Hi @kdallen, I'm sorry to hear you are still struggling with small fiber neuropathy. You mentioned your GP believes your condition has advanced to autonomic neuropathy and you think a referral to Mayo might help. I'm no expert but a lot of us have been in similar situations and worried about progression of our condition. The big question I would ask my GP is that will my treatment options change if I go to Mayo and if they are able to determine that I have autonomic neuropathy. My guess is it doesn't make a difference, they can only treat the symptoms since there is no cure for neuropathy.

If your current treatment isn't controlling the pain or other symptoms, have you looked into any complementary or alternative treatments? Have you seen the list of treatments on the Foundation for Peripheral Neuropathy's website? They also include complementary and alternative treatments which might be helpful — https://www.foundationforpn.org/treatments/.