My wife has sleepless nights because of the pain

doctor.jpegMy wife is having problems with her legs. Her feet feel numb and we have tried different tablets prescribed to us but to no avail. We were mostly prescribed vitamin pills of different colours and names but have seen no change in her condition. She has sleepless nights because of the pain. Can you help? MR. M, by e-mail

Numb feet and lower limbs, or peripheral neuropathy, is a common and disabling condition with many causes. Diabetes is probably the most common cause internationally- due directly to damaged nerves and indirectly to damaged blood vessels supplying the nerves. However, other causes include alcohol abuse, chronic kidney failure, polio, and less commonly motor neuron disease, heavy metal toxicity and drug-induced neuropathies.

I suspect, however, that Mrs. M is being treated for beri-beri, a disease caused by thiamine, or vitamin B-1, deficiency. The symptoms of beri-beri can include loss of sensation in lower legs, associated with loss of muscle power and cramps or burning pain. Thiamine cannot be made by the body, so it is stored mostly in muscle for a maximum of 3-4 weeks, before it is lost in the urine. A healthy person can therefore become deficient in thiamine within one month.

If Mrs. M does indeed have beri-beri, it may be from:

1. insufficient thiamine in her diet

2. poor absorption of thiamine in her body

3. increased use of thiamine by her body

4. or excess loss of thiamine in her urine

A diet high in chemicals and enzymes which destroy thiamine, such as processed food, milled rice, raw fish, tea and coffee can be a problem. Alcoholism, chronic bowel disease and malnutrition can lead to poor absorption of thiamine and folic acid deficiency prevents thiamine from being activated. Hyperthyroidism, severe infection and pregnancy can use up a lot of thiamine, while severe diarrhoea or drugs like diuretics can cause excessive losses.

As Mrs. M appears to be taking vitamins (presumably thiamine), and is not improving as expected, I offer the following advice. Ensure the vitamins you are taking include thiamine or vitamin B-1. If you are sure it is beri-beri and you are taking the right treatment look for an underlying reason for your vitamin deficiency eg. poor diet. Finally, if possible, seek a doctor to definitively test your vitamin levels and/ or look for another cause (perhaps one of the ones listed above) of this numbness in your legs.

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