Q: My boyfriend has a question about his feet. During the day they are cold and I mean as cold as ice. Then at night after 8:00, they are as hot as fire to him – not to touch as they are cold to the touch but when they are hot you cannot feel the heat. There are many nights when he cannot sleep and this has been going on for years. Please help if you can.
A: There are a number of reasons for feet to feel extremely hot. Nerve damage known as peripheral neuropathy may be one consideration. Peripheral neuropathy is damage to the peripheral nervous system, a network within the body that transmits information from the brain and spinal cord throughout the entire system and back to the brain and spinal cord. Symptoms can vary from person to person, with some individuals experiencing tingling, temporary numbness, muscle weakness, and sensitivity to touch. Others may have night-time burning pain, paralysis, or organ/gland dysfunction. In extreme cases, breathing may become labored (as in Guillain Bare syndrome) and organ failure may occur. In the case of Guillain Barre and when organs or glands are involved, the type of neuropathy is referred to as autonomic neuropathy, not peripheral neuropathy.
Alcohol neuropathy can result from chronic over-use of alcohol. Alcohol neuropathy is just that – damage to the nerves that results from excessive, chronic use. The cause may include a direct poisoning of the nerve from alcohol and poor nutrition from failure to maintain good dietary habits. Symptoms include numbness of the extremities, muscle cramping and pain, incontinence, impotence, constipation/diarrhea, nausea/vomiting, dysphagaia (difficulty swallowing), and a possible inability to use or store specific vitamins and minerals including A, the B’s, and others. Damage to nerves is usually permanent and may worsen with continued use. While the disorder is not life threatening, it certainly can affect a person’s quality of life.
Tarsal tunnel syndrome affects the medial mallelous (the bump on the inside of the ankle) and the flexor retinaculum (ligaments that stretch across the bottom of the foot. One of the nerves in the tarsal tunnel is known as the tibial nerve that provides sensation to the bottom of the foot. Symptoms include a burning sensation, tingling, numbness and pain.
Hypothyroidism refers to an under-active thyroid gland that fails to produce sufficient certain hormones. The reason for symptoms to occur in the feet in an individual diagnosed with hypothyroidism is not from the disease causing peripheral neuropathy, but from the hypothyroisism causing edema that squeezes the nerves. Symptoms include an increased sensitivity to cold, muscle weakness, muscle aches, joint pain, and a great deal more. On the positive side, laboratory testing can zero in on this deficiency and medication can be prescribed.
Raynaud’s disease affects the supply of blood to specific parts of the body – primarily the fingers and toes. The condition is usually triggered by cold weather, stress, and anxiety when blood vessels temporarily spasm and block the flow of blood. Symptoms include pain, numbness and tingling.
Other possible medical causes include a vitamin B deficiency, diabetes, exposure to toxins, poor circulation, chronic kidney disease, poor circulation, Charcot-Marie-Tooth disease, and more.
As you can see, there are numerous conditions that can cause cold and hot feet. As I see it, your boyfriend should make an appointment with a physician for an examination and lab testing. The history he presents should rule out specific conditions and his physician can then zero in on others he feels may be relevant. He doesn’t have to be concerned about testing for something he doesn’t want but discussion regarding dietary habits, alcohol consumption, and cigarette smoking will provide a great deal of information. Encourage him to make the call or if he allows it, you can do it for him.
