Do GP's routinely blame Perip Neuro on alcohol?

I’m sorry this is happening to you. I wouldn’t call it “routine” to attribute peripheral neuropathy to alcohol. Alcoholism, as far as I know, is one potential cause, not necessarily vague alcohol consumption. I occasionally drink; that’s not the cause of my neuropathy.

There are other causes: B12 deficiency, excess B6, exposure to a toxin at some point, chemo, shingles, insulin resistance/diabetes, etc…. It can happen with a thyroid condition.

And then there’s everyone’s favorite: “idiopathic,” no known cause. A GP/PCP can run basic labs and start a workup, but I would be concerned about the “muscle wasting” you mention.

It also might not even be peripheral neuropathy; disc compression in your spine could refer numbness to specific parts of your body and something as simple as stretches or PT could relieve that.

Did they suggest anything for a plan of care or further workup? If not, can you ask for referral to a neurologist?

Hello @rfsau140, Welcome to Connect. There are a lot of causes for neuropathy. Without testing and seeing a neurologist or specialist, a GP doc can tell you what they think might be the cause but it's just an educated guess. I had the neuropathy symptoms that started in my toes and I went 20+ years before bothering to get a diagnosis. My Mayo neurologist diagnosed me with idiopathic small fiber peripheral neuropathy and sadly I didn't have any better answers for what helps my numbness I was told by my PCPs over the years - nothing helps with the numbness and there is no cure for neuropathy. That's really why I joined Connect in 2016 when I wanted to learn what others with similar symptoms have learned. My neurologist did mention that my neuropathy could possibly be hereditary. I also have family members and cousins with similar neuropathy symptoms. I posted my neuropathy journey in another discussion here - https://connect.mayoclinic.org/comment/310341/.

Best suggestion I have is to learn as much as you can about neuropathy, your symptoms and what treatments may be available that might help. There are a lot of different discussions in the Neuropathy Support Group. It might be helpful to scan through them to see if there are ones that might be helpful. Here's a link to the discussions in the Neuropathy Support Group - https://connect.mayoclinic.org/group/neuropathy/.

Here are a few references you might find helpful for learning more about neuropathy:

Foundation for Peripheral Neuropathy:
-- Living Well with PN: https://www.foundationforpn.org/living-well/
-- Webinars on YouTube: https://www.youtube.com/@foundationforperipheralneu4122/videos

Matthew B. Jensen, Assistant Professor of Neurology, University of Wisconsin has some really easy to understand videos that help learn more about how neuropathy is diagnosed, the symptoms and more on his YouTube Channel here https://www.youtube.com/@MatthewBJensen.

Have you thought about having any genetic testing done or seeking a diagnosis with a neurologist?

The preponderance of idiopathic peripheral neuropathy cases can be related to glycemic issues. You need to have a two hour glucose tolerance test and not rely on random fasting serum glucose tests or the frequently flawed HbA1c.

Excessive alcohol use can cause PN by a direct toxic effect on peripheral nerves, or by blocking absorption of vitamin B12. The second cause can be diagnosed by blood tests (although other conditions can cause low B12), but the first is an assumption, after you have had other tests that confirm that you have PN, but of unknown cause.
The problem is knowing what is excessive. It seems everybody has their own opinion, including doctors. The trend has been in defining it down; that is, many suggest now that any amount of alcohol can be bad for you.
Ouch!

It was not my GP, but a neurologist, who suggested that alcohol might be an issue with PN. I also had twitching in my muscles. I was drinking quite a bit. Since I quit drinking altogether, The twitching has gotten a lot better - it's been almost a year - but the allodynia (PN) has remained steady.

@proteusx I do have chronic idiopathic axonal polyneuropathy and am prediabetic with an HgbA1C of 5.7%. Wondering how the two hour glucose test would help. If glycemic issues were the cause of my PN would there be options other than Gabapentin?

There's always going to be that knee-jerk blame it on the easy targets, alcohol consumption, poor diet, etc... It's like whenever you have a physical problem it's stop drinking alcohol, coffee, eating any and all the foods you enjoy eating, blah, blah, blah... Alcohol may or not be the result or exasperater of a person's neuropathy.

I've been a drinker most of my adult life, but not a drunk. I was told my SFPN was caused by my arthritic spine and slowly degenerating lower discs. Anyway, that was the best diagnosis I've gotten so far from all the tests I was put through.

Who knows. Keith Richards is still going at 80 and he did just about everything wrong in the health department you can think of, and in great measure.

Hello
I have idiopathic NP. The doctors all asked about alcohol usage when I was getting diagnosed so I guess there can be a correlation. In my case, I drink about 5-6 servings of alcohol about once a month. I do notice a definite increase in burning/pain in my feet the next day but goes back to more normal levels by the 2nd day.

rfsau, I urge you to get to a neurologist ASAP, one who specializes in neuromuscular disorders, because of the combination of PN with muscle wasting and weakness.
There is an uncommon condition called CIDP, chronic inflammatory demyelinating polyneuropathy, that causes these exact symptoms. It causes severe disabilities if progresses without treatment. The key is that it is treatable to prevent it from worsening. I have this myself with PN, muscle weakness, atrophy, and balance problems. There are several others on Mayo Connect with CIDP. It is autoimmune and similar to MS but in peripheral nerves rather than brain and spinal cord. I think it’s critical to rule this out, as the muscle symptoms put it in a different category than PN by itself. Please keep us posted on your diagnostic process.

Seems if alcohol use causes a reaction post have a few, this is something to totally avoid. It is well known alcohol is not a good thing to consume for anyone. The healthcare pros routinely say 1 drink a day. Hardly worth the risk. Try no more drinking before it gets worse.