Tingling or burning in my feet: diabetes or low B12?
Quick answer
A sensation of pins and needles, burning, or numbness in the feet is commonly caused by peripheral nerve damage from long-standing diabetes or vitamin B12 deficiency (often linked to long-term metformin use). Senior Physician Dr. Vishnu Anjan Nareddy evaluates nerve health, checks B12 and HbA1c, and prescribes targeted therapies in Tirupati.
Action guide
When to seek care
Emergency now (Call 108)
- Open wound, cut, or ulcer on the foot that has not healed or shows discharge
- Blackening or bluish discoloration of toes (gangrene / vascular block)
- Sudden loss of strength in foot or leg (foot drop)
- Severe unsteadiness and repeated falls while walking
See a doctor today
- Burning or tingling sensation worse at night in bed
- Feeling like you are walking on cotton wool or wearing invisible socks
- Taking metformin for diabetes for more than 2 years without a B12 test
- Loss of feeling to hot or cold temperatures on the feet
Care at home & watch
- Normal sensation to light touch and pinprick on both feet
- No burning, numbness, or night cramps
- Intact skin with good pulses in the feet
Diagnosis
Common possible causes
Diabetic neuropathyHigh blood sugar damaging small nerve fibers over years.Read more ›Vitamin B12 deficiencyCommon in vegetarians and patients taking metformin tablets.Read more ›Cervical or lumbar spine disc compressionTingling radiating from lower back down the back of the leg (sciatica).Read more ›
Frequently asked questions
Why does metformin cause tingling in the feet?
Metformin can reduce intestinal absorption of vitamin B12 over time. Low B12 damages the protective sheath of nerves, producing numbness and tingling that mimics diabetic nerve damage.
Can tingling feet be reversed?
Yes, if caught early. Replacing vitamin B12 and achieving steady blood sugar control can repair damaged nerve fibers and relieve burning symptoms.
Dr. Vishnu Anjan Nareddy
Professor of Medicine-Senior consultant physician · Open until 10 pm daily.
Medically reviewed by Dr. Vishnu Anjan Nareddy, MD (General Medicine) · Last updated October 2026