With respect to the B12, whether it's considered to be "hype" is something I contest because there would otherwise be no need for B12 monitoring, as well as patients historically demonstrating a range of symptoms of B12 deficiency that are well-documented. I also don't care to bandy the topic about and have shared my opinion. Whether you and your physician choose to treat it is entirely up to you.

Your postings tend to lean toward seeking diagnosis of various aches and pains and I'm constrained to point out that I'm unable to actually pinpoint what the cause may be via the internet. I can tell you that your symptoms appear remarkably benign and in patients with similar complaints, the cause is most always musculoskeletal in origin.

There is also the prospect that the sternal pain could be GERD-related and this sort of pain tends to penetrate through to the back and can also be aggravated when standing or walking in some instances. By contrast, I see absolutely nothing of your symptoms to even remotely suggest that it's heart-related in any manner.

Dizziness is also a very common symptom that can be associated with GI difficulties, most particularly constipation or excessive gas production, which can result in an odd sensorium accompanied by diaphoresis or sweating. Treatment of GI symptoms typically corresponds with a reduction in dizziness and other problems of a similar nature that concern patients. The dizziness and sweating would not be consistent with anything cardiovascular in my opinion.

Again, all of your symptoms are well within the corridor of being anxiety-related and although you seem to persist in steering your apprehension into the arena of serious disease, I simply do not see any clinical basis whatsoever for your rationale in that regard.

Best regards,

Rutheford Rane, MD (ret.)