Well... I'd look at the metformin for now. It can reduce B12 levels in 40% of the people taking them. So get a test for this and if the numbers are below 400, you need to supplement ASAP.
(doctors may say a result below this is "normal" but it is NOT).

I'd also test your blood sugar when you are feeling the pins and needles and/or numbness. Low blood sugar may cause this.

Can you tell me what else you take? Many drugs have effects on other nutrients, and may deplete common things. Some blood pressure drugs do this, ACE inhibitors deplete zinc.

Diabetics lose magnesium thru the urine. It is part of the process.
When magnesium levels get low, there can be cardiac effects. There can be Raynaud's (cold hands/feet), etc. Diarrhea can come from metformin itself. Loose stools lead to low potassium and MAGNESIUM as well.

Here is my magnesium thread:
http://neurotalk.psychcentral.com/thread1138.html
(do not use magnesium oxide for your supplement-- it is a laxative--and is not absorbed).

Get the B12 tested first off. And start a magnesium supplement (based on my link). Then see how you feel.
There are other things to do, that may/will help, but you should do these first to see how much of an effect they have.

Hi, thanks for the reply, I take Metformin 2 x 500mg daily, 1 x 75mg Aspirin and 1 x Propranolol 80mg daily, my BG levels have been fairly consistant and within my normal ranges throughout.

Following colour changes in my nail beds dependant on temperature my GP did say I had Raynaud's, but then another said I didn't and it was left at that.

The worst affects appear to be at night when I'm sleeping (waking with numb fingers etc), although this evening my arms feel like their burning and there have been plenty of shooting pains today...

Thanks for the advice and link to the magnesium thread, I'm off to have a look now,

Andy

Hi Andy,

When I was taking too much B-6 I had some of the same neuro symptoms you described. Also, I know you were tested for carpal tunnel but I wonder if there is a possibility of spinal stenosis. I had an MRI due to my hand/arm symptoms and found out I have cervical stenosis. It wasn't picked up on the NCV/EMG test. Nevertheless, my neuro doc said it didn't factor into my symptoms. I still wonder about that because there is compression of the cord and I still have some of the numbness you describe--the ring and little finger and a slight prickling sensation in my palms that sometimes wakes me up at night.

Jon

Hi, and thanks for the reply, I've had damage to my spine for several years (herniated L4-5 if I remember correctly), which saw me bed ridden a couple of times for up to 12 weeks at a time,but I haven't had any major problems with it lately but its something I'm going to bring up with my consulatant when I see him later this month.

I rang my GP's surgery this morning and asked for the results of my B12 test to be told it was normal, some further digging managed to get the count from him which was 312, so I'm guessing that its worth me trying a supplement and I'll get some today.

Regarding the magnesium, I read in the link provided (very informative thread by the way) that it may clash with Aspirin, would bathing in Epsom Salts be a good way of getting some Magnesium absorption through the skin rather than taking an oral supplement if this is the case, sorry for all the questions and thanks for your time, Andy

--given the rather acute onset of your symptoms, if there may be some spinal problem at some level.

The problem is that symptoms from spinal/nerve root compromise and those from more peripheral neuropathy (from diabetes or other causes) can often be exactly the same, which is why the testing process can be a long process of elimination.

Would they at least be open to giving you a brain/cervical spine MRI, to rule out nerve condition or central nervous system demyelinating diseases?

Beta blockers can cause those side effects of cold hands and feet.
This is a common side effect. Do you take the propranolol at night? Try taking it in the morning, and see if there is any difference.

Propranolol is listed in the reference I use called Drug Induced Nutrient Depletions.
The nutrient that was studied was CoQ-10. Since low levels of CoQ-10 impact the heart, I'd suggest you start a good supplement of this. (buy quality, and gel cap form, not dry powder capsules). You will need at least 200mg a day or more. Whatever you can afford, as it can be costly.

Here is a link with some information for you:
http://www.swedish.org/16749.cfm

I realize you need some beta blockade for your heart, but use of these drugs is problematic in diabetics.
It is a tight place to be...IMO.
Their biggest downside is that they mask symptoms of low blood sugar. While doctors are targeting high sugars, new research shows that LOWS are very damaging.

You can try this: soak your hands in epsom salts before going to bed each night. (at least 1/2 hr in lukewarm water) The magnesium will soak in and open the blood vessels and improve the circulation. (magnesium dilates blood vessels). This will help, but also point to magnesium oral as being your goal.

It is possible you may improve your heart functions with the CoQ-10 and magnesium and be able to get off the beta blocker in the future. This is a MAYBE... but a goal that will improve your daily life.

Cardiac arrhythmias respond to restoration of magnesium in some cases.

Thanks for all the information, a great help, and plenty to be getting on with.

I've managed to get some Epsom Salts and some B12 this morning, although its with a B complex but its all I could find and well worth a try, the magnesium for oral use will have to wait until I can get into town as the chemists didn't have any (the trouble of living in a rural area) but at least I got some new leads to try out

I did swap the Propranolol to the morning earlier in the week so its early days on that one and I'll see how it all pans out over the next month or so with that, meanwhile I've got a lot of information to read through courtesy of the links and no doubt will have a myriad of questions...

Please note, that some CoQ-10 supplements contain an additive that increases its absorption. This is called Bioperine (piperine).
This is contraindicated in patients taking propranolol.

http://www.publix.com/wellness/notes...Id=Propranolol

Doctor's Best is an example that has Bioperine added.

This type does not:
http://www.epic4health.com/

So read your labels carefully before you buy any CoQ-10.
Some just say Q-sorb or something like that. Turn the label over and read ALL the ingredients, including inert.

Andy,
Your use of the word 'chemists' and not pharmacist lends me to believe that you are outside the USA.
Are you from Australia, or the UK?
It may be possible to get the proper CoQ10 and B12 from the internet.
You should be looking for Methyl-cobalamin in sub-lingual form, not Cyano-cobalamin oral tablets.
The gel form of CoQ10 is available too.
I get mine from www.iherb.com
Just a suggestion.