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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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I have numbness in both feet. Started five years ago,

Answered by
Dr.
Dr. Aaron Branch

General & Family Physician

Practicing since :2011

Answered : 877 Questions

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Posted on Sun, 17 Mar 2019 in Brain and Spine
Question: I have numbness in both feet. Started five years ago, felt like coming out of dental work. First just in the right foot progressed to left. Seems to be getting more severe rapidly. Blood sugar levels good, seventy year old oriental male, 5'2,124#, causing balance problems. MRI two years ago, showed partially herniated discs L4 L5 and L5 S1.
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Follow up: Dr. Aaron Branch 0 minute later
I have numbness in both feet. Started five years ago, felt like coming out of dental work. First just in the right foot progressed to left. Seems to be getting more severe rapidly. Blood sugar levels good, seventy year old oriental male, 5'2,124#, causing balance problems. MRI two years ago, showed partially herniated discs L4 L5 and L5 S1.
doctor
Answered by Dr. Aaron Branch 1 hour later
Brief Answer:
Check B12 deficiency

Detailed Answer:
Hello, I'm Dr. Branch, thanks for using Ask a Doctor.

There are many causes of neuropathy in the feet, including from diabetes, chronic kidney disease, chronic liver disease, alcohol, vitamin deficiencies, medications, autoimmune diseases, infections, and sometimes malignancies. Oftentimes a cause cannot be found. Diabetes is the most common cause, so if you do not have diabetes, the work up is of course extensive, and you may already been checked for many of these things. You may also need an EMG and/or nerve conduction study to figure out what kind of nerve damage has been done.

However, in your case, I would especially want to make sure you don't have vitamin B12 deficiency, as this can cause the symptoms you describe and is a fairly common cause. If you haven't already, I would get your vitamin B12 level checked, and if it is low, you may need other tests to check for the reason it is low, as some people have a disease that impairs the absorption of vitamin B12.

I hope that helps, please let me know if you have any other questions and I would be glad to discuss it with you further. Also, if you can give me more of your medical history, that may also help me to give you more specific advice. Thank you for your question and take care.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Aaron Branch 0 minute later
Brief Answer:
Check B12 deficiency

Detailed Answer:
Hello, I'm Dr. Branch, thanks for using Ask a Doctor.

There are many causes of neuropathy in the feet, including from diabetes, chronic kidney disease, chronic liver disease, alcohol, vitamin deficiencies, medications, autoimmune diseases, infections, and sometimes malignancies. Oftentimes a cause cannot be found. Diabetes is the most common cause, so if you do not have diabetes, the work up is of course extensive, and you may already been checked for many of these things. You may also need an EMG and/or nerve conduction study to figure out what kind of nerve damage has been done.

However, in your case, I would especially want to make sure you don't have vitamin B12 deficiency, as this can cause the symptoms you describe and is a fairly common cause. If you haven't already, I would get your vitamin B12 level checked, and if it is low, you may need other tests to check for the reason it is low, as some people have a disease that impairs the absorption of vitamin B12.

I hope that helps, please let me know if you have any other questions and I would be glad to discuss it with you further. Also, if you can give me more of your medical history, that may also help me to give you more specific advice. Thank you for your question and take care.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Aaron Branch 2 hours later
Thanks for your prompt response. Had been taking one B12 supplement for several years due to low iron (not eating enough red meat), per new Dr reduced B12 (2500 MCG ) to twice a week. Other med history, now have low back pain, dry AMD (taking AReds2), losartrin 50mg and mrt





























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About 8 years ago, took 2500 mcg B12 for low iron, 6 months ago reduced to 2x per week per new DR. Also take 50mg Losartan and 25mg Metoprolol (cut in half 2x per day) for high blood pressure. Take AREDS2for dry AMD. Take 1800 Mg Calcium w/D for osteopenia, Had osteoporosis 20 yrs ago but reduced w/ Fosamax. also deal w/ osteoarithritis ( bone density checked 18 mos). Both parents had osteo arithus, Mother and her sibilings had type 2 diabetes. Have full labs from 6/18/18








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Follow up: Dr. Aaron Branch 0 minute later
Thanks for your prompt response. Had been taking one B12 supplement for several years due to low iron (not eating enough red meat), per new Dr reduced B12 (2500 MCG ) to twice a week. Other med history, now have low back pain, dry AMD (taking AReds2), losartrin 50mg and mrt





























o

















































p



rol











































































































































































































































































About 8 years ago, took 2500 mcg B12 for low iron, 6 months ago reduced to 2x per week per new DR. Also take 50mg Losartan and 25mg Metoprolol (cut in half 2x per day) for high blood pressure. Take AREDS2for dry AMD. Take 1800 Mg Calcium w/D for osteopenia, Had osteoporosis 20 yrs ago but reduced w/ Fosamax. also deal w/ osteoarithritis ( bone density checked 18 mos). Both parents had osteo arithus, Mother and her sibilings had type 2 diabetes. Have full labs from 6/18/18








doctor
Answered by Dr. Aaron Branch 36 minutes later
Brief Answer:
Need details

Detailed Answer:
I see. Have you been told the cause of your neuropathy? Have you had Vitamin B12 blood levels checked? Like I said, sometimes patients do not absorb it well, so even though you are taking Vitamin B12 supplements, you might still be low. Have you had an EMG or nerve conduction study done?
Need the details so that I am better able to help.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Aaron Branch 0 minute later
Brief Answer:
Need details

Detailed Answer:
I see. Have you been told the cause of your neuropathy? Have you had Vitamin B12 blood levels checked? Like I said, sometimes patients do not absorb it well, so even though you are taking Vitamin B12 supplements, you might still be low. Have you had an EMG or nerve conduction study done?
Need the details so that I am better able to help.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Aaron Branch 44 hours later
Blood and urine labs 6/18/18 B12 >1500 H. Have mentioned the numbness to VA Dr for several years, but, as I mentioned it is getting worse. No nerve conduction or EMG (I don't know what this is). Will follow up with VA on further tests
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Follow up: Dr. Aaron Branch 0 minute later
Blood and urine labs 6/18/18 B12 >1500 H. Have mentioned the numbness to VA Dr for several years, but, as I mentioned it is getting worse. No nerve conduction or EMG (I don't know what this is). Will follow up with VA on further tests
doctor
Answered by Dr. Aaron Branch 2 hours later
Brief Answer:
See below

Detailed Answer:
Yes, it appears your Vitamin B12 is fine. I believe the next step would be an EMG/nerve conduction study, I would discuss that with your doctor the next time you see them.

Please let me know if I can help with anything else.
Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Aaron Branch 0 minute later
Brief Answer:
See below

Detailed Answer:
Yes, it appears your Vitamin B12 is fine. I believe the next step would be an EMG/nerve conduction study, I would discuss that with your doctor the next time you see them.

Please let me know if I can help with anything else.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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