A case of pins and needles - Too much of a good thing!

 “Moderation!” - my mother’s favorite word

The sensation of tingling, pins and needles poking our skin. Most of us have experienced it when our limbs fell asleep from being in the same position for too long or when we hit our funny bone in the elbow. I recently encountered a case of pins and needles of the entire body and thought I will talk about it. It is a deviation from anti-aging, but staying young and healthy is not just skin care, it is a balance of everything in life. 

    Paresthesia is the term used for the sensation of pins and needles, numbness of the skin. When the nerve is irritated, it will cause paresthesia of the area of the body it innervates. There are many causes of paresthesia, persistent ones need medical attention. Here, I will be discussing generalized paresthesia, meaning the whole body having the feeling, rather than just one side or one limb. When it is generalized, all the nerves are affected, so the cause is usually something in the blood. Persistent generalized paresthesia warrants a medical work up. In this blog, the case is temporary and has resolved with a change in lifestyle. 

    So, back to the case. I got a call from my relative. She suddenly woke up with pins and needles all over her body from the neck down, more on both arms and legs, less so on her body and back. The clothes touching or the water splashing on her skin would give her the sensation of thousands of needles shooting at the area. It was not intensely painful, but every time the lightest pressure is applied to her skin, she will get the pins and needles. This relative is a very healthy, active young lady in her 20's, and she was fine the day before the onset of the symptoms. When something like this happened so abruptly, in my experience, it is usually diet related. Long story short, she was not poisoned! She was drinking 3 large flasks of water everyday without her usual activities and exercise. Once she started to reduce the amount of water intake and increased her salt consumption, the symptoms gradually resolved. 

    We always tell people to drink lots of water. We have been programmed to say we should drink 8 glasses of water a day. Staying hydrated is very important to our health and of course, our skin. It keeps our skin plump from within! We also always tell people to eat less salt. In addition to all the medical conditions high sodium diet can lead to, salt also causes the face to be swollen and bigger eye bags!

    However, too much of a good thing can sometimes lead to harm. This young relative of mine is very health conscious, eating a low salt diet with lots of vegetables, drinking plenty of water. She usually also exercises regularly, but with the recent shelter-in-place, she is not as active. When she drinks too much water and eats too little salt, her body's electrolytes became slightly imbalanced, sort of diluted in a sense. Some of you might have experienced muscle cramps. When you exercise a lot and replenish with only water, the electrolyte imbalance can cause severe muscle cramps. In this case, it was probably low sodium in the blood, hyponatremia. Mild hyponatremia is usually without symptoms. Severe hyponatremia can lead to confusion, seizure or death! 

    I am not advocating drinking less water or eating more salt! Everything in life needs to be in moderation. Being well hydrated is very important and the amount of water really depends on your body weight, health conditions and activity level. It is too generalized to say everyone should drink 8 glasses of water a day. For a 90 lb elderly lady who hardly walk, 8 glasses of water will be way too much. On the other hand, a 180 lb muscular athlete who spends hours in the gym, 8 glasses will hardly be enough. We need at least 4-6 glasses to begin with and we need to learn to adjust daily according to our needs. Obviously when exercising or on a hot day, we will need more water.  Do not wait till you feel thirsty! By then, you are already dehydrated. It is an example of finding the balance. 

    As for salt, it is generally good to use less. In the US, we usually do not have a problem of having too little sodium. With all the processed food and meat injected with salt, there are plenty of sodium in the food without additional salt. We are also spoiled by tasty food. In order to achieve that, chefs have to use lots of seasoning, which is sodium. My relative is too health conscious. She does not eat any processed food and has been eating very bland without much seasoning and definitely no salt. In her case, she is getting too little sodium. Compound with too much water, she developed some electrolyte imbalance.

    In life, everything should be balanced, like yin and yang, work and play, rest and activity. Balance in life will be a whole discussion itself. Topic for another blog! For now, we will stick with moderation. Water and salt in moderation. We are after all, made of salt! Not really "Sugar and spice, and all that’s nice,"as the nursery rhyme told us girls!