<s>[INST] l am almost 50 years old female l recently under a lot of stress had some bloods taken am now having vit 12 injections and taking vit d tablets l have lost a lot of weight not felt like eating with the stress my appettie has improved l have a very healthy diet l have numbness and tingling in my hands and feet and a unusal sensenation below the knees l have being diagnosised with raynaud disease some years ago l often feel nauseas and really unusual coppery taste in my mouth l often have foggy feeling l dont drink alcohol very often l am smoker l dont have diabetes or any other known illness [/INST] Hi, I would suggest the following tests if they have not been done earlier. Complete blood count, peripheral blood smear, blood Urea serum, liver function tests, creatinine, urine routine examination, lipid profile, thyroid function test, fasting blood sugar., ANA. I presume that you have been prescribed vitamin B12 because your vitamin B12 is low. A deficiency of vitamin B12 and vitamin D do produce the symptoms you have described, but it is also important to rule out Diabetes mellitus and thyroid problems as well hence I have suggested a battery of tests. The Maynard type of symptoms may have no cause in which case its idiopathic, or it may be secondary to autoimmune diseases. Your Vitamin B12 deficiency may be nutritional or immunological such as pernicious anemia. Depending on the cause of your vitamin B12 problem you may be treated as a short course of vitamins or life long if it is the pernicious anemia type. If all tests are negative the Reynolds phenomenon may be alleviated by keeping your feet and hands warm by gloves and socks and also avoiding cold temperature. It is important that you should get your feet examined for loss of pulses and peripheral neuropathy. As a precautionary measure avoid walking barefoot and avoid immersing your limbs in hot or cold water. If your lipid profile shows abnormal values that has to be treated either through dietary modifications for mild values or lipid lowering Chat Doctor.  Protection of hands and feet from injury is essential. Smoking aggravates Reynolds. As you have expressed that you do not have diabetes or any known illness I presume that you have done most of the lab tests. If it has been a long time since you had the tests it is prudent to get the tests done now. Should you require further information please post your lab test results and further clarifications here so that I may assist you in getting all the information that you need? Best regards </s>