Toe Numbness

[ANW]

About 18 months ago the tips of my toes were numb.  The numbness progressed down my foot to about 1 inch past my toes within the first 2 months.  I can feel my toes but when you ***** it with a needle, it just feels like you are touching it with your finger. It has not progressed since then.  My Dr. has run several blood test (B12, Thyroid, Diebetes, metabolic workup, etc.) and nothing has shown up.  An EMG showed inconclusive muscle irregularities in my toes.  No other test were done.  I have some weakness/tiredness in my legs sometimes when I exercise or stand for a long time.  Heat aggravates the numbness especially when I exercise, wear closed toe shoes for long periods or if I keep my feet under the covers all night.  It feels like my toes are swollen and they hurt when they get warm.  

My Dr. has suggested waiting another 6 months and running blood test again to see if anything shows up.  He also has told me to take Vitamin E and a Multi Vitamin.

Is there any other test I should have and do you have any suggestions to what might be causing the numbness?

[SummerGirl]

Hello. I also have tingling toes and numbness on the bottoms of my feet. For me this started after undergoing chemotherapy. At that time I did not find the problem to be debilitating, as much as an annoying nusance. Lately, I have experienced numbness in my fingers too. All this has been accompanied by increasing fatigue, sleeplessness and memory difficulties. All of which is causing me depression. I started to research fatigue and have found that there can be a vitamin B12 deficiency at the root of this problem caused by loss of "intrinsic factor", an amino acid necessary for the absorbtion of B12 manufactured in the stomach. And all of the symptoms I am experiencing are associated with lack of B12. Apparantely there are a number of causes for lack of vitamin B12: (certain medications as well as certain chemotherapy treatments, and autoimmune problems).
   I did more reading and see where a simple blood test for Vitamin B12 is not necessarily a good indicator of B12 deficiency (pernicious anemia). Vitamin B12 is stored in the liver anywhere from 2 to 6 years so blood levels may appear nornal. Since vitamin B12 is required for good nerve function more testing may need to be done. Apparently there are a few tests for Vitamin B12 deficiency. Blood tests for the amino acid homocysteine are the most sensitve for measures of vitamin B12 defiency according to Phyllis Balch, CNC. High levels of this amino acid indicate inadequate levels of the vitamin. I am in the process of having another test for B12 analysed. I encourage you to research Vitamin B12 defiency (pernicious anemia) and see if you have other symptoms too. You may want to have other tests done that give a truer picture of what is really going on. Best of luck.

[ANW]

I don't take any meds.  So far if I wear open toe shoes during the day and limit the amount of time in closed toe shoes and try to keep my feet out from under the covers, I have very little pain.  Unlike you I have no known trigger of the problem.  I just woke up one morning and noticed the tips of my toes where numb when I was in the shower.  Hopefully they can figure out what is wrong with you.

[MBL]

Sept 1 of this year I suffered with high fevers. I waited for a week and the weekend before seeing my doctor. The fevers were so high I would break out in welts.  I cooled myself down by getting into the tub.  I waited so long to see my doctor because I figured I was coming down with a cold/flu.  Monday of the new week I saw my doctor, she ordered blood and urine. The urine showed I was dehydrated.  My blood work would not be back for another 5 days.  Doctor said to continue fluids and fever reducer.

By Sept 11 I could take no more, I was hardly eating foods they  didn't taste good.  My sister took me to the hospital.  They drew blood and urine, and sent me to a room.  On call doctor came in and said he was admitting me, high liver enzymes and fever.

Well finally to make a long story short they removed my gallbladder because it had a slight infection.  My liver looked fatty.

At home recovering I noticed the tips of my fingers and toes were tingling, sometimes numb and sore.  Surgeon said its not uncommon from surgery gas, give it about a week to go away.

Well this is November a couple months later and 5 doctors can't figure out what is wrong. Yes I had the nerve test too, one hand and one leg, results were fine. The neurologist put me on a medicine for depression ( Amitriptyline 25mg 2x evening )and also ( ambien 10mg ) if I need it for sleep.

The medicine works slightly, it takes the edge off (feels like raw nerve endings) although I enjoy the heat, it is the cold air, a breeze, cold water, cold bed sheets. If my hands touch a cold pillow it wakes me up.

I am seeing a neurologist and a rhemutism doctor. Some of my blood work stills shows elevated liver and other (I don't know the name) blood work still high.

I have been on Thyroid medicine just as recent as July 2001.

Seems like I am not the only one with this problem.  Please write if you have any new answers for this condition.  Mine gets so bad at times I can't work.

Thank you
Mary B

[CCF-Neuro-M.D.-JT]

From the description of your symptoms, it sounds like you have some kind of peripheral neuropathy. Your doc has run all the right tests. Some less common causes include syphillis, heavy metal poisoning (like arsenic), exposure to certain chemicals used in plastics, lead, medications such as those used in chemotherapy, heriditary diseases (ask your parents/siblings if they have similar symptoms), and protein abnormalities in your blood (ask your doc if he did serum electrophoresis).  

Your doc's game plan sounds good. I would also add that you get a repeat EMG with importance on the nerve conduction test where they shock you.  Finally, something simple: did you get new shoes when you started having these symptoms?

Best of luck.