Feet are quiet messengers, and when they begin to burn, tingle, or ache without a clear cause, they may be signaling something the body has been carrying for a long time. Dr. Sudhir Kumar, a neurologist associated with Apollo Hospitals in Hyderabad, points to two common sources: the slow wear that prolonged high blood sugar places on small nerves, and the quieter depletion that follows a shortage of vitamin B12. In both cases the nerves are the ones paying the price, and the path to relief begins not with managing the discomfort alone but with finding and addressing the root cause.
Foot Pain or Burning May Signal Blood Sugar Problems or B12 Deficiency, Apollo Neurologist Warns
Sore feet may be the first signal, before diabetes is ever diagnosed.
Mark
Why does a doctor single out foot symptoms? People get sore feet all the time.
Mimi
Because the pattern matters. Kumar describes burning, tingling or electric-like pain that worsens at night, starting at the toes and moving upward. That's different from ordinary tiredness.
Luke
Worth saying, though, that this is one neurologist's account of two common causes. The article doesn't say they're the only ones, and it gives no figures on how often either is responsible.
Mark
The prediabetes point seems important.
Mimi
It is. The symptoms can appear before diabetes is diagnosed, so sore feet could be the first signal someone gets.
Luke
Right, but the piece says can, not will. Plenty of people with prediabetes may have no symptoms at all, as the article itself notes.
Mark
And the B12 side?
Mimi
Vegetarians, vegans, and people on metformin or acid-lowering drugs are named as commonly affected. Symptoms include pins and needles, numbness and balance trouble in both feet.
Luke
Notice that metformin shows up there, and it's also a diabetes drug. The article doesn't explore that overlap, so I wouldn't read more into it than what's stated.
Mark
So what should someone actually do?
Mimi
Get tested. HbA1C, fasting glucose or a glucose tolerance test for blood sugar, and a blood test for B12. Then treat the root cause.
Luke
And medications like gabapentin, pregabalin or duloxetine are for easing symptoms, prescribed by neurologists. The article doesn't say how well they work.
Der Puls
- Persistent burning, tingling, or pain in the feet is often dismissed as fatigue, yet it can be the first audible sign of nerve damage.
- Unstable blood sugar quietly injures the small nerves of the feet, and the sensations can creep upward from the toes over time.
- A shortage of vitamin B12, common among vegetarians, vegans, and people on metformin or acid reducers, brings numbness and balance trouble in both feet.
- Doctors are urging patients to confirm the cause through HbA1C, fasting glucose, or B12 blood tests before pursuing symptom relief.
- The outlook is hopeful: once the underlying deficiency or blood sugar imbalance is treated, the discomfort can begin to ease.
Feet are quiet messengers, and when they begin to burn, tingle, or ache without a clear cause, they may be signaling something the body has been carrying for a long time. Dr. Sudhir Kumar, a neurologist associated with Apollo Hospitals in Hyderabad, points to two common sources: the slow wear that prolonged high blood sugar places on small nerves, and the quieter depletion that follows a shortage of vitamin B12. In both cases the nerves are the ones paying the price, and the path to relief begins not with managing the discomfort alone but with finding and addressing the root cause.
Dr. Sudhir Kumar, a neurologist trained at CMC Vellore and now working with Apollo Hospitals in Hyderabad, has a message for anyone whose feet hurt, burn, or tingle without an obvious reason. It may not be simple tiredness. He named two of the most common culprits: unstable blood sugar tied to diabetes, and a shortage of vitamin B12.
The first is diabetic neuropathy. Prolonged high blood sugar gradually damages the small nerves, especially in the feet. The result can be numbness, tingling, or a sharp, electric-like pain that often worsens at night, usually beginning at the toes and climbing upward. These symptoms are not limited to people already diagnosed with diabetes; they can appear in prediabetes, offering an early warning before the condition fully develops. An HbA1C test, a fasting blood sugar test, or an oral glucose tolerance test can help clarify the picture.
The second common cause is low vitamin B12, which leads to nutritional neuropathy. It is especially likely in vegetarians, vegans, and people taking metformin or acid-lowering medications. Pins-and-needles sensations, numbness, and balance problems in both feet can follow, and a simple blood test can confirm the deficiency.
Treatment starts with the root cause, whether that means managing diabetes or replenishing B12. To ease symptoms in the meantime, neurologists may prescribe medications such as gabapentin, pregabalin, or duloxetine. The takeaway is clear: persistent foot pain or burning deserves testing, because finding the cause is the first real step toward relief.
Dr. Sudhir Kumar, a neurologist trained at CMC Vellore and now associated with Apollo Hospitals in Hyderabad, has a message for anyone whose feet hurt, burn or tingle without an obvious reason: it may not be fatigue. In remarks reported by The Economic Times, he named two of the most common causes behind such symptoms, unstable blood sugar linked to diabetes and a shortage of vitamin B12.
The first is diabetic neuropathy, which results from prolonged high blood sugar. Over time, he explained, excess glucose damages the small nerves, particularly those in the feet. The result can be numbness, tingling, or a sharp, electric-like pain that often gets worse at night. The sensations typically start at the toes and creep upward, a progression doctors describe as a stocking pattern.
The symptoms are not reserved for people who already have a diabetes diagnosis. They can show up in prediabetes too, which makes them a possible early warning before full diabetes develops. To confirm the cause, doctors generally recommend an HbA1C test, a fasting blood sugar test, or an oral glucose tolerance test, depending on the case.
The second most frequent cause is low vitamin B12, which produces what is known as nutritional neuropathy. Kumar noted that it commonly affects vegetarians, vegans, and people taking medications such as metformin or acid-lowering drugs. When B12 levels drop, the nerve damage can appear as pins-and-needles sensations, numbness, and balance problems, in both feet. A simple blood test for B12 confirms the deficiency.
Treatment begins with the underlying cause. That means managing diabetes effectively, or replenishing vitamin B12 where it is low. To ease the symptoms themselves, neurologists often prescribe medications such as gabapentin, pregabalin, or duloxetine.
The report also lists what high blood sugar can look like more broadly, and it stresses that it varies from person to person. Some people with prediabetes, gestational diabetes or type 2 diabetes may have no clear symptoms at all, while type 1 diabetes often announces itself suddenly and severely. Common signs include excessive thirst, frequent urination, unexplained weight loss, fatigue, mood swings, blurred vision, wounds that heal slowly, and frequent infections of the skin, gums or elsewhere.
The practical takeaway is straightforward: persistent foot pain or burning is worth testing for. A blood sugar test or a B12 level can point to the cause, and treating that cause is the first step toward relief.
Bemerkenswerte Zitate
Persistent foot pain or burning may be a warning sign of unstable blood sugar, with diabetes and vitamin B12 deficiency among the most common causes (paraphrased).— Dr. Sudhir Kumar, neurologist, Apollo Hospitals Hyderabad
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