Burning Mouth Syndrome following dental extraction nightmare - please help!

[nervepain2021]

Hi All - not doing so great, thanks to those who have reached out individually with some tips. Good news is I am off Gabapentin, but looks like weaning off has brought on a major serotonin imbalance which I know need to work through. The main symptom for me is constant very severe nausea. I can sometimes get a little break in the day, but today it started at 4 am and has been pretty much nonstop. I am still taking .5 mg Ativan night and morning, will wean off that once this nausea has gone away. Mouth pain is still there as well but hopeful between trying some progesterone in small doses (hormone lab still hasn't come back), along with a few other suggestions vit D etc, i can get my hormones and thyroid settled and the pain will subside. Meanwhile, just trying to dig deep and power through this nausea which is definitely bringing me to tears...

The labs for the other values did come back very slowly through the entire week - posting here. @KaurSingh - the B6 was elevated but i was on a B supplement up until 2 days before the blood draw so i suspect all my B's would have been high. Will try to dig deeper on the next set of labs with some of those other measurements. PTH is added, but my func dr doesn't always follow through on the other ones, i think she feels it is all excessive.

Pasting in from the lab report as it came in diff pages - happy if anyone has any feedback, but no pressure:

Test Name	Value	Reference Range	Loc
IRON, TIBC AND FERRITIN PANEL
IRON, TOTAL	92	40 - 190 mcg/dL
IRON BINDING CAPACITY	441	250 - 450 mcg/dL (calc)
% SATURATION	21	16 - 45 % (calc)
FERRITIN	14 LOW	16 - 154 ng/mL
FASTING:YES FASTING: YES
Accession No.: SZ906208B Status: FINAL Collected: 05/21/2021 7:47 am Completed: 05/25/2021 12:03 pm

Test Name	Value	Reference Range	Loc
VITAMIN D,25-OH,TOTAL,IA
VITAMIN D,25-OH,TOTAL,IA	32	30 - 100 ng/mL
Vitamin D Status 25-OH Vitamin D: Deficiency: <20 ng/mL Insufficiency: 20 - 29 ng/mL Optimal: > or = 30 ng/mL For 25-OH Vitamin D testing on patients on D2-supplementation and patients for whom quantitation of D2 and D3 fractions is required, the QuestAssureD(TM) 25-OH VIT D, (D2,D3), LC/MS/MS is recommended: order code 92888 (patients >2yrs). See Note 1 Note 1 For additional information, please refer to Vitamin D Testing (This link is being provided for informational/ educational purposes only.)
FASTING:YES FASTING: YES
Accession No.: SZ906208B Status: FINAL Collected: 05/21/2021 7:47 am Completed: 05/25/2021 12:03 pm

Test Name	Value	Reference Range	Loc
VITAMIN A (RETINOL)
VITAMIN A (RETINOL)	66	38 - 98 mcg/dL
**Clin Chem Vol. 34.No.8. pp1625-1628. 1998 Vitamin supplementation within 24 hours prior to blood draw may affect the accuracy of results. This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.
FASTING:YES FASTING: YES
Accession No.: SZ906208B Status: FINAL Collected: 05/21/2021 7:47 am Completed: 05/25/2021 12:03 pm

Test NameValueReference RangeLoc
MAGNESIUM, RBCMAGNESIUM, RBC 4.6 4.0 - 6.4 mg/dL

This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.
FASTING:YES FASTING: YES

Accession No.: SZ906112B Status: FINAL

Collected: 05/21/2021 7:44 am Completed: 05/27/2021 9:30 pm

 

[yerrag]

You're very likely low on iron given the ferritin and transferrin saturation being on the border of normal. Your hgb, mch being low also strengthens this view.

Vitamin D is lower than 50, which makes you in deficient territory.

While the RBC magnesium tests says your magnesium is fine, the test isn't conclusive. Since it was basically a waste to test magnesium, I didn't and just assumed I'm deficient as I look back at my own history of food intake. So, I went on a 1 year therapeutic dosage of 800mg elemental magnesium. I think that when one's not sure of his acid-base balance, taking a neutral magnesium salt would be best - like magnesium oxide, magnesium carbonate, or magnesium chelates. But cost-wise, magnesium oxide and mag carbonate is better. There is no danger of overdose with orally taking magnesium supplements, as you will have diarrhea and that's the body's way of telling you enough.

 

[nervepain2021]

You're very likely low on iron given the ferritin and transferrin saturation being on the border of normal. Your hgb, mch being low also strengthens this view.

Vitamin D is lower than 50, which makes you in deficient territory.

While the RBC magnesium tests says your magnesium is fine, the test isn't conclusive. Since it was basically a waste to test magnesium, I didn't and just assumed I'm deficient as I look back at my own history of food intake. So, I went on a 1 year therapeutic dosage of 800mg elemental magnesium. I think that when one's not sure of his acid-base balance, taking a neutral magnesium salt would be best - like magnesium oxide, magnesium carbonate, or magnesium chelates. But cost-wise, magnesium oxide and mag carbonate is better. There is no danger of overdose with orally taking magnesium supplements, as you will have diarrhea and that's the body's way of telling you enough.

Thank you very much Yerrag. I have been using Mag Glycinate and epsom soaks plus a mag spray, but i will look into mag oxide or carbonate with your feedback that you cannot overdose (and therefore throw other things off balance, i am mindful of keeping sodium intake as well).