Question

I am a 72 year-old male, and for the past 10 years I have noticed a numbness in one foot. It has little bearing on my activities (I am very active) but it seems to be getting slowly worse, and now the other foot has begun to feel the same. Is this something to worry about?

Answer

What you are describing probably has to do with the circulation. It's great that you are in good shape for your age. The major areas of concern include diabetes, peripheral vascular disease (the circulation), and, possibly, peripheral neuropathy (a problem with the sensory nerves in your feet). The fact that you have had it for 10 years increases the probability that it's related to the circulation. Many of the foot problems that occur in diabetes result in the same symptoms, and are due to damage to the circulation rather than to the nerves.

Everyone begins to form plaques in their circulation, especially at branches of the arteries, starting in childhood. This is called atherosclerosis. It becomes a problem when the plaques get large enough to block or slow the normal circulation to a body area. High blood cholesterol is a prime culprit in this process. It typically takes many years to develop any symptoms in this disease process. At age 72, if you have been free of other medical problems, the atherosclerosis may have become significant enough to cause the symptoms that you describe. You should ask your physician to order some blood work that includes a "lipid panel" to check the cholesterol in your blood, particularly the LDL (low density lipoprotein) or what is called the "bad cholesterol". If the LDL is elevated then you may be actively depositing cholesterol in your arteries and worsening your circulatory status.

The other lab test that should be checked is the hemoglobin A1c, which measures the amount of sugar attached to the red blood cells, and is a fairly accurate indicator of diabetes. Both these conditions (high cholesterol, diabetes) can be treated with medication. Regular exercise and a balanced diet will also help.

If these tests show no abnormality, you may have a form of peripheral neuropathy. The extremely slow progress of the numbness suggests that this is unlikely to be a serious problem, but it could warrant a visit to a neurologist.