Idiopathic Progressive Polyneuropathy: How to find a specialist?

Posted by oldshep @oldshep, Feb 12, 2020

I was diagnosed about 2+ years ago. I had local testing, then a visit to Johns Hopkins. They cannot find the root cause and I continue to go downhill. Has anyone had a similar problem or does anyone know where you go after no one can diagnose and find the root cause?

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Hi. How are you doing? I think your post was from 2020 and I hope you have found answers and relief. Please let me know.
My experience so far:
My neuro symptoms started August 10 2022. Left side of face numb (ear lobe first and it felt novocained ) and progressed up and down left side as tingling and numbness and then heaviness. Now it has moved to entire head and spreading on the right side. I have some pain.
Saw a PA on Aug 18 and she ordered tests - I can't get an MRI due to metal in my body but she ordered a head cat scan and a nerve conduction test. Both were negative (good news) with one nerve borderline. Nerve Conduction was ordered on Aug 18 and scheduled for mid January 2023 (seriously?) but was eventually moved up to November 18 2022.
Neck xray showed possible problem but would not explain more than face.
I want a cat scan with contrast that will show the nerves. Ortho said to wait until nerve testing and what neuro says. I see an NP on February 9th.
The doctors and testing services are super backed up at my teaching hospital in SC. I called Mayo - got a phone interview and had that ray of hope extinguished when they said no to seeing me and no to being put on a waiting list.
Praying that you got some answers and some treatment.

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@thelman

Hello,
My name is Todd. Ive been reading posts on this forum for the past 2 years but have never actually posted anything. I have fast (by my standards) progressing idiopathic poly neuropathy. The tingling burning sensation in my hands, feet, arms (to my elbows) and legs (now to my hips) is impossible to ignore most of the day.
I guess what I'm asking you is, what questions should I be asking? I have seen 3 neurologists with no good answers, and the 600mg Gabapentin and 60mg of nortriptyline daily, do nothing.
I would love to find a route cause, and if not, at least a way to slow the progression down and curb the pain.
Please ask me questions as I'm looking for direction and feel like I'm just flailing and a bit on my own.

Todd

Jump to this post

I am in the same boat except not as severe (yet). My neuropathy started in May 2019 (all of a sudden), is in my feet only, and is numbness only - very numb but no pain (yet).

The word "idiopathic" drives me crazy. I am an engineer by training, and if a bridge fell down you would not say it was "idiopathic", you would find the cause. Yes, medicine is different, but they use the word as though it's an explanation, and it's not.

I have a virtual appointment with Dr. Anne Louise Oaklander at MGH in April. It took a while to get that. https://neuropathycommons.org/experts/anne-louise-oaklander-md-phd

I think she is quite an expert, so hoping.... will report back.

In meantime I am trying a keto diet to see if that helps. My blood sugar is within range but on the high end of normal, and some say that even slightly high sugar (and/or insulin levels) can cause neuropathy. It may actually be the insulin that is the problem, not the sugar (some need higher insulin levels to control sugar).

I am also suspect of the fact that I was put in a statin a year before my neuropathy started. I stopped the statin when neuropathy started (my cardiologist said I did not need it), but neuropathy has worsened, so not sure whether statin was a factor or not.

I have low B12 but have taken shots for that for years, and B12 blood tests are normal. I've taken B vitamins, alpha and R lipioc acid, magnesium, etc. Nothing works so far.

There is WAY too little research done in so many areas in medicine. If all the $$$ are taken up in cancer research and more serious things like that, then I get it, but man, we still know so little about so much.

REPLY
@thelman

Hello,
My name is Todd. Ive been reading posts on this forum for the past 2 years but have never actually posted anything. I have fast (by my standards) progressing idiopathic poly neuropathy. The tingling burning sensation in my hands, feet, arms (to my elbows) and legs (now to my hips) is impossible to ignore most of the day.
I guess what I'm asking you is, what questions should I be asking? I have seen 3 neurologists with no good answers, and the 600mg Gabapentin and 60mg of nortriptyline daily, do nothing.
I would love to find a route cause, and if not, at least a way to slow the progression down and curb the pain.
Please ask me questions as I'm looking for direction and feel like I'm just flailing and a bit on my own.

Todd

Jump to this post

Hi Todd, I'm John. I echo what some others here have said. First, I had to gradually have my primary doc raise my gabapentin dosage to 3600 daily during the day. That finally cut my feet pain in about half. Recently I have been trying CBD topical on my feet at 8 pm so which cut down my gabapentin use by 25% and my evening pain is now gone. Consider these and best of luck man. Johnmacc

REPLY
@rickhood

I am in the same boat except not as severe (yet). My neuropathy started in May 2019 (all of a sudden), is in my feet only, and is numbness only - very numb but no pain (yet).

The word "idiopathic" drives me crazy. I am an engineer by training, and if a bridge fell down you would not say it was "idiopathic", you would find the cause. Yes, medicine is different, but they use the word as though it's an explanation, and it's not.

I have a virtual appointment with Dr. Anne Louise Oaklander at MGH in April. It took a while to get that. https://neuropathycommons.org/experts/anne-louise-oaklander-md-phd

I think she is quite an expert, so hoping.... will report back.

In meantime I am trying a keto diet to see if that helps. My blood sugar is within range but on the high end of normal, and some say that even slightly high sugar (and/or insulin levels) can cause neuropathy. It may actually be the insulin that is the problem, not the sugar (some need higher insulin levels to control sugar).

I am also suspect of the fact that I was put in a statin a year before my neuropathy started. I stopped the statin when neuropathy started (my cardiologist said I did not need it), but neuropathy has worsened, so not sure whether statin was a factor or not.

I have low B12 but have taken shots for that for years, and B12 blood tests are normal. I've taken B vitamins, alpha and R lipioc acid, magnesium, etc. Nothing works so far.

There is WAY too little research done in so many areas in medicine. If all the $$$ are taken up in cancer research and more serious things like that, then I get it, but man, we still know so little about so much.

Jump to this post

I just want to express my sympathy. Just curious what your A1C is? Doctor at Hopkins feels that neuropathy can occur with A1C as low as 5,7 and the best way to reduce along w diet is exercise. Statins are overused and can cause neuropathy. Oaklander is an expert but care in most areas for researching cause is terrible. We are spending too much money on our defense budget and now is approaching a trillion = to next ten countries combined including Russia and China. Plus we are the only developed country in the world that has a for profit system leaving the development of drugs up to the drug companies. Didn't mean to get on my "soapbox" but our politicians are taking too much money from Big Pharma and their motive is profit. I hope Oaklander can shed light on what is going on.

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@lewin

I just want to express my sympathy. Just curious what your A1C is? Doctor at Hopkins feels that neuropathy can occur with A1C as low as 5,7 and the best way to reduce along w diet is exercise. Statins are overused and can cause neuropathy. Oaklander is an expert but care in most areas for researching cause is terrible. We are spending too much money on our defense budget and now is approaching a trillion = to next ten countries combined including Russia and China. Plus we are the only developed country in the world that has a for profit system leaving the development of drugs up to the drug companies. Didn't mean to get on my "soapbox" but our politicians are taking too much money from Big Pharma and their motive is profit. I hope Oaklander can shed light on what is going on.

Jump to this post

Thanks!

Below is some A1C history:
7/17/19 5.2
7/23/20 5.5
11/30/20 5.3
4/29/21 5.5
2/18/22 5.5
8/11/22 5.6
12/30/22 5.2

That last one at 5.2 was just before I started keto. I have not checked it since I started keto. Not sure if keto will help, but it is definitely healthy. I don't eat meat so it is lots of olive oil, kale, tofu, some eggs and fish, cheese, etc. More or less Med diet. Almond flour for any baking which is low carb.

Those are normal, but my fasting glucose is always slightly high:
96 104 102 104 99 98 101

I walk 1-2 hours per day. Glucose drops by 10-20 after my walk.

Yup, hoping Oaklander can help.

Yup, we spend WAY too much on defense (and tax cuts for wealthy).

REPLY

Could you let me know what Oaklander says about your situation. Her lab did biopsy, but didn't ever consult her. I also have bad arthritis and some other problems. My neuropathy was severe, so don't understand. You may have mild neuropathy from pre-diabetes. Good luck.

REPLY
@johnmacc

Hi Todd, I'm John. I echo what some others here have said. First, I had to gradually have my primary doc raise my gabapentin dosage to 3600 daily during the day. That finally cut my feet pain in about half. Recently I have been trying CBD topical on my feet at 8 pm so which cut down my gabapentin use by 25% and my evening pain is now gone. Consider these and best of luck man. Johnmacc

Jump to this post

I tried both. My neuropathy is severe. Pins , nieedles and knife like feeling from the hips throughout my legs and feet. It’s hard to walk and sleep. Anyone with suggestions would be greatly appreciated. I even tried acupuncture didn’t help. My body is so sensitive to medicine. Gabapentin stopped working and I started having seizures while using it. Doctors says it’s anxiety and depression but I know it’s not.

REPLY
@rickhood

I am in the same boat except not as severe (yet). My neuropathy started in May 2019 (all of a sudden), is in my feet only, and is numbness only - very numb but no pain (yet).

The word "idiopathic" drives me crazy. I am an engineer by training, and if a bridge fell down you would not say it was "idiopathic", you would find the cause. Yes, medicine is different, but they use the word as though it's an explanation, and it's not.

I have a virtual appointment with Dr. Anne Louise Oaklander at MGH in April. It took a while to get that. https://neuropathycommons.org/experts/anne-louise-oaklander-md-phd

I think she is quite an expert, so hoping.... will report back.

In meantime I am trying a keto diet to see if that helps. My blood sugar is within range but on the high end of normal, and some say that even slightly high sugar (and/or insulin levels) can cause neuropathy. It may actually be the insulin that is the problem, not the sugar (some need higher insulin levels to control sugar).

I am also suspect of the fact that I was put in a statin a year before my neuropathy started. I stopped the statin when neuropathy started (my cardiologist said I did not need it), but neuropathy has worsened, so not sure whether statin was a factor or not.

I have low B12 but have taken shots for that for years, and B12 blood tests are normal. I've taken B vitamins, alpha and R lipioc acid, magnesium, etc. Nothing works so far.

There is WAY too little research done in so many areas in medicine. If all the $$$ are taken up in cancer research and more serious things like that, then I get it, but man, we still know so little about so much.

Jump to this post

A caution to avoid supplementing with vitamin B6. Excess vitamin B6 can cause neuropathy.

REPLY
@rickhood

I am in the same boat except not as severe (yet). My neuropathy started in May 2019 (all of a sudden), is in my feet only, and is numbness only - very numb but no pain (yet).

The word "idiopathic" drives me crazy. I am an engineer by training, and if a bridge fell down you would not say it was "idiopathic", you would find the cause. Yes, medicine is different, but they use the word as though it's an explanation, and it's not.

I have a virtual appointment with Dr. Anne Louise Oaklander at MGH in April. It took a while to get that. https://neuropathycommons.org/experts/anne-louise-oaklander-md-phd

I think she is quite an expert, so hoping.... will report back.

In meantime I am trying a keto diet to see if that helps. My blood sugar is within range but on the high end of normal, and some say that even slightly high sugar (and/or insulin levels) can cause neuropathy. It may actually be the insulin that is the problem, not the sugar (some need higher insulin levels to control sugar).

I am also suspect of the fact that I was put in a statin a year before my neuropathy started. I stopped the statin when neuropathy started (my cardiologist said I did not need it), but neuropathy has worsened, so not sure whether statin was a factor or not.

I have low B12 but have taken shots for that for years, and B12 blood tests are normal. I've taken B vitamins, alpha and R lipioc acid, magnesium, etc. Nothing works so far.

There is WAY too little research done in so many areas in medicine. If all the $$$ are taken up in cancer research and more serious things like that, then I get it, but man, we still know so little about so much.

Jump to this post

Blood serums for B12 are inaccurate after any supplementation. Consider trialing EOD shots. It helped me a great deal until I ended up on an antibiotic which seems to have derailed me. My blood was normal but then I was IF positive.

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What is the exact definition of idiopathic neuropat

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