Numbness in feet

[Dufour]

I am experiencing numbness in the ball of my foot and big toe (in both feet). I have been diagnosed with type 2 diabetes but my blood glucose is rarely outside normal limits. My feet tend to be OK on waking but get worse during the day, particularly with psychological stress. They also get worse when I walk a lot. I feel as though I am walking on bricks or bandages but I have no loss of skin sensation in any part of the foot that seems to be numb. I have seen a neurologist who attributes it peripheral neuropathy. As my blood glucose levels are mostly normal when I test them I have difficulty accepting this. I have also been told by my local doctor that diabetic peripheral neuropathy is unlikely in the early stages of diabetes. I have noticed a few things that make the symptoms worse. I travelled trans-continentally by plane for 5 hours each way recently and my feet went through hell with numb symptoms despite my efforts to keep up circulation with exercise (it made me wonder whether poor air quality could have some affect). If I consume a meal rich in carbohydrates then the symptoms also get worse but they do gradually improve. One thing I cannot understand is how much the symptoms vary. At times they can be very slight and other times very debilitating. If it is peripheral neuropathy then how can they vary so much and how come I have skin sensation even when the symptoms are bad? I have high blood pressure which is controlled by CCB medication. I also have elevated cholesterol and triglycerides which are well controlled by Lipitor (stopping the Lipitor for a while had no effect on symptoms, by the way). One area I have found difficult to check out is my peripheral circulation. I don't know whether it is worth checking and what specialist physician would be best to consult.
I would welcome your views on all this. Thanks

[Kevin Pho, MD]

The symptoms of peripheral neuropathy can vary from person to person and can be episodic with varying symptoms.  I agree that diabetes would be less likely given the fact that it seems controlled and it is in its early stages.  

Peripheral vascular disease can be evaluated for during a physical exam where pulses in the foot and ankle can be palpated or measured with a doppler ultrasound.  A test known as the ankle-brachial index can be measured for further evaluation.  A vascular surgeon would be the specialist to discuss this possibility.  

Back to the neuropathy - if the symptoms continue, you can consider a referral to a podiatrist or neurologist for further evaluation.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
http://www.straightfromthedoc.com

[myfoot]

I get numbness on the top of my foot.  the numbness is constant.  I also have vertigo on occassion and cognitive difficulties.  This has going on for appox. 4 months now I have gone to the doctor and tests are ongoing.

[chic771]

A related discussion, foot numbness was started.