Small fiber peripheral neuropathy and alcohol

Posted by jeffrapp @jeffrapp, Jun 6, 2019

I'm fairly new to the forum. I've searched for this topic in previous discussions, but I've been unable to find it. If I've goofed, perhaps @johnbishop can direct me. Also , I'd appreciate directions as to how to search the forum in the future.
At any rate, I'm 74 y/o, diagnosed with idiopathic small fiber PN about 2 years ago. I've had the million doctor w/u at UCSF, including a positive skin biopsy, so I'm 98% certain that the diagnosis is correct, although, of course, I'm still searching and hoping for a specific, treatable diagnosis. My symptoms are mostly allodynia manifesting as sometimes severe burning of the feet when wearing shoes and/or socks, and burning or irritation of the legs when wearing heavy pants like jeans or even from bed sheets. I'm on multiple meds. The only thing that helps for sure is warm weather.
My question involves alcohol. At least one of my many MD's think it's likely that the cause of the PN is drinking. Others disagree. My consumption had been 3-4 drinks per evening for many years (a martini and 2 or 3 glasses of wine). As a trial, I stopped drinking completely for about 3 months, yet the PN progressed up my legs and got worse. Currently, I reduced my consumption to a martini and glass of wine (2-3 drinks per evening). My diet is pretty good. I'm active and productive.
Does anyone have an informed opinion or experience similar to mine. In particular, I would appreciate a reference to a good article which addresses this subject.
I understand that alcohol is a neurotoxin, so the simplest answer would simply be to stop drinking. However, I enjoy my martini and glass of wine. Furthermore, my evening drinks distract me somewhat from the pain. At my age, I'd hate to give them up if it's not really going to make a difference. On the other hand, I would do so gladly if I were convinced that it would stop the progression of the PN, or even allow my nerves to heal somewhat.
An additional question is if anybody can refer me to a practitioner (not necessarily an MD) somewhere near me who they have had a good experience with. I live in the wine country north of San Francisco. @johnbishop may want to convert this to a separate topic.
Thanks in advance.

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@jeffrapp

Thanks for the reply, @bkruppa. I too cannot find any good studies linking PN to a specific amount of alcohol. I have, however, found ones like this https://www.ncbi.nlm.nih.gov/pubmed?term=7826275, which seems to link PN to some amount of alcohol, independent of poor diet. Another more comprehensive paper is https://link.springer.com/article/10.1007%2Fs00415-018-9123-1, which also links PN to alcohol. Neither seems to indicate how much is too much.
It appears to be true that alcohol can be a nerve poison in some amounts in some people. The details appear to be lacking.

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The problem that I have with most studies is that they result in "guilt by association" conclusions rather than scientific analysis of why a condition occurs. And if there are outlying cases that don't fit the main conclusion they call it "anecdotal" which to me further supports the fact that the relationships between something and a result is unknown. There are way too many human variables in these mass testings to produce reliable results (in my opinion). Furthermore too many conclusions result in large percentage changes of a really insignificant number in the first place so the result is still insignificant.

I'm sure you can find reports/people who have increased nerve pain when using alcohol as well as finding people who don't have nerve pain. The problem is you don't know where you fit in this picture because while you know the benefits of a drink you don't know the risks involved and I doubt anyone really knows.. This is an engineer's perspective.:):).

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@wilcy

Diagnosed with spinal stenosis! Neuropathy in feet and moving to fingers! Had back surgery 10 months ago! Can’t walk more that 100 feet before having to sit! Had shots, prescriptions etc! Have started vaping with medical marijuana! Nothing so far works except alcohol! Will this make symptoms worse? Tks!

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Hi @wilcy, I have small fiber peripheral neuropathy and I avoid alcohol. There is another discussion where you can meet other members discussing alcohol and neuroopathy. I'm tagging our moderator @ethanmcconkey to see if we should move your post to the following discussion:

> Groups > Neuropathy > Small fiber peripheral neuropathy and alcohol
-- https://connect.mayoclinic.org/discussion/small-fiber-peripheral-neuropathy-and-alcohol/

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Diagnosed with spinal stenosis! Neuropathy in feet and moving to fingers! Had back surgery 10 months ago! Can’t walk more that 100 feet before having to sit! Had shots, prescriptions etc! Have started vaping with medical marijuana! Nothing so far works except alcohol! Will this make symptoms worse? Tks!

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Hi @wilcy, you may have noticed I moved your post to this discussion on neuropathy and alcohol so that you can learn and connect from others with similar experiences. Simply click VIEW & REPLY in your email notification to see your post.

I'd like to thank @johnbishop for responding and also tag fellow Connect members @bkruppa and @kimchi19 as they may be able to offer you support.

Have you asked your doctor about alcohol consumption?

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Am same as you except I have spinal stenosis! Enjoy sitting on porch in afternoon and having couple of drinks! Also the only thing bringing relief from neuropathy is the alcohol!

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Did you come to any conclusions regarding alcohol?

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@daverave

Did you come to any conclusions regarding alcohol?

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Hi @daverave, Welcome to Connect. This is an older discussion and I'm not sure if your question was for @wilcy or @jeffrapp who started the discussion. The conclusion I came to personally was that being and alcoholic can damage nerves and cause neuropathy and since I already have neuropathy I just decided I didn't need to take any chances on making my neuropathy worse. I have no medical training or background so I'm guessing there are a lot of different factors that can play a part and moderation is probably OK as in all thing.

Have you been diagnosed with neuropathy?

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ive been told i have neuropathy in my right foot after nerve conduction test this January. My right foot is numb ,painful, tingling etc. Symptoms are now appearing in left foot and mild symptoms in hands. No overall diagnosis or cause at the moment. I have a lumbar puncture for test samples of csf next week as i have raised ana marker in previous blood test.

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I realize this thread was started five years ago, and I don't know if anyone is still following it. But I, too, have questions about alcohol and neuropathy. I typically drink a glass of red wine with lunch and another with dinner. On occasion, I may have a cocktail, but not daily. When I first began to experience problems with neuropathy, I read of possible links between alcohol and this disorder. I cut out ALL alcohol altogether, but after a few months and noticing no improvement, I returned to having my red wine. When I have a glass of wine, I notice no immediate worsening of my neuropathy. And I have read that red wine, in moderation, can be beneficial for heart health. As with everything, I suppose we take our chances. How I wish there were more research done to identify specific causes of neuropathy and possible remedies. Best to all!!

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As a recovering alcoholic with IPN, I have not noticed much change other than my life is back in order. Still have numbness, an rare bouts of pins and needles. I have been through every test imaginable over the years including genetic and no plausible cause has been detected.
The one variable is that I use nicotine lozenges(couldn’t quit everything) and there is a suggestion that nicotine may trigger PN, but no definitive answer. Has anyone else looked into the nicotine connection?’

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