Hot Feet: Why Your Feet Burn and How to Cool Them Naturally

Hot feet feel like the soles of your feet are burning, or like someone turned up the heat under your skin, and for many people it's worst at night, right when you want to sleep. The feeling usually comes from the small nerves in your feet, thin fibers that sit at the far end of your longest nerves, so they're the first to misfire when blood sugar runs high, a B vitamin runs low or a toxin like alcohol builds up.12

Every symptom you're experiencing, as I see it, is your body's cry for help,11 and burning feet are a clear example. When you find the driver and take it away, your nerves get the chance to recover, because the small fibers in your skin can regrow once the pressure comes off them.12 In the meantime, cooling, a few well-tested nutrients and topical remedies can calm the burn.

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Below you'll find what makes feet burn, the tests that find your cause, why the heat flares at night, how to cool your feet tonight and the natural remedies with human trials behind them.

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What are hot feet?

Usually the burn comes from small-fiber nerves, the thin fibers in your skin that carry heat and pain signals. When they're irritated or damaged, they fire on their own, and your brain reads that as burning, electric or stabbing pain, typically worse at night, a condition called small-fiber neuropathy.214

Burning feet also have a long history in nutrition science. During World War II, the problem affected up to a third of the prisoners of war held in the Far East, men living on severely restricted diets. A 2017 analysis of 54 surviving case notes found a picture of possible nerve pain alongside severe malnutrition.15 In those prisoners, the burning was relieved specifically by pantothenic acid, also called vitamin B5.16 A natural B5 deficiency is very rare today outside severe malnutrition, but the lesson has held: your nerves need their nutrients.16

Why do my feet burn? The root causes of burning feet

Diabetes accounts for more than half of all neuropathy in Western countries, yet up to 27% of people with neuropathy never have a cause named.1 That's why a thorough search pays off: in a Dutch study of 921 people with small-fiber neuropathy, a standard screen found a linked condition in 47% of them, and it turned up extra causes in 26.7% of the people who already had one diagnosis.17

Blood sugar: diabetes and prediabetes

Blood sugar is the first thing to check, because it's the biggest single driver of nerve damage in the feet,1 and the small fibers can show it even before diabetes is diagnosed. By the American Diabetes Association's count, nerve damage is already present in 10% to 15% of people when type 2 diabetes is diagnosed and in up to half after 10 years, and the painful small-fiber kind may already be present in 10% to 30% of people with prediabetes. Smoking, high blood pressure, extra weight and high blood fats also track with diabetic nerve damage.2 In a U.K. study of 15,692 people with diabetes in community care, 34% had painful nerve symptoms, and women's risk ran 50% higher than men's after other factors were accounted for.18 Our guide to diabetes symptoms covers the other early signs.

Prediabetes is easy to miss on routine tests. In a U.S. series of 107 people told their neuropathy had no known cause, a 2-hour oral glucose tolerance test found prediabetes in 34%, nearly three times the rate in people of the same age, and diabetes in 12%, so 49 of 107 people in all, or 46%, had a blood sugar problem. The test often caught it in people whose fasting glucose and HbA1c were normal.3 My Insulin Resistance & Prediabetes protocol puts it plainly: fasting glucose can stay normal for a decade while insulin climbs, so always ask for fasting insulin.19

Blood sugar is also one of the drivers you can do the most about. As I see it, type 2 diabetes can be reversed in many cases with diet, exercise and lifestyle, supported by natural remedies.6 In a 12-month trial in 49 U.K. family practices, where 298 adults with type 2 diabetes knew which program they got, a structured weight-loss program, starting with a low-calorie formula diet for 3 to 5 months, put 46% into remission, against 4% with best-practice usual care.56 The movement remedy in the natural remedies section below shows what a year of diet and exercise did for the nerves themselves, and our guide to normal blood sugar shows the numbers to aim for.

Low vitamin B12 and other B vitamins

Vitamin B12 deficiency affects about 2% to 3% of U.S. adults, and nerve damage in the feet is one of its signs. The risk climbs with age, low intake, absorption problems and two everyday medicines: metformin and acid-blocking proton pump inhibitors.20 In a placebo-controlled trial of 390 adults with type 2 diabetes, metformin taken for 4.3 years lowered B12 19% compared with placebo and raised the share with a true deficiency by 7.2 percentage points, in a study a drug company funded.21 I've seen B12 deficiency in many of my patients with diabetes who had been on metformin long term.22 If you take metformin, a B12 test with MMA belongs on your next lab order.

Among the other B vitamins, thiamine (vitamin B1) tends to run low in people who drink heavily, as the alcohol section explains, and our guide to thiamine deficiency covers the rest of its signs.23 Magnesium belongs on the list as well: I consider tingling and numbness, especially in your hands and feet, a warning sign of magnesium deficiency.24 Test it rather than guess by asking for red blood cell (RBC) magnesium. The optimal range is 5.5 to 6.5 mg/dL, and our guide to the signs of magnesium deficiency covers food and supplement options.5

Alcohol

Heavy drinking can injure the nerves in your feet. A 2019 review pooled 17 studies of 1,596 long-term heavy drinkers that used nerve testing and found neuropathy in 46.3% of them. Across all its studies, the risk climbed with the total amount a person had drunk over a lifetime. When it came to recovery, the same review found that what treatment data exist support B vitamins, thiamine included.23 I consider alcohol one of the most well-established cellular toxins, even at moderate intake.11 If your feet burn and you drink most days, a month without alcohol is a simple experiment worth running.

An underactive thyroid

A slow thyroid can show up in your feet, even early on. In a prospective Dutch study of adults newly diagnosed with hypothyroidism, 79% had muscle or nerve complaints and 42% had signs of nerve damage on nerve testing, early in the course of the disease.25 My Hypothyroidism Protocol calls for the full thyroid panel (TSH, free T4, free T3 and thyroid antibodies), and its thyroid quiz lists tingling or numbness in the hands among the signs.26 Our guide to thyroid problems covers the rest, but when your feet burn, the first step is to ask for the full panel, not TSH alone.

Kidney disease

Your kidneys clear waste from your blood. When they fail, waste products and potassium build up and the nerves suffer, a problem called uremic neuropathy that affects 60% to 100% of people on dialysis and usually appears once kidney filtration falls very low, under about 12 mL/min.27 A kidney panel (creatinine with an estimated filtration rate) belongs in the first round of tests.

Athlete's foot

Sometimes the burn starts in the skin rather than the nerves. Athlete's foot, a fungal infection, can cause burning or stinging pain along with itching and cracked, peeling skin, usually between the toes.28 Dry your feet well, wear breathable socks and treat it fully, and our athlete's foot guide covers the options, tea tree oil among them.

Menopause and the heat Chinese medicine calls Empty Heat

Menopause can bring heat to the feet too, and part of that is simple physiology: a hot flush is a surge of blood flow to the skin, set off when the brain's thermostat narrows the range of temperatures it will tolerate.29 Traditional Chinese medicine has its own name for heat that settles in the palms and soles and worsens at night. The World Health Organization's standard terms for Chinese medicine describe feverish sensations in the palms and soles as most often caused by internal heat from yin deficiency, the body's cooling, moistening reserve running low, and note that a person may feel feverish without a raised temperature.30

In my Perimenopause & Menopause protocol, the traditional answer is to nourish Kidney Yin with rest, warm cooked food, black sesame, goji and bone broth.31 For the heat itself, use the cooling steps in the night section below, and see our guides to perimenopause symptoms and the cooling foods and herbs Chinese medicine pairs with heat.

Erythromelalgia: red, hot, burning feet

Erythromelalgia is a rare condition that brings flares of redness, heat and burning pain, set off by warmth or exercise and eased by cooling.3233 In a population-based study in Olmsted County, Minnesota, which found 33 cases, about 1.3 new cases per 100,000 people were diagnosed each year, more in women (2.0) than in men (0.6).34 In a Mayo Clinic series of 168 people, it affected the feet in 88.1% and the hands in 25.6%. Of the 94 whose symptoms were tracked over an average of 8.7 years, 31.9% got worse, 30.9% improved and 10.6% saw it go away entirely.32 If your feet turn red and hot in flares and cool water brings relief, ask your doctor to name it, and cool your feet with water rather than ice (the safety section explains why).

Medications, chemotherapy and other causes

Some chemotherapy drugs and some HIV medicines can damage nerves, as can an abnormal blood protein called a monoclonal gammopathy.1 Autoimmune disease, including sarcoidosis, Sjogren's syndrome and celiac disease, turns up more often in people with small-fiber neuropathy.17 A small share of neuropathy is inherited, and genetic testing can confirm it when the family pattern fits.4 Too much vitamin B6 from high-dose supplements can cause numb, burning feet by itself, as the safety section explains.35 And if your legs feel warm, heavy and achy along with your feet, our guide to varicose veins covers that cause.

How hot feet start in your body, and how they heal

Your longest nerves run like wires from your spine all the way to your toes. Damage shows up first at the far ends and climbs upward over time, which is why burning usually starts in both feet at once.1 The thin fibers that carry heat and pain sit in your skin, and when high blood sugar, a missing nutrient or a toxin wears on them, they start firing on their own, and that firing is the burn you feel.214

Your body can also rebuild these fibers once the pressure comes off. Take the driver away and nerve fibers in the skin can grow back and nerve signals can grow stronger, as the fourth step below shows,1236 which is why the root cause matters more than any single remedy.

Find your cause: the tests to ask for

A test once gave me my own answer, back in college when I was on a triathlon team and kept getting lightheaded. A nutrient test showed that the only thing I was deficient in was vitamin B2, and once I started taking it, my lightheadedness went completely away.22 Burning feet are a different problem, but the principle is the one that runs through my protocols: test, don't guess.19 Your doctor can order every test below.

The tests to ask for when your feet burn

My bloodwork guide's rule for B12 is simple: if your B12 looks normal but your energy is wrecked, run MMA, and it lists metformin among the root causes of a B12 shortfall.5 If the first round comes back clear, a second round can check thiamine, B6, and celiac and Sjogren's antibodies, all part of the Dutch screening protocol for small-fiber neuropathy.17 A skin punch biopsy, which counts the nerve fibers in a small sample of skin, can confirm small-fiber neuropathy when the picture is unclear, and it picks up about three in four cases. A broad lab screen finds a metabolic or immune cause in up to 64% of people.14

Why are my feet hot at night?

As I explain on my show, to start sleep your core body temperature has to drop,40 and your hands and feet work like your body's radiators, letting that heat out. A 1999 report in Nature summed up its finding in its title: warm feet promote the rapid onset of sleep.39 When your nerves are healthy, that shift helps you fall asleep, but when they're already irritated, the extra warmth can add to the burn, and even the touch of socks or bedclothes can hurt.2 Chinese medicine reads heat in the soles that builds at night as yin deficiency, as the menopause section explains.30

Before air conditioning and central heat, homes cooled off at night along with the air outside, and I believe that's the way God designed us to live,40 so let your bedroom work with you.

My Deep Sleep Protocol puts it at about 65 to 68°F for a cool, dark bedroom,9 and your bedding matters just as much. Breathable wool and high-quality cotton let heat leave, and the dense, heat-trapping sheets on many hotel beds are a pet peeve of mine for exactly that reason.40 Our guides to sleep hygiene and natural sleep aids cover the rest of a good night. Scripture holds out the kind of rest worth aiming for: "When thou liest down, thou shalt not be afraid: yea, thou shalt lie down, and thy sleep shall be sweet" (Proverbs 3:24, KJV).

How to cool hot feet at night

• A cool soak. Fill a basin with cool tap water, about 55°F, and soak for 10 minutes. In the test above, feet took 26.2 minutes to warm back up afterward. Pat them dry when you're done.8

• Moving air. Put a fan at the foot of the bed and let your feet stick out from under the covers.

• Breathable layers. Sleep in cotton or wool sheets, with loose, breathable socks or none.

• Cooling socks or gel insoles. Some people find them soothing at night; choose ones that breathe.

• A peppermint-oil rub. Massage a diluted peppermint blend into your soles at bedtime; the peppermint remedy below has the dilution.10

A warm soak has its place too, especially when the burn comes with sore, tired feet and trouble winding down.

My version is a cup of Epsom salt in a warm bath for about 20 minutes, with a few drops of lavender oil.41 On my show I've also said a foot bath soak in Epsom salts is great, and if you'd rather soak just your feet, our foot soak guide has recipes.24 In my herb and oil field guide, lavender oil is a cooling oil, best for people who are anxious, overheated and sleepless; mix 5 drops into a cup of Epsom salt or a spoon of carrier oil first, then add it to the water, because oils don't dissolve in water.10

Persian medicine has long used warm foot baths, called abzan, for pain, and a randomized trial put one to the test. Sixty adults aged 30 to 70 with painful diabetic neuropathy either soaked their feet for 15 minutes each night for a month in warm water (104 to 113°F), soaked in the same water with 250 grams of mineral salt added, or did nothing. Pain scores fell significantly in the salt-water group.42 Keep the water comfortably warm, and if heat makes your feet flare, stick with the cool soak.

Natural remedies for burning feet

These remedies do two jobs: they calm the burning signal now, and several help the small nerves recover once the driver is gone. The order follows how strong the human research is for each one, and much of that research comes from people with diabetic neuropathy, the best-studied cause of burning feet.

Two more supplements, acetyl-L-carnitine and vitamin D, also have trial support. Acetyl-L-carnitine, a form of L-carnitine, was tested at 500 mg or 1 gram three times a day in two year-long placebo-controlled trials with 1,257 people with diabetic neuropathy, where it improved nerve-fiber regeneration and vibration sense. Pain eased in one trial and in the combined higher-dose group, and one author worked for the maker.50 And in a 2025 analysis of 4 placebo-controlled trials with 320 people with painful diabetic neuropathy, vitamin D eased short-term pain.51 Test your level and aim for the optimal range of 50 to 80 ng/mL, and our guide to vitamin D deficiency covers the signs.5

Foot care and footwear for burning feet

When your feet burn, they deserve daily care. The International Working Group on the Diabetic Foot's 2023 guideline advises people at risk to check their feet every day, to wear properly fitting shoes with room for the foot, and to wear suitable foot protection whenever they walk, indoors or out.52 It recommends a supervised foot-and-ankle exercise program for people at low to moderate risk, and it rates adding about 1,000 steps a day as likely safe.52

• Check your soles and between your toes each night, with a mirror if you need one.
• Choose roomy, well-fitting shoes and moisture-wicking socks, and change damp socks.
• Dry well between your toes, and treat athlete's foot early.
• Keep walking, because movement is one of the ways your nerves recover, as the movement remedy above shows.

When to see a doctor, and how to use these remedies safely

Cool, never icy. Ice packs and long cold soaks can injure the skin. In one documented case, a woman with diabetes and erythromelalgia developed gangrene that led to amputation after using ice packs on her feet.33 Use cool water for minutes, then dry your feet. If you run cold, or have poor circulation or a slow thyroid, a fan and lighter covers are the gentler choice.

Numb feet can't judge heat. Test bath or soak water with your hand or a thermometer before your feet go in, and keep heating pads and hot water bottles off your feet.

Alpha-lipoic acid. Nausea, vomiting and dizziness rose with the dose in the 5-week trial.7 In the 4-year trial, serious adverse events were reported in 38.1% of people on alpha-lipoic acid and 28.0% on placebo, while tolerability and dropouts didn't differ.46 Because it improves insulin sensitivity, check your readings if you take diabetes medicine and let the doctor who prescribes it know you've started it. As your diet, movement and alpha-lipoic acid bring your blood sugar down, your prescriber may need to lower the dose.6 Rarely, it has triggered insulin autoimmune syndrome, which causes repeated low blood sugar, so stop it and get checked if you have shaky, sweaty spells.54

Vitamin B6. High-dose B6 supplements can themselves cause numb, burning feet, which improved after the 7 adults in an early case series stopped taking them, and a daily multivitamin caused B6 toxicity in a 2023 case report.3555 Get B6 from food or a modest B complex, and if your feet get worse on a high-B6 product, stop it and ask for a B6 level.

Capsaicin and peppermint. Keep both off broken skin and away from your eyes, and wash your hands after use. Keep peppermint oil away from the faces of children under 6 and away from cats.10

Alcohol. If you drink heavily every day, don't stop all at once on your own: withdrawal can bring shaking, sweating and even seizures within a day of the last drink, so get your doctor's help to cut back safely.57

Metformin and acid blockers. Keep taking any prescription exactly as prescribed, and ask the doctor who manages it for a B12 test if you've been on it for years.2120

The bottom line

Hot feet: frequently asked questions

References

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2. Pop-Busui R, Boulton AJ, Feldman EL, Bril V, Freeman R, Malik RA, et al. Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care. 2017;40(1):136-154. doi:10.2337/dc16-2042. PMID:27999003
3. Singleton JR, Smith AG, Bromberg MB. Increased prevalence of impaired glucose tolerance in patients with painful sensory neuropathy. Diabetes Care. 2001;24(8):1448-53. doi:10.2337/diacare.24.8.1448. PMID:11473085
4. England JD, Gronseth GS, Franklin G, Carter GT, Kinsella LJ, Cohen JA, et al. Practice Parameter: evaluation of distal symmetric polyneuropathy: role of laboratory and genetic testing (an evidence-based review). Report of the American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, and American Academy of Physical Medicine and Rehabilitation. Neurology. 2009;72(2):185-92. doi:10.1212/01.wnl.0000336370.51010.a1. PMID:19056666
5. Axe J, Cole W. The 25 Root-Cause Bloodwork Markers That Matter Most. DrAxe.com protocol. 2026. Markers 2 (HbA1c), 3 (fasting insulin), 10 (vitamin D), 11 (RBC magnesium) and 12 (MMA: root causes including metformin; methylcobalamin 1,000 to 5,000 mcg daily with methylfolate 400 to 800 mcg).
6. Axe J. The Type 2 Diabetes Protocol. DrAxe.com protocol. 2026. p. 11 (Step 2, Move: walks after meals, strength training and alpha-lipoic acid 600 mg daily), p. 14 (Step 5, Reverse: pursue remission), p. 17 (supplement protocol: alpha-lipoic acid 600 mg daily; omega-3s 1 to 2 g a day with food) and p. 18 (prescriber adjusts doses as numbers improve).
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19. Axe J. Insulin Resistance & Prediabetes: The 90-Day Healing Protocol. DrAxe.com protocol. 2026. "Test, don't guess" (fasting insulin); meal order, liquid sugar and walks after meals; p. 20 (alpha-lipoic acid 300 to 600 mg daily for insulin sensitivity and nerve health).
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22. Axe J. 10 Signs You Have a B Vitamins Deficiency (How to Boost B Vitamins Naturally). The Dr. Josh Axe Show. 2024. At 4:08 (his vitamin B2 story), 11:35 (B6 and B12 and the nerves; quoted, lightly edited) and 13:41 (metformin and B12 in his patients).
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39. Kräuchi K, Cajochen C, Werth E, Wirz-Justice A. Warm feet promote the rapid onset of sleep. Nature. 1999;401(6748):36-7. doi:10.1038/43366. PMID:10485703
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