Why do my feet get so hot in bed that I can’t sleep?

Q In bed, while the rest of my body remains at a comfortable temperature, the soles of my feet burn up. I have to hang my feet over the side until they cool down, which can take over an hour, by which time the other exposed areas (legs, ankles, upper feet) are cold. Standing in cold water has little effect. I don’t want to bother my GP, but it is affecting my sleep. I am 70 and had heart bypass surgery in 2021, but this problem predates that. What is the issue?

A A short-term burning sensation of the soles of the feet can be caused by inflammation of the skin, due to an infection, or irritation from your socks, but this is unlikely to be the cause of a long-term issue. I suspect that the discomfort you are feeling is because the nerves in your feet are sending a false message to your brain that the skin is hot, when it isn’t, a condition known as peripheral neuropathy.

There are many different underlying causes of this, including lack of vitamin B12 or folic acid, drinking too much alcohol or an imbalance of chemicals in the blood caused by chronic kidney disease. There is a bit more information about this in my final answer today.

It can also be linked to an underlying condition, such as coeliac disease, rheumatoid arthritis and most commonly, diabetes. Your GP can check for all these, as treating any underlying problem is important and can help reduce neuropathy symptoms. However, in some, no underlying cause can be found.

The best way of easing this pain is usually with medicines to dampen down the abnormal nerve messages. This can be done with drugs commonly used (in higher doses) to treat epilepsy, such as pregabalin, gabapentin or carbamazepine. Drugs known as tricyclic antidepressants, such as amitriptyline, can also be helpful. These are all available on prescription from your GP.

Q I sometimes notice a mouse in my kitchen. The traps I bought seem to have not caught anything and though friends have suggested I get a cat, I can’t as I’m allergic to them. Mice don’t frighten me and I’m not particularly bothered by my little visitor, but should I be? Are they dangerous, health wise? A friend told me they carry rabies.

A Unfortunately mice are not as sweet and innocent as they may look. Wherever they are, they pass urine and faeces which can carry both bacteria and viruses that can be harmful to humans. Their droppings may be visible on the floor, but their need to eat up to 20 times a day means food left on a work surface or shelf where mice are able to chew through the packaging can easily become contaminated.

Mice don’t carry rabies, but can transmit hantavirus and the virus responsible for a type of meningitis.

While both are rare, they can be very serious and life threatening. They can also transmit typhus, leptospirosis and, more commonly, salmonella, which can cause gastroenteritis, with diarrhoea and vomiting.

Mice can also contaminate dust in your home and bring in ticks, fleas and mites. Another major concern is that they can damage appliances and furniture, and gnaw through wires, leading to a risk of electrical fires.

Though you have only spotted one mouse, it is likely there are several in your home, as they are rapid breeders producing lots of babies in just a few months. So you really do need to get rid of them, which I’m well aware is more easily said than done. The British Pest Control Association has lots of information on its website (bpca.org.uk). In the meantime, be really careful about hygiene, and wash the floor and all surfaces regularly with a disinfectant.

Q I was diagnosed with diabetes a couple of years ago, and understand I need to have an annual blood test to check my sugar levels. Recently I’ve been asked to provide a urine sample, but I don’t understand what this is for. I thought checking urine for sugar wasn’t done any more?

A Though an initial diagnosis of diabetes may be suspected after finding sugar in urine (using a test strip) you are correct that testing urine for sugar is not done once the diagnosis has been made.

Though excess sugar in the blood may leak out in urine, a far better way of checking if blood sugar levels are too high is with the glycosylated haemoglobin (HbA1c) level, which gives an indication of blood sugar levels in the previous three months. It’s usually checked via a blood test at least once a year in all diabetics.

Unfortunately, the high blood sugar levels that can occur in diabetes can damage the kidneys. So a blood test for kidney function should also be done at least annually as well, along with a urine test to see if it contains abnormally high amounts of protein, a test known as the albumin: creatinine ratio, or ACR. This can be a good detector of early kidney disease, which is otherwise not causing any symptoms, and will be the test you have been asked to do.

It is easier to tackle kidney disease if it is diagnosed in the early stages. In those with diabetes, this involves making sure blood glucose levels and the blood pressure are really well controlled as both of these can contribute to kidney damage.

Some drugs, such as ACE inhibitors like ramipril or lisinopril, and angiotensin receptor blockers (ARBs) such as losartan or candesartan can help protect kidneys from further damage, as well as lower blood pressure. So one of these is usually prescribed in addition to drugs that help control blood sugar levels.

It is also important to avoid taking medicines that may damage kidneys, especially anti-inflammatories, such as ibuprofen.