Dr. Basuki Nath Bhagat
Family Physician
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am a 52-year-old female. I am overweight but in good shape cardiovascular-wise nevertheless, and I have a weird numbness or dead feeling in my toe closest to the baby toe of the left foot. It does not change color, it is not on both sides, and it is always the same toe. It is on and off again. Sometimes I get pain across the top of the foot where the affected toe is present. I imagine it is most likely due to the footwear. Would a circulation disorder appear differently? Last year, I got tested for diabetes, and my glucose and HbA1c levels were normal. Kindly help.
Hello,
Welcome to icliniq.com.
I understand your concern. I would like to ask the following:
1) Could you mention what factors or conditions aggravate or relieve such numbness in the left fourth toe?
2) What is the duration of the numbness? Is it recent in onset or chronic in the course, occurring on and off?
3) Are you taking any lipid-lowering medicine?
Kindly revert with answers.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply. My cholesterol level is 150 mg/dL. I am not on any lipid medication. The numbness goes on and off. So, it is not chronic. Kindly help.
Hi,
Welcome back to icliniq.com.
According to the medical history, there is no dyslipidemia or diabetes as the HbA1c (hemoglobin A1c) is normal. Therefore, these two are very important risk factors for peripheral vascular disease, and unlikely that the present problem could be due to PVD (peripheral vascular disease). You have also mentioned no color change in the affected toe. I would like to know, does the numbness aggravate due to tight footwear or any relation when you wear tight shoes and after removing them? Does it increase with heavy exercise or stress, or cold exposure?
Kindly revert in case of further queries.
Patient's Query
Hi doctor,
Thank you for the reply. I work out 40 minutes a day, so there is no pain when I walk. I have Raynaud's disease, so my feet are cold sometimes, although there is no relation here. The orthopedic doctor advised me to wear shoe inserts which I have not been wearing. It seems to occur randomly and disappear randomly. I have a Kardia device and did a six-lead ECG. Also, I had an echocardiogram on my heart last year for an RF for early-onset atrial fibrillation. My echocardiogram was normal, and the stress echocardiography test was normal. Kindly help.
Hi,
Welcome back to icliniq.com.
I understand your concern. I meant by it because it also blocks or narrows arteries which lately produces numbness. Still, this symptom appears very lately as limb claudication is the most common symptom (along with other symptoms). It is one of the least differential diagnoses I would think here before other suspects are ruled out through medical history. It seems that the improper fitting of shoes is the reason for the numbness. I suggest you follow the orthopedic doctor's guidance, and the necessary intervention would help resolve the symptom. You have mentioned that you have Raynaud's disease. Is it affecting other toes when exposed to cold, stress, or anxiety?
Kindly revert in case of further queries.
Patient's Query
Hi doctor,
Thank you for the reply. It is just that one toe. My Raynaud's disease has improved with age- strangely. I used to get white tips on my fingers, but now I just feel cold feet and hands from time to time. There is no discoloration. Kindly help.
Hi,
Welcome back to icliniq.com.
Sorry for the late reply.
Kindly revert in case of further queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply. It happens when I am cold. I do get anxiety, but it does not trigger Raynaud's disease. Kindly help.
Hi,
Welcome back to icliniq.com.
I understand your concern. It is good to read that Raynaud's disease is improving, and the literature mentions it can sometimes enhance. However, maybe it is very mild Raynaud affecting the left fourth toe. So I would suggest you avoid cold exposure in every possible manner, wear well-fitting shoes and follow an orthopedic doctor's guidance, and hopefully, it will improve altogether.
I hope you get well soon.
Thank you.
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Family Physician
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