Abnormal Sensations in Feet: Causes and Solutions

Q: Abnormal Sensations in Feet: Causes and Solutions

Hello Student H： You mentioned that "the neurologist said an MRI was not necessary, and only advised me to exercise more, maintain a regular sleep schedule, and eat more B vitamins, without prescribing any medication. <br>At that time, I did not have the unusual symptom of coldne

Abnormal sensation

Hello Doctor, I have recently been experiencing a strange sensation in my feet, where they often feel cold (or hot? It's a peculiar feeling that starts from my toes and extends upwards).
Although my feet feel cold, their actual temperature seems normal.
I've also noticed that my hands and feet are very prone to numbness, but changing positions usually alleviates the numbness.
The unusual sensation in my feet has persisted for many days; it feels strange but does not affect my daily activities, and I do not experience any pain.
I'm concerned that this might be a sign of serious neurological disorders or sclerosis.
Additionally, two months ago, I visited a neurologist and an immunologist due to headaches, dizziness, and an eye infection (referred by an ophthalmologist).
I underwent an EEG and basic physical examinations, and had numerous blood tests for autoimmune diseases.
However, both specialists reported no abnormalities.
The neurologist advised against an MRI, suggesting that I should exercise more, maintain a regular sleep schedule, and consume more B vitamins.
At that time, I did not have the unusual sensation in my feet, so I am unsure if I need to return for further evaluation.
Could you please advise on what might be causing these abnormal sensations? Are there any additional tests I should consider, or how can I improve this situation? Also, during the blood tests, I was not required to fast, and I believe they included a complete blood count.
Would diabetes be detectable through those tests? Thank you, Doctor.

Student H, 20~29 year old female. Ask Date: 2023/05/28

Dr. Jiang Junyi reply Neurology

Hello Student H: You mentioned that "the neurologist said an MRI was not necessary, and only advised me to exercise more, maintain a regular sleep schedule, and eat more B vitamins, without prescribing any medication.
At that time, I did not have the unusual symptom of coldness in my feet." Your symptoms may suggest possible compression of the sciatic nerve.
Nerve compression typically presents with pain that may have a burning or tingling quality.
Evaluating peripheral nerve issues often involves electrophysiological tests to assist in diagnosis.

Nerve conduction studies assess the conduction velocity and waveform of large fiber nerves.
Electromyography (EMG) evaluates muscle responses in the areas supplied by the nerves.
I recommend that you visit a neurology clinic for follow-up examinations, preferably with a physician who specializes in peripheral nerves, as they have more experience with EMG testing.
Regarding your question, "Is fasting required for blood tests? I remember it includes a complete blood count, and can diabetes be detected?" Hemoglobin A1c can be tested without fasting, and it can help in diagnosing diabetes.
Additionally, a urine glucose test can be performed.
Thank you for your inquiry, and feel free to discuss any related questions! Wishing you good health and peace.
Dr.
Jiang Junyi, Neurology, Taoyuan Hospital, cares about you.

Reply Date: 2023/05/28

More Info

The sensations you are experiencing in your feet, such as a feeling of coolness or warmth, along with the occasional numbness, can be concerning. These symptoms can arise from a variety of causes, and while they may not currently interfere with your daily activities, it is essential to understand their potential origins and whether further evaluation is necessary.

Firstly, the abnormal sensations in your feet could be attributed to peripheral neuropathy, which is a condition that affects the peripheral nerves. This can lead to symptoms such as tingling, numbness, and unusual temperature sensations. Peripheral neuropathy can be caused by several factors, including diabetes, vitamin deficiencies (especially B vitamins), alcohol use, and certain medications. Given that you mentioned having blood tests done recently, it is worth noting that diabetes can often be detected through blood tests, including fasting blood glucose levels or HbA1c tests. If these tests were performed and returned normal, it is less likely that diabetes is the cause of your symptoms.

Another possible explanation for your symptoms could be related to circulation issues. Conditions such as peripheral artery disease (PAD) can lead to reduced blood flow to the extremities, causing sensations of coolness or warmth. However, this is typically accompanied by other symptoms, such as pain or cramping in the legs during activity.

Additionally, anxiety and stress can manifest physically in various ways, including abnormal sensations in the limbs. If you have been experiencing increased stress or anxiety, this could also contribute to your symptoms.

Given your recent medical history, including headaches, dizziness, and eye infections, it is understandable to be concerned about potential neurological issues. While the neurologist you consulted did not find any abnormalities and did not recommend an MRI, it may be beneficial to follow up with them regarding your new symptoms. They may suggest further testing or a referral to a specialist if they deem it necessary.

In terms of management, there are several strategies you can consider to alleviate your symptoms. Regular physical activity can improve circulation and nerve health, so incorporating exercise into your routine is advisable. Additionally, ensuring you have a balanced diet rich in vitamins and minerals, particularly B vitamins, can support nerve function. If you suspect that your symptoms may be related to anxiety or stress, techniques such as mindfulness, meditation, or cognitive behavioral therapy (CBT) can be beneficial.

If your symptoms persist or worsen, or if you develop new symptoms such as pain, weakness, or changes in coordination, it is crucial to seek medical attention promptly. A healthcare provider may recommend additional tests, such as nerve conduction studies or imaging, to further investigate the underlying cause of your symptoms.

In summary, while your symptoms may not currently be severe, it is essential to monitor them closely and maintain open communication with your healthcare providers. They can help guide you through the process of diagnosis and management, ensuring that any potential underlying conditions are addressed appropriately.

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