Progressive numbness in your feet with hATTR-PN
Fact-checked by Numbness in your toes or feet can happen for many reasons and might not seem concerning at first. However, persistent numbness that worsens, spreads upward, or begins affecting your balance or walking may need medical attention.
For people with hereditary transthyretin amyloidosis with polyneuropathy (hATTR-PN), foot numbness can be an early sign of nerve damage.
Why foot numbness can be an early sign of hATTR-PN
In hATTR-PN, an inherited change in the TTR gene causes the transthyretin protein to misfold and form abnormal protein clumps called amyloid deposits. These deposits mainly affect the peripheral nerves found outside the brain and spinal cord, leading to nerve damage (neuropathy) that often starts in the feet.
Because these nerves help you sense touch, pain, heat, and cold, early changes sometimes feel like tingling, burning, or “pins and needles.”
In hATTR-PN, nerve damage often progresses gradually, so symptoms that begin as mild tingling or numbness in the toes can slowly spread through the feet and legs over time. Paying attention to progressive numbness in the feet related to amyloidosis may help you recognize potential early hATTR-PN symptoms in the feet and seek medical evaluation sooner.
How hATTR-PN neuropathy differs from diabetes-related neuropathy
Diabetes is a more common cause of neuropathy affecting the feet, so early hATTR-PN symptoms may sometimes be mistaken for diabetes-related nerve damage. Because both conditions can cause issues such as sensory changes, shooting pain, and weakness, it can be difficult to tell them apart based on symptoms alone.
One key distinction is how symptoms change over time. With hATTR-PN, numbness and weakness can continue spreading upward from the feet into the legs and arms, and walking may become more difficult as more nerves are damaged. Nerve damage in hATTR-PN also tends to progress more quickly than neuropathy caused by diabetes and other conditions.
Why CIDP can be confused with hATTR-PN
Chronic inflammatory demyelinating polyneuropathy (CIDP) is another rare condition that can cause numbness, weakness, and trouble walking. It develops when the immune system damages the protective myelin coating around peripheral nerves.
Because both CIDP and hATTR-PN can affect sensation and movement in the legs and feet, the two conditions may look similar at first. Some people with hATTR-PN can also have nerve test results similar to those seen in CIDP, especially when severe nerve damage affects how nerve signals travel. As a result, hATTR-PN is sometimes initially misdiagnosed as CIDP.
Doctors might find it easier to make a hATTR-PN diagnosis when neuropathy appears alongside other clues, such as carpal tunnel syndrome or heart involvement. These additional symptoms can provide clues that amyloid deposits are causing the neuropathy.
Other symptoms that may appear with progressive numbness
Other nerve-related symptoms sometimes accompany numb feet in hATTR-PN. These might affect feeling, movement, and autonomic body functions, such as digestion, bladder control, and blood pressure. Other symptoms may include:
- trouble walking or balancing
- progressive muscle weakness
- constipation, diarrhea, or feeling full quickly
- dizziness when standing or sweating changes
- urinary problems or sexual dysfunction
- blurred vision or confusion
These signs could suggest that hATTR-PN is progressing beyond the nerves in your feet.
What to do if symptoms keep worsening
If foot numbness keeps spreading or starts to affect your gait, you should talk with your care team promptly. They’ll likely want to know when the symptoms started, how they have progressed, and whether one or both feet are affected. Tell your doctor about any other new or worsening symptoms, such as balance problems, digestive changes, or heart issues.
Your doctor may collect a detailed family history and perform a nerve exam, and they may also order nerve conduction studies, which check how well signals move through the nerves. If your symptoms continue to worsen, your care team will discuss your treatment options for slowing hATTR-PN progression.
When rare neuropathy could be the cause
When numbness in the feet keeps worsening over time, doctors may look beyond common causes of neuropathy, such as diabetes or a pinched nerve. In hATTR-PN, certain patterns — including progressive symptoms and involvement of multiple nerves — may suggest a rarer underlying condition.
But amyloidosis is not the only rare condition that causes progressive neuropathy in the feet. Other possible causes may include:
- inherited nerve diseases, such as Charcot-Marie-Tooth disease
- Fabry disease
- Sjögren’s disease
- porphyria
- certain autoimmune and immune system disorders
Always tell your doctor about any changes, even if they don’t seem related to numbness in your feet. These details can help your care team see the full pattern, choose the right tests, and avoid delays in diagnosis and care.
Amyloidosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
