Can small fiber nerves regenerate?

Posted by jwr @jwr, Dec 5, 2023

I first became plagued with small fiber neuropathy in 2017 due to an environmental exposure to abnormally high levels of carbon dioxide and carbon monoxide from an unvented construction space heater. I had numerous polyneuropathy symptoms including hyperacusis (reduced tolerance to sound), tinnitus, heart arrythmia , chest pain, headache, night sweats, urge incontinence, and non painful numbness and tingling in my feet. Also fasciculations in my lower legs. It lasted about 6 months and then all the symptoms completely resolved. Then the numbness and tingling in my feet and the lower leg fasciculations returned in 2020. My SFN was confirmed by a skin biopsy. So the question is, did the small fiber nerves in my feet regenerate between 2017 and 2020? Has anyone else had a complete resolution of their numbness and tingling symptoms, only to have them return? I now struggle with balance. My body sways when I try to stand motionless. Is this due to the SFN, or are the fasciculations in my legs indicative of large fiber neuropathy? I guess only another EMG will tell. It will be my fifth.

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Hi @jwr, That is definitely a question a lot of us struggle with and I'm not sure there is a definitive answer but there are a lot of folks like us thinking I certainly hope so. Here's some information that I found that talks about it.

"What are the signs of nerve regeneration? — The pain is a sign of irritation of the nerve; tingling is a sign of regeneration; or more precisely, tingling indicates the presence of young axons, in the process of growing." — The Sign of "Tingling" in Lesions of the Peripheral Nerves: https://jamanetwork.com/journals/jamaneurology/article-abstract/570603

I've had idiopathic small fiber peripheral neuropathy for a little over 30 years and started taking supplements for it in 2016 and after a few months my numbness seemed to get a little better and the progression seems to have slowed or stopped but I haven't had any follow on nerve test to see if they are better that when I was diagnosed. The past few years my feet feel a little more normal and I feel some tingling but not a lot. So I often think about that question – are my nerves starting to heal a little. I also have balance issues and find it a little difficult to stand for very long. My personal thoughts are it has a little to do with my SFN but my old age also plays a part with degenerative arthritis. I've just never felt that it's worth it to have an EMG just to find out if it may be better than the previous one. I never had a skin punch biopsy and my thinking is they count the number of nerves so it would take a skin punch biopsy to see if there are more nerves (just my humble opinion).

There is an older similar discussion that you might find helpful to learn what others have shared.
--- Can Severe (electric shock-like) Pain be a sign of Regeneration?: https://connect.mayoclinic.org/discussion/can-severe-electric-shock-like-pain-be-a-sign-of-regeneration/

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From what I’ve read, yes small fiber nerves can regenerate…it is a very slow process…and I presume dependent on the original cause of damage being stopped.

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I had a terrible fall on black ice in the late 90's. I remember seeing my feet in front of my face when I fell. I landed on my lower right side/hip and my head bounced twice off the pavement. Believe it or not, I didn't pass out, nor did I bust my head open or break any bones. The Lord was watching over me. I was lying in a parking lot where I worked, so I began to roll myself away from the center of the parking lot so no one would run over me. I think this fall may have caused my SFN; I also have PMR. Does anyone think that is possible?

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I sure hope so! I have had neuropathy in my feet for about 3 years. I had some success with using a combination of B-complex vitamins especially B-12, R-ALA. rubbing my feet with essential oil and compression sleeves. Sounds crazy but it seemed to work! Anyway it got so good I stopped this protocol a few months ago! Guess what the symptoms returned! I am now returning to that protocol again hopefully it will again give me relief. Hope this is encouraging to you.

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@alfer

I sure hope so! I have had neuropathy in my feet for about 3 years. I had some success with using a combination of B-complex vitamins especially B-12, R-ALA. rubbing my feet with essential oil and compression sleeves. Sounds crazy but it seemed to work! Anyway it got so good I stopped this protocol a few months ago! Guess what the symptoms returned! I am now returning to that protocol again hopefully it will again give me relief. Hope this is encouraging to you.

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Can you tell us the exact supplements and dosages you are using?
I have Charcot Marie Tooth and have been dealing with it since 2000.
I also fell on ice in late 1994 resulting in a severe concussion, I think that accelerated the onset of the PN. Shortly after that my feet started slapping.

Thank you for the information.

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@hulst43

Can you tell us the exact supplements and dosages you are using?
I have Charcot Marie Tooth and have been dealing with it since 2000.
I also fell on ice in late 1994 resulting in a severe concussion, I think that accelerated the onset of the PN. Shortly after that my feet started slapping.

Thank you for the information.

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I use two products. NERVIVE which has both both B vitamins, B-12 and synthetic ALA 300 mg. I also use INMUNOVITES R-ALA , 600mg each day.

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@alfer

I use two products. NERVIVE which has both both B vitamins, B-12 and synthetic ALA 300 mg. I also use INMUNOVITES R-ALA , 600mg each day.

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PS: R-ALA is a natural version which is said to be more effective.

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