Hello @kfuentes21, welcome. I'm Rachel, its nice to meet you. I've been where you're at and am real sorry you are experiencing these neurological disruptions. I know how dismantling the variety of symptoms can be physically, emotionally and behaviorally.

Yes, I was diagnosed with small fiber neuropathy via skin punch biopsy and what you describe is what I also struggled with. I was ironically 46 as well and had a plethora of tests to rule out auto immunes and everything under the sun. How do you feel about your doctors plan? Do you feel you should have further testing like a lumbar puncture?

There are two sides of testing -

1. The negative effects continued testing can have on your body by causing a stir up to the central nervous system which in turn creates an uptick in neurological symptoms and emotional distress. If a doctor is very experienced, they may feel strong about how they see it and try to reduce what they feel is unnecessary testing.

2. On the other hand not all docs are correct or go the extra mile. At the end of the day it comes down to your gut and your trust in your doctor. If you have doubt or concern and need to satisfy yourself then you have every right to seek a second opinion or request more from your current doctor.

What are your thoughts?