@sassytwo
If they can get to the bottom of what is causing small fiber neuropathy/small fiber nerve damage (like diabetes, drinking alcohol, vitamin deficiencies, vitamin toxicities, chemo toxicity, etc.), they can treat to stop further progression of SFN. If they can’t, it is called idiopathic (which is what I was told), there really isn’t treatment other than taking Cymbalta to help with nerve pain, using over the counter creams and supplements (like Capsaicin cream, alpha Lipoic acid, Acetyl l carnitine, magnesium, etc.). My neurologist told me there isn’t really a cure for SFN but if you can get to the source of what is causing small fibers to die, that may be the best you can do.

I focus on all of the above plus take detoxing types of supplements, too (like inositol) and addressed my iron deficiency due to heavy menstrual cycles. Poor oxygen flow may be behind some of my SFN plus sedentary lifestyle (worked a desk job for 30+ years). I drank red wine for a period of time but stopped that. I also have Hashimoto’s thyroiditis which is my own body attacking itself (autoimmune) and not sure what is behind it but believe mine is hereditary plus toxins in air, water, food, hormones, vaccines disrupting my system. An anti inflammatory diet might help plus I am doing physical therapy to try to recover some strength and fitness. Once my iron deficiency was addressed, I noticed some improvement in numbness in my calves.