Unexplained nerve sensation

[mattgmann]

I've had an ongoing issue that is hard to describe, but I will try to do my best.  The most outward symptom is a nervous sensation in my extremities.  It is not pain or tingling, but more of a generalized discomfort.  It is felt in the tips of my fingers, radiating from the nail beds, and likewise in my toes.  I can also feel it in my knees and teeth.  

This started sporadically a few months ago.  At the beginning of this year I started a genuine effort to improve my health.  I have lost 45lbs in 8 or so months by means of an improved diet and regular exercise ( I cycle ~20 miles/day 5 days/week).  

My health overall has improved dramatically.  My resting heart rate is below 70bpm, my blood pressure has returned to a healthy level (~120/70 last checked), my body fat percentage is below 20%, and some of my digestive problems have ceased or become much less frequent.

This nerve sensation though has increased in regularity now to the point that I am worried it is a symptom of something.  It is somewhat accompanied by tiredness and an overall weak feeling.  The feeling has been pretty much constant now for the last 2 weeks.  Overall, I have experienced it for 4-5 months in some degree.  

I have not found any measurable form of relief yet.  The sensation seems to increase with exercise and it becomes an extreme mental effort to work through it.  I have refrained from exercising for 3 days now and the sensation has not decreased.  I eat a relatively healthy and balanced diet and supplement my nutrition with a multi-vitamin daily as well.

For further information, I had an appendectomy approximately 2 months ago which was routine and was fully recovered within 10 days.

Any insight into this would be appreciated.  Visiting a doctor is not an option for me at the moment outside of emergency care.

[Dr. Kokil Mathur]

Hi!
The nerve sensations or paresthesia are generally due to peripheral neuropathies or vascular pathologies. Hence peripheral vascular pathologies like deep vein thrombosis have to be ruled out either by angiograms or by dopplar studies. There are several causes for peripheral neuroptahies including diabetes, hypothyroidism, chronic involvement of liver or kidney, chronic alcohol use etc. Hypoparathyroidism too should be looked into apart from hypothyroidism. Neck strain, spondylotic changes in cervical vertebrae, bone disease or bad posture should be looked into. Nerve infections as in lyme’s disease too should be investigated. Nerve conduction studies should be done along with blood tests for above mentioned disorders. Vitamin B12 deficiency too should be looked into. Multiple sclerosis is another possibility but less likely in your case.  
Please consult your PCP for primary examination followed by proper referral. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.

[mattgmann]

further information: age: 31, weight: 218lbs, height: 6'1". No other known current medical conditions. Not taking any prescription drugs. Take nsaids regularly for joint pain relating to past injuries. Have suffered from sporadic unexplained headaches recently. Occasionally use omeprazole for heart burn. Mood and temper are also effected by these symptoms. Quit smoking 2 months ago. Drink moderately (once a week). Do not consume any illegal drugs. Sleep is starting to be effected as well.