Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
Without the ability to obtain a history from you and examine you, I can not comment on a formal diagnosis or treatment plan for your symptom. However, I will try to provide you with some information regarding this matter.
The cause of tingling symptoms depends largely on their distribution and historical circumstances. Since you mentioned bilateral hands and feet, I’ll just focus on this.
Symptoms worst in the hands and feet can be caused by a process called a neuropathy. There are 2 types of nerves that provide sensation to the feet, large nerves and small nerves. A problem with either of these could lead to burning and tingling. There are many causes to this group of disorders called "neuropathies". They include but are not limited to most commonly diabetes, vitamin deficiencies, autoimmune disorders such as lupus or a disease called Sjogren's, certain types of neoplasm, and certain toxins (such as lead). There are several other genetic, metabolic, and hereditary disorders that cause neuropathy, and what tests need to be ordered depend on the history and physical examination of the patient. With small fiber neuropathy, the EMG/NCS test which measures how nerves conduct electricity and how muscles respond to them may be normal. In large fiber neuropathy, it will be abnormal. Small fiber neuropathy can be diagnosed with a skin biopsy and with a test called a QSART. Drugs such as gabapentin and pregabalin are commonly used to treat neuropathic pain.
Thank you for using the forum, I hope you find this information useful, good luck.
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