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Vitamin B12 and Tingling Feet: Why a Simple Blood Test Comes First
Yes, low vitamin B12 can cause numbness and tingling in the feet and hands, even when your blood count is normal (ODS, Vitamin B12). Metformin can lower B12 over time. If your feet tingle, ask your doctor for a B12 blood test. Neuralisse contains no vitamin B12, so it cannot fix a B12 shortfall.
Written by the Goneuralisse editorial teamUpdated · 8 min read
The short version
Can low vitamin B12 cause tingling feet?
Yes. The NIH Office of Dietary Supplements says B12 deficiency can cause numbness and tingling in the hands and feet, even without anemia (ODS, Vitamin B12).
B12 helps the body make the protective coating around nerves. When B12 runs low for months, nerves in the feet are often the first to show it. People describe pins and needles, burning, or feet that feel asleep.
NINDS lists B12 deficiency as one of the best-known vitamin causes of peripheral neuropathy (NINDS, Peripheral neuropathy). It matters because, unlike many causes, it can be found with a blood test and treated by a doctor.
A common mix-up
Can you have low B12 without anemia?
Yes. Nerve symptoms can show up before, or without, any change in red blood cells (ODS, Vitamin B12).
Many people assume a normal blood count rules out a B12 problem. It does not. A routine complete blood count looks at red cell size and number. B12 can be low enough to affect nerves while those numbers still look fine.
If your feet tingle, ask your doctor to check your B12 level directly. A normal blood count alone is not a B12 test.
Diabetes medicine
Does metformin lower vitamin B12?
Yes. ODS says metformin may significantly reduce B12 levels, and regular users should talk with their clinician about B12 status (ODS, Vitamin B12).
This creates a tricky overlap. Diabetes is the leading cause of nerve damage in the U.S. (NINDS, Peripheral neuropathy). Metformin is one of the most used diabetes medicines. So when a person on metformin gets tingling feet, it could be diabetes, low B12, or both.
Do not stop metformin on your own. It works well for blood sugar, and the B12 issue can be checked and handled while you keep taking it. Just ask whether a B12 test is due, especially if you have used metformin for years.
Risk factors
Who is most at risk of low vitamin B12?
People who absorb B12 poorly or eat little of it are most at risk. B12 comes mainly from animal foods, and the body needs stomach acid and a special protein to absorb it (ODS, Vitamin B12).
| Group | Why B12 may run low |
|---|---|
| Long-term metformin users | The drug can lower B12 levels over time |
| Older adults | Less stomach acid makes B12 in food harder to absorb |
| Users of acid-reducing drugs | Long use of stomach acid blockers can reduce absorption |
| Vegans and some vegetarians | Plant foods have little natural B12 |
| After stomach or bowel surgery | Less of the gut is left to absorb it |
| Pernicious anemia | The body stops making the protein needed to absorb B12 |
Testing
What B12 test should you ask your doctor for?
Start with a serum vitamin B12 blood test. If the result is borderline, doctors may add a methylmalonic acid (MMA) test, which can show a shortfall more clearly.
Describe the symptom
Say where it tingles, when it started and whether it is spreading.
List your medicines
Name metformin, acid blockers and every supplement, including any B6.
Ask about B12
Ask whether a B12 test, and maybe an MMA test, makes sense for you.
Follow the plan
If B12 is low, your doctor will choose pills or shots and recheck later.
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What else can cause tingling feet besides low B12?
Many things. More than 100 types of peripheral neuropathy have been identified, and diabetes is the leading cause (NINDS, Peripheral neuropathy).
Diabetes
Up to half of people with diabetes have nerve damage in the feet or legs (NIDDK, Diabetic peripheral neuropathy).
Too much B6
Too much vitamin B6 can also harm nerves, so check every supplement label (NINDS, Peripheral neuropathy).
Other conditions
Injury, kidney or liver disease, alcohol, toxins and some medicines can all play a part (MedlinePlus, Peripheral nerve disorders).
Read the nerve health guide for more on causes. People with diabetes should also keep up the daily foot care checklist.
New or worsening numbness, tingling, burning, weakness or balance trouble needs a doctor, and fast if it comes on suddenly.
The label
Does Neuralisse contain vitamin B12?
No. The Neuralisse label lists no vitamin B12 and no other B vitamins. The only nutrient with a printed amount is magnesium, 80 mg per capsule (19% DV).
The 575 mg blend holds magnesium glycinate, alpha lipoic acid, butcher's broom, L-carnitine, turmeric and CoQ10. You can check every line on the Supplement Facts page.
So if your tingling comes from low B12, Neuralisse cannot correct it. A B12 test and your doctor's treatment plan do that job. If you take Neuralisse with diabetes medicine, see the medicines guide first, because alpha lipoic acid can lower blood sugar (LPI, Lipoic acid).
Takeaway
What should you do first about tingling feet?
See your doctor and ask about a B12 test, especially if you take metformin. Find the cause before choosing any supplement.
FAQ
Vitamin B12 and tingling feet FAQ
Can low vitamin B12 cause numbness in feet?
Yes. The NIH Office of Dietary Supplements says B12 deficiency can cause numbness and tingling in the hands and feet, even without anemia. Because nerve symptoms can come first, ask your doctor for a B12 blood test if your feet tingle or feel numb for no clear reason.
Does metformin cause B12 deficiency?
Metformin can lower vitamin B12 levels over time, according to the NIH Office of Dietary Supplements. Regular users should ask their clinician about checking B12. Do not stop metformin on your own. A low level can be found with a blood test and treated while you keep your diabetes plan.
What B12 level causes neuropathy?
There is no single cutoff that fits everyone. Labs set their own normal ranges, and some people have nerve symptoms with borderline results. That is why doctors may add a methylmalonic acid (MMA) test. Ask your doctor to explain your number and whether more testing makes sense.
How long does it take for B12 to help tingling feet?
It varies with how low B12 was and for how long. Some people notice change within weeks of treatment, while long-standing nerve damage may improve slowly or only partly. Your doctor will recheck your level and track symptoms. Finding low B12 early gives the best chance.
Does Neuralisse have vitamin B12 in it?
No. Neuralisse lists no vitamin B12 or other B vitamins. Each capsule has 80 mg of magnesium and a 575 mg blend of magnesium glycinate, alpha lipoic acid, butcher's broom, L-carnitine, turmeric and CoQ10. It cannot correct a B12 deficiency, so get tested if you are at risk.
Can too much vitamin B6 cause tingling feet?
Yes. NINDS lists both low vitamin B12 and too much vitamin B6 as known vitamin-related causes of peripheral neuropathy. Check the labels of every supplement you take, including multivitamins and energy products, and tell your doctor the total amount of B6 you get each day.
Who wrote this
Written and reviewed by
A small team that reads the bottle label line by line, checks every number against public health sources (NIH, NCCIH, MSKCC, FDA, FTC, CDC) and rewrites it in plain English. We do not write for the manufacturer, and we update a page whenever the label, the prices or the evidence changes.
Last updated . See our editorial standards and how we check reviews. This website is run by a U.S. authorized merchant, not by the manufacturer. This site is paid a commission when you buy through its order links.
Keep reading
More about Neuralisse
Nerve health guide
What peripheral neuropathy is, what causes it, red flags that need fast care, and a daily foot-check routine.
Read moreSupplement Facts
Every line of the Neuralisse label typed out, with the blend math the label does not show.
Read moreDiabetes foot care checklist
A printable-style daily, weekly and yearly foot care checklist for people with diabetes, based on CDC and NIDDK advice.
Read moreU.S. authorized Neuralisse merchant
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