When I asked my neurologist about treatments, he said the best treatment was to treat the underlying condition that caused the small fiber neuropathy. Of course, he didn't know what that was. He recommended Vitamin B and referred me to my PCP. Before I left, I asked him to precisely detail what's coming, which he did. When I saw my great long-term PCP, he let me know that not all Vitamin B's are created equal, that the wrong one can worsen things, and that I should take Vitamin B12 only. I now take 1000 mg at breakfast along with my Vitamin D3 (chronic kidney disease, stage 3) as well as cheery juice concentrate and alopurinol (gout). I also take other prescriptions at other times for other things. My nonmedical guess is that I got SFN from a prescribed med that adversely interacted with another prescribed med, which were then changed.

I am proactive with my health. I have consulted with "Dr. Google". I travel to see specialists, including Mayo Rochester. I seek out specialists at teaching hospitals, stick with the doctors that help, and move on from those that don't, which is why I keep returning to Mayo. When medicine doesn't help, I adjust lifestyle and diet accordingly. I know "gravity doesn't care", so my response is to take what I get and then do the best I can with what I've got.

@davelobb12 I hope this helps, and I do and wish you well.