tumour or stroke — was the reason a 70-year-old woman lived in fear of falling for six weeks. Also read | AIIMS Raipur orthopaedic surgeon shares real reason for middle-aged man’s frozen shoulder: ‘Sugar levels were sky high’
The woman reportedly had a vitamin B12 deficiency due to her diet. (Representative picture: Freepik)
Dr Kumar shared on February 4 that the patient had spent over a month feeling as though the ground was moving beneath her. Dr Kumar said, “She described it as ‘the ground moving under my feet… there was no spinning sensation… yet her symptoms persisted.”
Despite a battery of tests and visits to multiple specialists, she remained without an answer. Dr Kumar’s diagnosis, shared on X (formerly Twitter), served as a cautionary tale for those on strict vegetarian diets.
The brain was blamed, but the nerves told the truth
Dr Kumar recalled that the patient arrived at the clinic ‘deeply worried’ and exhausted from being told her results were normal. She had already ruled out common culprits: ENT specialist confirmed no issues with the inner ear or hearing, brain MRI ruled out strokes, tumours, or structural diseases, her blood pressure was stable and well-managed with medication.
The breakthrough
While the brain scans were clear, Dr Kumar found the truth during a physical examination of the patient’s feet. He noted several clinical red flags:
⦿ Impaired joint position: She couldn’t accurately feel the position of her toes.
⦿ Loss of vibration sense: Reduced sensation at the toes and ankles.
⦿ Positive Romberg’s test: The patient swayed noticeably when asked to stand and close her eyes.
Dr Kumar identified the condition as sensory ataxia: the patient wasn’t ‘dizzy’ in the traditional sense; her brain simply wasn’t receiving the signals it needed from her feet to maintain balance.
The ‘vegetarian’ connection
The missing link was the woman’s lifestyle, Dr Kumar explained. As a ‘strict vegetarian with minimal dairy intake’, she was at high risk for nutritional gaps. A blood test confirmed the suspicion: the doctor shared that her vitamin B12 levels were at 153 pg/mL — a severely low reading.
Vitamin B12 is essential for maintaining the myelin sheath that protects nerves. Without it, the ‘large-fibre’ nerves responsible for carrying position and vibration signals to the brain began to fail.
A simple recovery
The solution was as straightforward as the diagnosis. Rather than ‘fancy drugs’ or surgery, Dr Kumar shared that the patient was started on intramuscular vitamin B12 injections.
The results were transformative. Within weeks, her gait steadied, her fear of falling vanished, and she no longer needed to hold onto walls for support. “Sometimes, the diagnosis is not hidden in the scan; it is hidden in the toes,” Dr Kumar concluded.
According to Dr Kumar, here are the key takeaways for patients:
⦿ Diet matters: Long-term vegetarianism without dairy or supplements significantly raises B12 deficiency risks.
⦿ MRI isn’t everything: A ‘normal’ scan doesn’t mean the symptoms aren’t real; it just means the problem is elsewhere.
⦿ Early intervention: B12-related nerve damage can be reversed if caught early, but delay can lead to permanent disability.
Note to readers: This report is based on user-generated content from social media. HT.com has not independently verified the claims and does not endorse them.
This article is for informational purposes only and not a substitute for professional medical advice.
