Tingling hands and feet?
Your nerves may be
asking for B vitamins.
Tingling in hands and feet — that pins-and-needles feeling — is common, and it’s easy to brush off. Often it’s just how you sat or slept. But when it keeps coming back, it’s worth a closer look. Your nerves need B vitamins to work well, and low B12 or B1 are common, testable causes in India. Here’s what to know.
Sudden numbness or weakness on one side of your face or body is an emergency — call for help straight away. See a doctor for tingling that lasts, spreads or gets worse.
Tingling in hands and feet: why your nerves need B vitamins
Your nerves are like electric wires with a protective coat called myelin. B vitamins help keep that coat healthy and give nerve cells the energy they need. When B vitamins run low, nerve signals can misfire — and you feel tingling or numbness.
Think of each nerve as an electric wire running from your fingertips to your brain. The wire has a protective coat called myelin, like the plastic around a cable, which keeps signals fast and clear. Vitamins B1, B6 and B12 help keep that coat healthy and give nerve cells the energy they need. Each of them contributes to the normal functioning of the nervous system.1
When one of these vitamins runs low, signals can misfire. That’s the tingling, pins-and-needles or numb feeling — a nerve telling you something isn’t quite right.
Numbness in hands and feet: the common causes
The most common causes are high blood sugar, pressure on a nerve (like carpal tunnel), thyroid problems, alcohol, some medicines and low B vitamins. In India, diabetes and low B12 top the list.
Common causes
- High blood sugar — 11% of Indian adults have diabetes and 15% prediabetes2
- Pressure on a nerve, like carpal tunnel or sleeping on your arm
- An underactive thyroid
- Regular heavy drinking
- Some medicines
Nutrient causes
- Low vitamin B12 — very common in India
- Low vitamin B1 (thiamine)
- Too little — or far too much — vitamin B6
- Low B vitamins behind “burning feet”
Vitamin B12 deficiency symptoms: the most common nutrient cause
Low vitamin B12 is the most common nutrient cause of tingling in the hands and feet. About half of Indian adults are low in B12, especially vegetarians and people on metformin. A simple blood test checks it.
B12 builds and protects the myelin coat around your nerves. When it runs low, the coat wears thin, and tingling, numbness or a “walking on cotton” feeling can follow. In a North Indian study, 47% of adults were low in B12.3 B12 comes mainly from milk, eggs, fish and meat, so vegetarians are most at risk — and so are people taking metformin for diabetes.4
The good news: tingling from low B12 often improves once B12 is back to normal, especially when caught early. Read our vitamin B12 guide for more.
Vitamin B1: why polished rice matters
Your body stores very little vitamin B1, so it can run low in a few weeks. Polished white rice — especially washed several times — and heavy drinking are the main risks. Low B1 often starts with tingling toes and burning feet.
Vitamin B1, or thiamine, powers your nerve cells. Your body holds only a small store of it, so on a diet without B1, stores run low within about 18 days.5 Low B1 often starts with tingling toes and burning feet.6
This matters in India. Polishing rice removes most of its B1,6 and washing rice several times before cooking washes away even more.7 Regular heavy drinking also drains B1 quickly.
That’s why our multivitamin uses benfotiamine, a special form of B1. Because it passes into the body more easily, it raised blood thiamine about 11 times higher than standard B1 in a study, and nearly doubled the active form inside red blood cells.8
“Your body can’t store much vitamin B1. A few weeks of polished rice and little else can be enough to run low.”
The simple version
Vitamin B6: the right amount matters
Vitamin B6 is needed for healthy nerves. But very high doses taken for a long time can also cause tingling. Everyday amounts are best, and the active form, P5P, is the one your body uses.
B6 is unusual. Your nerves need it — but very high doses over a long time can cause tingling too. That’s why regulators in Australia and Canada ask for warning labels on products with more than 10 mg a day,9 and Europe’s upper limit is 12 mg a day.10
We use 2.4 mg of P5P, the active form of B6, in line with India’s recommended daily amount. In lab research, the nerve problems seen with high-dose B6 came from pyridoxine, the common form — not P5P.11 Read P5P vs pyridoxine to learn more.
Burning feet: first described in India
“Burning feet syndrome” was first described by doctors in India — in Calcutta in 1826 and by Dr C. Gopalan in 1946. It’s linked to low B vitamins, and in prisoners of war, vitamin B5 relieved it.
A burning feeling in the soles of the feet, often worse at night, has a special history in India. It was first described in Calcutta in 1826, and in 1946 by Dr C. Gopalan, who later led India’s National Institute of Nutrition.12 The same year, doctors saw it in prisoners of war living on rice gruel — and vitamin B5 (pantothenic acid) relieved their symptoms.13 Today it’s linked to low levels of several B vitamins, including B1, B5 and B12.
Tingling or numbness lasts, spreads or gets worse, comes with weakness, or you have diabetes. Sudden numbness or weakness on one side of the face or body is an emergency — call for help straight away.
The nerve B vitamins, in their best forms.
Everyday amounts of the B vitamins your nerves use, in forms your body can take up and use easily.
Bioactive Multivitamin
Benfotiamine B1 (BenfoPure®), methylcobalamin B12 and P5P B6 at 2.4 mg — plus B2, B3, B5, biotin and Quatrefolic® folate. Thiamine, B6 and B12 contribute to the normal functioning of the nervous system.
See the multivitamin →Element 5
300 mg of magnesium with a little extra P5P B6. Magnesium contributes to the normal functioning of the nervous system and normal muscle function.
See Element 5 →What to do about tingling hands and feet
Get emergency help for sudden one-sided numbness. See a doctor for tingling that lasts. Check your blood sugar and B12. Eat less-polished grains, and choose everyday B vitamin doses rather than mega-doses.
- Know the emergency signsSudden numbness or weakness on one side of your face or body needs urgent help.
- See a doctor for lasting tinglingTingling that lasts, spreads, comes with weakness or affects someone with diabetes needs a check-up.
- Test blood sugar and B12Ask for HbA1c and vitamin B12 — especially if you’re vegetarian, over 50 or take metformin.
- Protect your B1Choose less-polished rice or mix in whole grains, don’t over-wash rice, and keep alcohol low.
- Choose everyday B vitamin dosesEveryday amounts in active forms are better than mega-doses, especially for B6.
- The benfotiamine study compared single doses in healthy volunteers, at a higher dose than a daily multivitamin.8 An earlier review found about 5 times higher blood thiamine.14
- The 18-day figure comes from people on a strict diet with no thiamine at all.5
- The B6 nerve findings come from laboratory studies on nerve cells. B6 warning labels apply to all forms, including P5P, above 10 mg a day.11,9
- Burning feet syndrome can have many causes; B vitamin shortfalls are one of them.12
Tingling and numbness, answered simply.
Which vitamin deficiency causes tingling in hands and feet?
Can B12 deficiency cause numbness?
Can too much vitamin B6 cause tingling?
Does polished rice cause vitamin B1 deficiency?
What is benfotiamine?
What causes burning feet?
Is tingling always caused by a vitamin deficiency?
Can nerve tingling from low vitamins get better?
When is numbness an emergency?
Which forms of B vitamins are best for nerves?
Studies behind this guide
- Commission Regulation (EU) No 432/2012 — authorised health claims: thiamine, vitamin B6, vitamin B12 and magnesium contribute to the normal functioning of the nervous system.
- Anjana RM, Unnikrishnan R, Deepa M, et al. Metabolic non-communicable disease health report of India: the ICMR-INDIAB national cross-sectional study (ICMR-INDIAB-17). Lancet Diabetes Endocrinol. 2023;11(7):474–89.
- Singla R, Garg A, Surana V, et al. Vitamin B12 deficiency is endemic in Indian population: a perspective from North India. Indian J Endocrinol Metab. 2019;23(2):211–4. PMID 31161105
- Niafar M, Hai F, Porhomayon J, Nader ND. The role of metformin on vitamin B12 deficiency: a meta-analysis review. Intern Emerg Med. 2015;10(1):93–102. PMID 25502588
- Fattal-Valevski A. Thiamine (vitamin B1). J Evid Based Complementary Altern Med. 2011;16(1):12–20 — severe depletion within 18 days on a strict thiamine-deficient diet.
- Linus Pauling Institute, Oregon State University. Micronutrient Information Center: Thiamin — dry beriberi, burning feet, polished rice.
- Thiamine deficiency — beriberi: a forgotten disease. Review of an outbreak linked to highly polished rice washed two to three times before cooking.
- Xie F, Cheng Z, Li S, et al. Pharmacokinetic study of benfotiamine and the bioavailability assessment compared to thiamine hydrochloride. J Clin Pharmacol. 2014;54(6):688–95 — plasma thiamine bioavailability ~1,147% of thiamine HCl.
- Therapeutic Goods Administration (Australia). Peripheral neuropathy with supplementary vitamin B6 — safety update; Health Canada Summary Safety Review, 2026 — warnings above 10 mg/day.
- EFSA NDA Panel. Scientific opinion on the tolerable upper intake level for vitamin B6. EFSA Journal. 2023;21(5):8006.
- Vrolijk MF, Opperhuizen A, Jansen EHJM, et al. The vitamin B6 paradox: supplementation with high concentrations of pyridoxine leads to decreased vitamin B6 function. Toxicol In Vitro. 2017;44:206–12. PMID 28716455
- Gopalan C. The “burning feet” syndrome. Indian Medical Gazette. 1946;81:22–6; Grierson J. On the burning feet of natives. Trans Med Phys Soc Calcutta. 1826;2:275–80.
- Simpson J. “Burning feet” in British prisoners-of-war in the Far East. Lancet. 1946;1:959–61.
- Loew D. Pharmacokinetics of thiamine derivatives especially of benfotiamine. Int J Clin Pharmacol Ther. 1996;34(2):47–50.