Tingling in Your Hands and Feet? A Vitamin Deficiency Might Be the Problem

Written by Nicole Andonian, MD | Reviewed by Katie E. Golden, MD Updated on February 9, 2023

Key takeaways:

• Paresthesia — the medical term for tingling in the hands and feet — is often a sign of a problem with the nerves. There are many different causes. 
• Vitamin deficiencies are a common cause of paresthesias. The B vitamins — vitamin B12 and vitamin B6 — are the most common ones.
• Deficiencies in copper, calcium, and magnesium can also lead to tingling in your hands and feet. Most of the time, correcting the deficiency can help reverse the symptoms. 

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Do you ever get that feeling of pins and needles in your hands and feet? It feels like your arm or leg falls are asleep. Many times, this can happen simply because you were in one position for too long. 

But if you notice this feeling easily or more often than normal, something else might be causing it. A vitamin deficiency is one possibility. We’ll go through the different vitamin deficiencies that can cause tingling in the hands and feet to help you figure out if this could be happening to you. 

What causes tingling in the hands and feet (paresthesia)?

Paresthesia is the medical term for any abnormal sensation that happens when your nerve endings get compressed or damaged. This can feel painful — like burning or prickling — or it can just feel like numbness. 

Paresthesia can be temporary and go away on its own. This is often the case when nerve compression is the cause — like when you’re lying or sitting in one position too long. But if it keeps coming back or is happening more often, it may be a chronic (long-term) paresthesia. 

Chronic paresthesias can be a sign of something wrong with the nerves. Causes include: 

• Neurological disorders, like Guillain-Barré syndrome, or problems with the spinal cord 
• Infections, like HIV, herpes, or Campylobacter jejuni
• Trauma or injuries that damage nearby nerves
• Diabetes, which can lead to peripheral neuropathy

And there are a number of different vitamin deficiencies that can cause paresthesias. 

Vitamin and mineral deficiencies that can cause tingling in your hands and feet

Vitamin deficiencies that cause tingling in the hands and feet can happen for different reasons. Some people may not be getting enough from their diet. For other people, their gut can’t absorb a specific vitamin well. Let’s walk through the details of specific vitamins and minerals. 

Vitamin B6 (pyridoxine)

Vitamin B6 is interesting because both too much and too little B6 can cause paresthesias. Usually the tingling starts in your feet and goes up your legs and into your arms. Some people also complain of a burning feeling. In babies, B6 deficiency can even cause seizures. 

B6 deficiency is associated with:

• Poor intake of B6 and malnutrition (common in people with heavy alcohol consumption)
• People who are on dialysis 
• Some medication interactions, like hydralazine and isoniazid

B6 deficiency is treated with oral supplements. Symptoms do improve after correcting the amount of B6 levels. 

Vitamin B12 (cobalamin)

Low levels of vitamin B12 can cause paresthesias in both the hands and feet at the same time. Other neurological issues, like weakness and vision changes, can also occur. 

B12 is also important in making new blood cells, so low levels can lead to anemia (low blood counts). This can also make you feel weak and tired. 

Causes of vitamin B12 deficiency include:

• Poor intake (sometimes this happens with a vegan diet)
• Medications (metformin and PPIs can disrupt the absorption of B12)
• Recent gastrointestinal surgery, which can also affect absorption
• Pernicious anemia

B12 deficiency can be treated with oral, nasal, or injectable forms of B12. Rapid diagnosis and treatment is key to reversing the effects of B12 deficiency. 

Biotin 

Biotin is another B vitamin. In addition to tingling in the hands and feet, biotin deficiency can cause: 

• Thinning hair and hair loss
• Skin infections and rashes
• Hallucinations 
• Seizures

Deficiency of biotin is quite rare. It’s associated with pregnancy/breastfeeding, chronic alcoholism, and deficiency in the biotinidase enzyme. Oral biotin supplements help regulate biotin levels and reverse symptoms.

Vitamin E 

Vitamin E deficiency causes a clumsy gait (ataxia) along with paresthesias. Vitamin E needs fat to be absorbed with it. Deficiency is caused by:

• Issues with fat absorption, like in cystic fibrosis
• Genetic disorders, like with abetalipoproteinemia

Oral supplements can correct vitamin E levels. Sometimes improving the body’s absorption of fat is also helpful. Fortunately, vitamin E supplementation can reverse the neurologic symptoms. 

Calcium 

Calcium deficiency can be mild or very serious, depending on how quickly it develops. The symptoms include:

• Paresthesias around the mouth and/or hands and feet
• Muscle cramps 
• Abnormal heart function, which can lead to heart failure
• Confusion and hallucinations
• Seizures 

The causes of low levels of calcium can include:

• Low levels of vitamin D, which helps with calcium absorption
• Liver and kidney disease
• Low parathyroid levels, which can be due to surgical removal of the parathyroid or low production
• Other electrolyte abnormalities, like low magnesium or high phosphate levels
• Some medications, like bisphosphonates
• Pancreatitis 

Calcium levels need to be corrected with either IV (intravenous) or oral supplementation. Sometimes, an underlying cause needs to be addressed as well. Paresthesias typically resolve once calcium levels are more normal. 

Magnesium 

Magnesium has many jobs in the body, such as regulating potassium and calcium. So low levels of magnesium can cause symptoms similar to low levels of calcium — like tingling around the face and mouth. Magnesium deficiency can also cause weakness, muscle cramping, and abnormal heart rhythms. 

Causes of low levels of magnesium include:

• Chronic alcohol use
• Chronic diarrhea
• Medications, like the aminoglycoside antibiotics (gentamicin) and diuretics (furosemide) 

Fortunately, magnesium supplementation can quickly correct magnesium levels and improve potassium and calcium levels. Symptoms usually improve once the electrolytes are normalized. 

Copper

Copper deficiency can cause paresthesias in the legs and difficulty walking. Copper deficiency is rare but associated with taking too much zinc or having surgery on the stomach, causing poor absorption of copper. Treatment includes taking copper supplements and reducing any zinc intake. Unfortunately, symptoms are not always reversible even after copper levels are corrected.

The bottom line

Paresthesia occurs when your nerves are damaged and they don’t get all the nutrients they need. This includes vitamins, which play an important role in nerve function. When a vitamin deficiency causes tingling in the hands and feet, it’s often the B vitamins. But others can do it too.

These vitamin deficiencies can happen for a number of reasons, beyond just inadequate intake from your diet. Talk to your provider to see if you need to check your vitamin levels. Most of the time, the paresthesias will go away once the vitamin levels are corrected.