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 Comments

  1. I knew it was B12 because I am on B12 !!! This would have been a great video if you didn’t smile so much and show a lot of your big mouth teeth !!! Your ugly dimples didn’t help either !!! You look like you enjoy other peoples suffering!!! This channel needs someone else to give out information ! Also your head and face and once again , your teeth , are too big !!! You are not fit for this channel !!! 😠😠😠😡😡😡😖😖😖

  2. Can you explain how illnesses cause anger issues, what kind of deficiency causes you to become angry?

  3. Need to send this to billie eilish

  4. USA! USA! USA! 😉

  5. Great video! Produce more like these. 🙂

  6. This channel is completely amazing

  7. What about if you have too much B12? On every blood test, I have too much!

  8. Topical some kid in the UK went blind recently because of a similar diet

  9. Great video! You have excellent speaking and energy. 🙂

  10. I’m in school studying human nutrition so I found this one very interesting. I knew B12 was important but didn’t think all of that could happen.

  11. Methyl-B12 is absorbed much faster.
    I have blood work that's days I have a vitamin D deficiency but I consume 3 gallons of 1% or 2% milk a month & get lots of vitamins. I think I developed an absorbing problem. I don't know yet. This man may have an absorbing problem as well. B is water soluble. Maybe he drinks too much water? Don't know.

  12. Im a poor human being and i love channels like this that keep me informed and learning. I do what i can without insurance and try to stay healthy at all times. I'll sub. Before anyone says anything, internet is the only luxury i have and im grateful for it. Keeps us learning. Plus, you are gorgeous.

  13. Honestly I wish I would have seen this video when I was dating this guy that was a picky eater. The only things he ate where burgers, fries, and chicken fingers. And I know they have b12 in them, but it really shows you the importance of having a verity of a diet and the harm you can cause yourself. I tried to get him the wat some vegetables, but he wouldn't. Hope he's in good health.

  14. Hype meaning low

  15. What an idiot no common sense

  16. At 2:31 suspected B12 deficiency. and suspected the patient was vegan. but had no idea about B12 supplements in cereal in the US was not the same in Canada – great twist in the story!

  17. Just starting off and I’m like my sister eats this exact diet, but she’s not active at all and she constantly has weird stuff pop up on her.

  18. Crazy, I've seen you around Hamilton I think.

  19. Your videos are seriously so informative and interesting! I was TOTALLY shocked about the B12, was not expecting that!
    I love your content so much! You finally confirmed that you’re Canadian, I knew it! 😂
    You have a slight accent just like me

  20. Good video!

  21. “Cheerios without the milk”

    sacrilege

  22. Methionine and cysteine are amino acids, not proteins. Either you didn't know that, in which case I have to question if you're even a real doctor, or you assumed your audience was not educated enough to understand what amino acids are, which is frankly offensive.

  23. Interesting 😍

  24. I just gained 3 brain cells from this video. Thank you.

  25. Lol I love the giggle towards the end

  26. There are so many people saying that his parents should have forced him to eat other stuff but you need to recognize this isn't just picky eating — this is an eating disorder and he cannot control it. I know somebody who has something similar and they literally cannot force themselves to eat many foods (it will make them gag/puke). Of course this appears slightly differently in everyone but he clearly has something along these lines. It's good that he started seeking treatment for it (as mentioned in the video)
    I highly recommend looking into selective eating disorders to understand this before you comment that his parents messed up

  27. To all you vegan folks: pay attention.

  28. Love your videos. You are amazing! Makes me want to get into the medical field. Ultrasound tech!

  29. Thank u

  30. U are lovely

  31. Wow. I've have B12 deficiency or did on my last doctor's visit. That scares me.

  32. Surprised! And I researched efficacy of cobalamin in diets for biochem lab lol.

  33. His logic: I will rather cripple myself than eating meat.

    Wow, prioities

  34. Holy cow, being smart like her must be the best thing in the world.

  35. So fun!!!! I guessed b12 deficiency!!!! I’ve certainly been paying attention in my anatomy and physiology and nutrition courses!

  36. James also has an eating disorder. And if he wants stay healthy for longer, he's gonna have to get his eating disorder treated.

  37. why is it so funny???

  38. Interesting that he was severely deficient but not anemic.

  39. whaaat?? noooo your not a doctor. your handwriting is too good

  40. Omg!!!

  41. This woman has crazy psycho eyes.

  42. I work in the emergency department at a level 1 trauma center as a technican. I see alot and love to learn my question is with the b12 deficiency he had. What's the difference between what james had and "wet brain"??

  43. or just eat chicken nuggets. Seems better than a shot.

  44. Usually when Rbc are big then they check b 12 and give patient b12.

  45. boring. bikini try on haul?

  46. My name is james and im a 21 year old university student with a picky appetite 😧

  47. 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

  48. That's why your moms always said TAKE YOUR VITAMINS. They weren't lying they know shit.

  49. Anemia

  50. Does this make you a Chubby Siobhan or a Violin Emu?

  51. 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

  52. You and Chubbyemu should collab !!!

  53. I get my vitamin B12 from steak and chicken

  54. Just let idiots like this Darwin Award themselves out of the population.

  55. 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

  56. 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.

  57. I see you’ve gained inspiration from chubby emu

  58. The editing on this is amazing!!

  59. 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.

  60. After watching this I went and bought some fish oil lol

  61. This was step No 1. Diabetes is about to knock on his door. A canadian or us one.

  62. In Emu we trust 🚑🏥

  63. unlucky James 🙁

  64. 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.

  65. You are very attractive.

  66. I skipped Vitamins during my studies as I thought they aren't that important 😀😀, Here is my patient👍

  67. Glad I ran across this youtube channel I learn something new and interesting every video.

  68. As a vegan, the lack of B12 immediately came to mind.

  69. I felts relate to his diet. I only eat burgers, pizza bagels, and pancakes

  70. You should definitely do more of these videos! So awesome and very educational 😀

  71. 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

  72. B-12… Which is why I always take reasonable levels of supplements, to mitigate my habitual failings.

  73. Every time I watch your videos I always learn words I never heard of! I feel like a child learning from my mom ❤️

  74. good case… thanks for sharing… 🙂

  75. 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

  76. 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 ?

  77. I really love your videos and your sweet personality 😍

  78. 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

  79. 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 🙂

  80. roughly the same case here
    https://www.youtube.com/watch?v=VINtwoyaF_8

  81. Soooo when are you and Doctor Mike doing a Collab?

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

  83. Are you single?

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

  85. Dr. House would've figured it out in like 30 min

  86. Way late commenting, but as a non medical professional who watched WAY too many episodes of House, I recall an episode in the first season where a patient was experiencing auditory hallucinations and accidentally drowned her baby as a result. House concluded that the lady was suffering from polagra (I probably misspelled that as a don't have any latin knowledge, but it was phonetically pronounced pro lag ruh in the episode in question). The temporary mental illness was diagnosed as polagra and said to be caused by vitamin B12 deficiency, likely related by the patient's gluten intolerance and gluten free diet as she was diagnosed with celiac disease. Is any of that a real thing? Does vitamin B12 deficiency possibly cause psychosis and does celiac disease necessarily predispose a person to b12 deficiency? My wife has celiac disease and eats primarily meat, which based upon this video should provide plenty of B12 and she has never experienced a psychotic episode, except that one time when I borrowed her razor without telling her.

  87. interesting

  88. 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

  89. So 20 years old is the limit?

  90. What kind of physician is the lady is?

  91. God years to recover……

  92. 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!

  93. 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

  94. 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.

  95. Amazing informative entertaining video

  96. I Love your channel ! You seem like the sweetest doctor ever! Your videos are perfect, keep it up!

  97. This is awesome!!! Make more like these, explaining symptoms , causes, !

  98. 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.

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

  100. Vitamin B12 isn't made by animals 😉

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