Exploring Causes of Hand and Foot Numbness Beyond Diabetes

Q: Exploring Causes of Hand and Foot Numbness Beyond Diabetes

Dear Mr. <br>Luka： <br>1. <br>There are many diseases that can lead to numbness or abnormal sensations in the hands and feet, including common conditions such as vascular compression, diabetes, peripheral neuropathy, peripheral vascular disease, degenerative spinal disorders, her

Dear Dr. Hsiao, aside from diabetes, what are the other possible causes of numbness in the hands and feet?

Today's lab report is out: fasting blood glucose is 80 mg/dL, and hemoglobin A1c is 5.7, so I should not have diabetes, right? Ever since I started experiencing numbness and a crawling sensation in my hands and feet, I began seeing a traditional Chinese medicine practitioner.
I have since cut out sugary drinks, fast food, fried foods, and sweets! I also exercise daily and have reduced my meal portions.
What other bodily warning signs might also start with numbness in the hands and feet? My hands and feet still occasionally feel slightly numb, but the crawling sensation has mostly disappeared...

Luka, 30~39 year old female. Ask Date: 2020/04/29

Dr. Xiao Yongxun reply Family Medicine

Dear Mr.
Luka:
1.
There are many diseases that can lead to numbness or abnormal sensations in the hands and feet, including common conditions such as vascular compression, diabetes, peripheral neuropathy, peripheral vascular disease, degenerative spinal disorders, herniated discs, spondylolisthesis, piriformis syndrome, vitamin deficiencies, electrolyte imbalances, stroke, brain tumors, autonomic nervous system disorders, epilepsy, and more.
Some of these conditions may appear very similar, while others can be easily distinguished.
It is essential for a physician to conduct a personal examination or discussion.
If necessary, laboratory or imaging tests may be required to establish a diagnosis.
2.
I recommend that you first consult with your family physician to discuss and clarify a direction among the numerous differential diagnoses.
This can help identify which conditions are more likely, allowing for a more informed decision moving forward.

Reply Date: 2020/04/29

More Info

Hand and foot numbness can be a perplexing symptom, especially when diabetes has been ruled out based on your recent blood tests, which show a fasting blood sugar of 80 mg/dL and a hemoglobin A1c of 5.7%. While these results suggest that you are not diabetic, it is essential to recognize that numbness can arise from various other conditions.
Firstly, peripheral neuropathy is a common cause of numbness in the extremities. This condition can occur due to several factors, including vitamin deficiencies (particularly B vitamins), alcohol use, and certain medications. For instance, vitamin B12 deficiency can lead to nerve damage, resulting in symptoms like numbness and tingling. If you suspect a deficiency, it may be worthwhile to have your vitamin levels checked.

Another potential cause is poor circulation. Conditions such as peripheral artery disease (PAD) can restrict blood flow to the limbs, leading to numbness and pain, especially during physical activity. If you experience symptoms like leg pain when walking or coldness in your feet, it would be prudent to consult a healthcare provider for further evaluation.

Nerve compression syndromes, such as carpal tunnel syndrome or tarsal tunnel syndrome, can also lead to numbness. These conditions occur when nerves are compressed in the wrist or ankle, respectively, and can cause tingling and numbness in the hands or feet. If you have repetitive hand movements or spend long hours in a position that puts pressure on your nerves, this could be a contributing factor.

Additionally, systemic conditions such as hypothyroidism or autoimmune diseases like lupus or rheumatoid arthritis can manifest with neurological symptoms, including numbness. These conditions can affect nerve function and lead to sensations of tingling or numbness. If you have other symptoms such as fatigue, weight changes, or joint pain, it may be worth discussing these with your doctor.

Anxiety and stress can also contribute to sensations of numbness or tingling, often referred to as paresthesia. Hyperventilation during anxiety attacks can lead to temporary changes in blood flow and nerve function, resulting in these sensations. If you find that your symptoms correlate with periods of stress or anxiety, addressing these underlying issues may help alleviate your numbness.

Lastly, it’s important to consider that some neurological conditions, such as multiple sclerosis (MS) or even transient ischemic attacks (TIAs), can present with numbness as a symptom. While these conditions are less common, they warrant consideration, especially if you experience other neurological symptoms such as weakness, vision changes, or coordination issues.

In summary, while your blood tests indicate that diabetes is not a concern, hand and foot numbness can stem from a variety of causes, including nutritional deficiencies, circulation problems, nerve compression, systemic diseases, anxiety, and more. It would be beneficial to consult with a healthcare provider who can conduct a thorough evaluation, including a detailed history and possibly additional tests, to determine the underlying cause of your symptoms. Addressing the root cause is crucial for effective management and relief of your numbness.

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