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What causes trembling in body and burning in feet?

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Dr. M. Vamsi Krishna

Diabetologist

Practicing since :2007

Answered : 988 Questions

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Posted on Tue, 19 Aug 2014 in Digestion and Bowels
Question: Hello Doctor,

For the past two days , I am feeling shaky and trembling. I visited a GP two days back in the evening and checked my BP (130/90) and CBG (88 mg/dl). He told me that I may have digestion problem and prescribed PAN IV inj.
Yesterday I felt very hot from inside in the night , it was like i am burning in my feet , but there was no fever and It was ok after like 30 min.
I drink and smoke daily . My weight / height is 93 KG/170 cm. I was on amlong 2.5mg and razel f for a month.
DO i have low blood sugar or any other issues .
doctor
Answered by Dr. M. Vamsi Krishna 36 minutes later
Brief Answer:
Hello

Detailed Answer:
Dear XXXX

I have gone through your query and understood your concerns.
In my opinion most of your symptoms might be due to consumption of alcohol, in medical terms this condition is called as Alcoholic Neuropathy.

The exact cause of this is unknown but its seen in people taking alcohol for long term and poor in nutrition.

The common symptoms will be
1.Numbness in the arms and legs
2.Abnormal sensations, such as"pins and needles"
3.Painful sensations in the arms and legs
4.Muscle weakness
5.Muscle cramps or muscle aches

As per your CBG report its fine and can not be considered as low sugar.
I suggest you to check some blood test like B12 and Thiamine (vitamin B1)

Honestly, I don't diagnose you with this condition; but it's definitely worth evaluation in these lines since there are many matching symptoms. Please discuss with your treating doctor

Kindly reduce your weight to 72-76 as excess weight can make one prone for diabetes. Reducing weight will also improve your blood pressure control.

Hope I was able to help you.
If you have any further question feel free to write me back. I will be happy to help.
Take care.
Best Regards.
Dr Vamsi Krishna
Consultant Diabetologist
Apollo Hospitals
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. M. Vamsi Krishna 1 hour later
Thanks Doctor,

I stay in XXXXXXX Can you suggest me a Lab where I can get the blood test done and what are the names of the test.

In the meantime, Can you prescribe any medicine to over come this shakyiness in my body.

Do I need to be worried if the test result shows negative or vitamin deficiency. Can this be cured.

I am not able to avoid alcohol immediately, can I take it in little quantity and how much. Please suggest.

Thanks
XXXX
doctor
Answered by Dr. M. Vamsi Krishna 22 minutes later
Brief Answer:
Hi there

Detailed Answer:
Dear sir

There are many labs in XXXXXXX which are doing this test.
I suggest you my place where I did my post graduation, it's Dr Mohans diabetes specialty center in Royapeta, corner XXXXXXX road. They are having a good lab.

Ask for serum Vitamin B12 and serum Thiamine levels. You can do the testing as outpatient with out seeing a doctor there.

There is nothing to feel bad if the vitamin levels are less.
kindly take inj neurobion, one injection alternate days for 7 doses and take tablet Matilda forte daily one tablet for 3 months but don't start the medications before testing.

Reduce your alcohol consumption to half of the quantity what you are taking and after 10 days slowly reduce the dose of alcohol.

Regards
Dr XXXXXXX XXXXXXX
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. M. Vamsi Krishna 45 hours later
Dear doctor,

I stopped talking alcohol for last two days. I am feeling shaky in the whole body some times. I am able to eat/ drink well no nausea etc. I am on Multivite gold (multivtamin caps). My legs seems little bit swollen.

I Enquired about the blood test and would be taking it soon . Its very costly (Rs 4500).

Can you prescribe any tabs or injection for a quick relief from this shakiness.

Thanks and Regards
XXXX
doctor
Answered by Dr. M. Vamsi Krishna 33 minutes later
Brief Answer:
Hi

Detailed Answer:
Dear XXXX

I got your concern

Its not advisable to stop alcohol suddenly as it might cause little withdrawal symptoms like shaking of body and legs. I suggest you to reduce the dose of alcohol to half and slowly taper the intake.

I am afraid that there are no medications for quick relief in this scenario as most of the effects are mediated by nervous system it will take time for recover.

Taking injection neurobion and good protein food is the best option.

Don't worry about swelling of foot they will return to normal soon.

Check your Haemoglobin, serum Albumin and serum creatinine levels and let me know.

Regards
Dr XXXXXXX
Diabetologist
Apollo Hospitals
Muscat
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. M. Vamsi Krishna 3 days later
Hello doctor,

I had a blood test for vitamin B12 , SGPT, SGOT, Lipid Profiles and Blood sugar.

Not able to attach the report. Please share your email. Below are the details :

Vitamin B12 - 150 pg/ml
Glucose (fasting) - 88 mg/dl
Glucose (PP 1 1/2 hr) - 136 mg/dl
SGOT(AST) - 23.9 U/L
SGPT (ALT) - 30.5 U/L
Lipid profile :
Total Cholestrol : 255 mg/dl
HDL Cholestrol : 46 mg/dl
Triglycerides : 286 mg/dl
LDL Cholestrol : 187 mg/dl
VLDL Cholestrol : 57.2 mg/dl
Total CHO/HDL Ratio : 5.5


Presently i am in below medication :

1) PAN D - (1 cap before food everyday morning)
2) Matilda forte (1 cap after food everday morning) started on 28-july
3) Razel - F 20 ( 1 Cap night after food everyday)

Please suggest
1) should I have to visit a neurologist with the report and go for neurobion inj.
2) Do I have low sugar.
3) how long will it take to get a good B12 count
4) Should I have to go for thiamine test.
5) any change in food habits
6) Present alcohol Consumption 90 ml per night before food.

Any other precautions and treatment to be taken :

Thanks
XXXX
doctor
Answered by Dr. M. Vamsi Krishna 26 minutes later
Brief Answer:
Low vitamin b12

Detailed Answer:
Dear XXXX

hope everything is fine in XXXXXXX Thank for doing test on advice.

Test reports are saying that your B12 is slightly low. I suggest you to take inj neurobion once alternate days for 7 doses.
1.Good news first liver function is good.Nothing to worry about sugar you are not having low sugar.
2.lipid profile is not good
Bad cholesterol--LDL is 187 which is not a good sign.even total cholesterol and Tri gly are also elevated the medication what you are taking for cholesterol is good but you can see good response by reducing alcohol and daily go for some exercise.
Regarding food habits i suggest you to take refined sunflower oil or safflower oil.
Stop taking red meat and try taking fish or omega 3 fatty acid which is also available in form of capsules.
3.right now no need for thiamin test
4.with in one month try to reduce the dose of alcohol to half dose that is 45 ml/day
wait for 1 month and in case symptoms are not settling i suggest you to consider meeting neurologist.
In one month time your b12 might return normal
relax and nothing to worry and control your self in taking alcohol
with the grace of XXXXXXX everything will be alright.
relax
Regards
Dr XXXXXXX XXXXXXX
Diabetologist
Apollo hospital
Muscat
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. M. Vamsi Krishna 20 hours later
Hi Doctor,

Thanks for the reply.

Yesterday I visited a neurologist to get a prescription for injection. He tested me with a small hammer like device and have given a prescription. (Attached) .

1) Is the prescription has same medicine as you prescribed. Is there any side effects for the injection.
2) Please elaborate on his findings written on the back of the sheet.
3) I started walking for past few days and cannot walk for more time as I get pain in the bone below the knee on the right leg. What could be the issue.
4) Do let me know any capsule name for omega3 fatty acid.

Regards
XXXX
doctor
Answered by Dr. M. Vamsi Krishna 4 hours later
Brief Answer:
Hello

Detailed Answer:
Hi XXXX

I am very happy to see that your neurologist also prescribed the same medication.

1.The injection is not having any side effects. It consist of a combination of B vitamins which help in growth of nerves. This vitamin is water soluble so the excess of vitamin will come out in form of yellow urine there is nothing to feel bad about this.

2.The findings of your doctor says first about your complaint paresthesia in both feet, there is no major neural defect, you are having reduced vitamin B12 in blood and your ankle jerk is normal, you are having habit of taking alcohol since long time.

3.Relax dear recover will take more than 4 wks, don't panic.

4.Omega 3 fatty acids are available in form of seven seas cod liver oil capsules. You can take daily two capsules after food in night.

In addition your doctor also prescribed vitamin D and calcium also which will help in speedy recovery.
My suggestion is don't panic you are going to be fine. Just give some time for medication to work and show their effect.

Relax

Regards
Dr XXXXXXX Krishna
Diabetologist
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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