I started off with similar symptoms. It began with numbness and tingling in my feet and calves, that spread, and prompted an arduous series of appointments with neurologists. I was diagnosed with small fiber neuropathy. The first neurologist I saw missed it because like you, my EMG was normal, along with my blood tests. I was watching and waiting too, but it got worse and then I developed other symptoms.

With SFN, if it’s just sensory, the small fiber nerves affect sensation and temperature and pressure. Because of this, it’s negative on a EMG. I have no idea why the first neurologist didn’t think of that.

But small fiber nerves also affect autonomic function (things your body automatically does)—like digestion, breathing, sweating.

I have GI symptoms as well and hyperhidrosis, but we don’t know for sure if it’s related to the neuropathy. I also have central sensitivity syndrome, POTS, and HSD/hEDS. Technically I have a fibromyalgia diagnosis but it seems redundant with the central sensitivity.

So it is possible that the symptoms you mention are linked. Or it could be that they’re occurring together. One thing I learned with functional GI conditions like IBS is that stress exacerbates it because if the mind/body connection, and of course chronic pain will do that. There are treatments and strategies though, so it makes sense to talk to your PCP about it. For me, there are not many great options for medications for neuropathy or my chronic pain; I’m very sensitive to medication. I’ve relied more on pain neuroscience based PT and interventions.

For the GI conditions, I work with a GI-trained dietician and GI psychologist who teaches CBT and gut directed hypnotherapy (which has been shown to work for people).

You’re not alone, and I think it makes sense to ask more questions and talk to your PCP. I think we all want an answer when we suddenly aren’t feeling well and start having numbness and tingling. The answer isn’t always satisfying, but for me the uncertainty is the most challenging part.