Hello,
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     44 year old male
•     Complaints of: pins and needles sensation in hands and lethargy.

I would like to consider multiple possibilities in following hierarchy:
•     Stress, Anxiety or Depression: need to be rule out by detailed interview by psychiatrist.
•     Vitamin deficiency: Get serum B12 level. Start multi vitamins as they are easily available.
•     Side effect of substance use: specially alcohol
•     Thyroid related problem: get thyroid hormonal assay done
•     Neurological problem: Need evaluation by neurologist

Final message to you: Do not worry about symptoms, follow above advice, stop substance use if any and take multi vitamins.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Regards,

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