Hath Paon Sun Hona: B12, Diabetes, Posture and the Right Test

Why do your hands or feet keep going to sleep, hath paon sun hona, even when you have not been sitting oddly? Sometimes it is nothing, a nerve pinched for a minute under your own weight. Sometimes it is your body telling you about a vitamin gap or a blood sugar problem you have not been screened for yet.

The everyday, harmless kind

Sit cross legged too long on a charpai and the peroneal nerve behind the knee gets compressed, cutting circulation to the foot briefly. Sleep with an arm tucked under your pillow and the same thing happens to the hand. This kind resolves within a few minutes of moving and shaking it out, comes back with a pins-and-needles rush, and never happens without a clear positional cause. If that describes your numbness, posture is the whole story.

When it is not just posture

Numbness that shows up without an obvious position, that lingers for hours, that keeps recurring in a pattern, or that comes with weakness, burning or loss of balance needs a proper look at three usual suspects: vitamin B12, diabetes, and a genuinely pinched nerve from posture built up over years rather than minutes.

Vitamin B12 and who runs low

B12 lives almost entirely in animal foods, meat, eggs, dairy and fish. Vegetarians, people who eat very little meat for cost reasons, older adults whose stomachs absorb it less efficiently, and anyone on long-term metformin for diabetes are the groups who run low most often in Pakistan. Low B12 causes numbness and tingling that typically starts in the feet and moves up, sometimes with fatigue, a smooth sore tongue, or memory fog that gets mistaken for simple tiredness.

Diabetes and nerve damage

Long-standing high blood sugar damages the small nerves in the feet first, then the hands, in a pattern doctors call a glove and stocking distribution because it affects the areas those items cover. This numbness tends to be symmetrical, on both sides equally, and gradual, worsening over months. Anyone with diagnosed diabetes, or undiagnosed risk factors like a strong family history and central weight gain, should treat new numbness as a reason to check blood sugar, not ignore it as ageing.

The one test worth asking for

If numbness is recurring without a clear positional cause, ask your doctor for two tests specifically: a fasting blood sugar or HbA1c, and a serum B12 level. Both are cheap, widely available, and together explain the vast majority of chronic numbness cases seen in general practice here. Do not accept a prescription for a vitamin injection without first confirming the level is actually low, since normal levels do not need topping up.

1. Note when the numbness happens, at rest, after a specific position, or randomly through the day, for one week.
2. Book a fasting blood sugar or HbA1c test, plus a serum B12 test, at any diagnostic lab.
3. If B12 is below the lab’s normal range, your doctor will usually prescribe 1000 mcg injections weekly for 4 to 8 weeks, then a maintenance dose or oral tablets, depending on the cause found.
4. If blood sugar is high, follow up with a full diabetes workup rather than treating numbness in isolation.
5. If both come back normal and numbness persists beyond 3 weeks, ask for a referral to check for a specific pinched nerve, such as carpal tunnel in the wrist.

Other, less common causes worth knowing

Thyroid problems, particularly an underactive thyroid, can cause numbness and tingling in the hands as one of several vague symptoms alongside fatigue, weight gain and cold intolerance, and a simple TSH blood test rules this in or out cheaply. Certain medications, some chemotherapy drugs and a handful of blood pressure medicines, can cause nerve-related numbness as a side effect, worth mentioning to your doctor if new numbness started after a medication change. Excess alcohol intake over years is another recognised cause of nerve damage in the hands and feet, following a similar glove and stocking pattern to diabetes. None of these are common compared to posture, B12 and diabetes, but a doctor working through a numbness complaint will usually ask about all of them, because ruling things out properly is faster in the long run than treating the wrong one first.

Pregnancy and numbness

Pregnant women commonly experience numbness or tingling in the hands, sometimes worse at night, largely from fluid retention pressing on nerves at the wrist, a pregnancy-related version of carpal tunnel that often eases naturally after delivery. B12 and iron needs also rise in pregnancy, and antenatal blood tests routinely screen for deficiencies as part of standard care. Numbness in pregnancy is common and usually not alarming on its own, but it should still be mentioned at the next antenatal visit rather than dismissed as an expected inconvenience, since it is worth confirming which of these ordinary causes actually explains it.

Food habits that help meanwhile

Include an egg most days, a portion of meat, chicken or fish a few times a week, and dairy daily if tolerated, to keep B12 intake steady while you sort out testing. For those managing borderline sugar, spacing carbohydrate portions through the day rather than one large plate at dinner, and a short walk after meals, both support nerve health over time, though they are supportive habits, not a substitute for medical monitoring once diabetes is diagnosed.

The diabetes connection here overlaps with our piece on Prediabetes with Desi Food: HbA1c in Plain Words, useful if your test comes back borderline rather than clearly diabetic. For sugar control approaches once a diagnosis is confirmed, including where guava leaves fit honestly, see our guide to guava leaves and sugar control. Both sit within the site’s broader Desi Remedies collection.