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Burning, itchy ankles throughout the day. Cause?

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I started getting burning in my feet about 6 weeks ago. It was bad for a few days then it went away for a few days. For the next few weeks it would come and go. Generally better at night and when I woke up, often getting progressively worse throughout the day. I'm not diabetic and all bloodwork came back normal. Doctor referred me to a neurologist who I have yet to see. Then last week it was gone completely for more than 7 days. Came back with a vengeance on Monday and is terrible today. Mostly burning in bottoms of feet but other times it is a prickly sensation in my legs and sometimes arms. Sometimes it is itchy ankles.

My family doctor thought it was peripheral neuropathy caused by the propafenone I was using for my heart for previous 14 months. I quit 3 weeks ago and it did seem to get better after a week or two.

1) Does this sound like peripheral neuropathy, the way it comes and goes during the same day and then gone for days at a time?
2) could it still be from the drug?
3) could it be something environmental or food related?

Category: Neurologist, Medical

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Category: Pediatric Neurologist
 20 Doctors Online

Thank you for your query at
I understand your concern.
Burning sensation in the feet most commonly is due to vitamin b12 deficiency or other vitamin deficiency. The other causes such as vasculitis, chronic kidney disease, e.t.c do not seem probable in your case. Propafenone does not cause neuropathy as it's side effect commonly but it could be causing the burning sensation in your case. Before labelling this to Propafenone, I will like to know if you got your serum b12 levels tested. Also, do you have any history of thyroid disorders? Hypothyroidism also causes similar problems.
In absence of diabetes, and since it is on and off it does not sound like peripheral neuropathy.
I feel it is due to a vitamin deficiency, Let me know your values if you got it tested already.

Patient replied :

Thank you for your answer doctor.
Below are my Lab values from march 31st:
creatinine 75 mg 0.93 Albumin 49
estim GFR 106 bilirubin 24 umol/l total protein 78
glucose 5.8 Ca 2.5 CBC all normal
na 138 vit b12 317
K4.7 ferritin 343
cl 103 tsh 2.79
CO2 28 A1C 5.5
anion gap 10
My billirubin and ferritin are always borderline high (X5 years). I would appreciate any advice you could give me.

All your reports seems normal except for the ferritin and that does not explain the burning sensation on the foot.
I will advise you to get your serum b12 levels evaluated.
Meanwhile, I will advise you to start Tab. Neurobion Forte, once daily at bed time, and revert back to me in 7 days, whether it caused any improvement. Based on the values, I can decide if injections are required.
Hope this was helpful,

Dr. Sudhir Kumar
Category: Pediatric Neurologist
Senior Residency, Fellowship: DM, Neurology, CMC, Vellore, 2001
Junior Residency: MD, Internal Medicine, CMC, Vellore, 1998
Medical School: MBBS, Christian Medical College, Vellore, 1995
Dr. Sudhir Kumar and 4 other Medical Specialists are ready to help you

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