Should the doctor have told me my treatment options before I took the tests?

I’ve been suffering from pretty severe dizziness for several months now.I just spent over $1000 on CAT scans and a cardio pulmonary Doppler just to find out all I really need is some B12 and some Hallpike maneuvers. They could have told me about that first and I could have saved $1000. What do you think? Or maybe the better question is: would taking B12 have harmed me?

Depends. The doctor might well have thought something serious and worth excluding ASAP might turn up on those tests, while taking B12 and such might take too long to show good results if you had the less-serious diagnosis and put your health/life at risk if you really had something more serious.

When I worked in pediatric cardiology, easily over 95% of the teenagers with chest pain that we had come into the office turned out to be just musculoskeletal pain, take some OTC painkiller if it gets too bad, you’ll grow out of it. But if they got referred to us, we put them on the schedule right away, and ran (expensive) tests if the doctors weren’t sure it was just an unrelated pain. They don’t want to be the doctor who says “it’s probably nothing, take some meds and go home” and then it’s all over the news that “17 year old drops dead on basketball court of undiagnosed heart problem; parents say Dr. So-and-So told them it was nothing and didn’t run tests.”

I don’t think $1,000 in tests is out of line considering the wide range of serious things that could cause severe dizziness. It’s not the B-12 that might have harmed you (necessarily, IANAD), but the delay in detecting a potential brain tumor or whatever. If you had other symptoms that clearly pointed to a B-12 issue (whatever those might be) I could see wondering if about ruling that out first.

I had some dizziness a couple years back and didn’t get a bunch of tests, because it was pretty clearly related to my allergies, and by treating them more actively it cleared up. But you have my sympathy in that I remember severe unexpected dizziness as really unpleasant.

Forgive the hijack, but is this common? I would occasionally get crippling chest pains for a few hours at a time when I was a tween/teen; but for reasons I never learned my parents never took me to a doc for them.

It only occurred to me much later that chest pains are also sometimes things you could die from… but by then I’d outgrown them by several years already. So in hindsight, I occasionally wonder what the hell those pains were, since obviously they didn’t kill me. Muscle spams? Which muscles?


From what I’ve heard, it sounds as if your doctor screwed up (on the side of caution, which is a good place to screw up). I’m going to go ahead and guess your dizziness was caused by anemia? B12 (or folate) deficiency is the most common cause of what is known as megaloblastic anemia.

The doctor should have picked up on the anemia right away. From there, he should have taken a look at your blood and he would have seen enlarged red blood cells. A test for serum B12 and folate should have soon followed.

This is all assuming, of course, that you were anemic. If you didn’t present with anemia, a CT would have been warranted.

Also, while taking B12 wouldn’t have harmed you (indeed, taking a multivitamin every day is wise regardless), there may not have been any indication to do so. Dizziness can be a troublesome symptom to diagnose.

We did see quite a few teens with that situation, though I think most of them were probably teenage athletes who maybe suffered those pains while playing sports, and were told/highly encouraged by coaches that they should get it checked out. I notice every now and then a news story of a local teen who drops dead of a previously undiagnosed problem, often cardiac. I suspect those stories get into the heads of both doctors and parents (not to mention coaches and the like), and if a teen complains about chest pain they might well get dragged off to the doctor in that case.