Idiopathic Small Fiber Neuropathy Research

Posted by magnum52 @magnum52, Mar 29, 2021

This coming June, I will make a journey to the Mayo Clinic in Rochester, Minnesota seeking answers to my diagnosis of idiopathic small fiber neuropathy. This will be my last major effort in getting some kind of relief. I was diagnosed about 5 years ago (skin biopsy) and have tried gaba, Lyrica and Cymbalta. I am currently taking 300 mg of gaba ( got as high as 2,400 but it’s useless) and 60mg of Cymbalta. I retired from the pharmaceutical industry after 40 years, and was 62 when diagnosed. My major complaint is burning feet, especially the bottom of my feet. I exercise routinely.

From my research it appears that there is not a lot of research on the etiology of neuropathy, but more on palliative treatment, and not much of that. Mayo is considered the #1 neurology hospital in the country. Does anyone have any first hand information as to what research is taking place there, if any?

Interested in more discussions like this? Go to the Neuropathy Support Group.

@leslie47

I know this is a response to a post from last year, but I am new to this group. Do you, or anyone know of someone who has urinary incontinence due to SFPN? My research has shown that this can be caused by SFPN, but I have yet to connect with someone with this condition...And what might be done about it? Thanks to everyone for any help.

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Hi @leslie47, Welcome to Connect. There is a discussion on the topic started by @margaretob but there hasn't been much discussion yet.

-- Urinary incontinence, neuropathy, pain, leg cramps and more: https://connect.mayoclinic.org/discussion/peripheral-neuropathy-pain-in-legs-and-feet/

There is also a somewhat related discussion that may be helpful that discusses a supplement (Alpha Lipoic Acid) that may help with urinary incontinence.
-- Alpha Lipoic to help with incontinence.: https://connect.mayoclinic.org/discussion/alpha-lipoic-to-help-with-incontinence/

Have you been diagnosed with small fiber PN and suspect it maybe causing urinary incontinence?

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I am in the same boat. No pain but numbness from knees down and hands. I can no longer touch type or button up a shirt, and lack of balance is a major problem.

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his was my diagnosis about 18 years ago. I was told by the neurologist that this won't kill you; see you in 20 years!
My diminishing sense of balance and my lack of strength and stamina in all physical activities are the predominant symptoms causing me to readjust my lifestyle.
Any tips on how to keep more active and safe? I also have osteopenia, high blood pressure and persistent constipation. Does PN affect the muscles of the digestive system?

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@allwheeldrive

his was my diagnosis about 18 years ago. I was told by the neurologist that this won't kill you; see you in 20 years!
My diminishing sense of balance and my lack of strength and stamina in all physical activities are the predominant symptoms causing me to readjust my lifestyle.
Any tips on how to keep more active and safe? I also have osteopenia, high blood pressure and persistent constipation. Does PN affect the muscles of the digestive system?

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@allwheeldrive
Depending on the type you have it can affect virtually everything.
Nerves, muscles, one or more, heart and other internal organs, sexual function, weakness to paralysis, constipation, digestion problems and the list is nearly if not endless since there are over 100 types of Neuropathy.
Best of luck,
Jake

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@jakedduck1

@allwheeldrive
Depending on the type you have it can affect virtually everything.
Nerves, muscles, one or more, heart and other internal organs, sexual function, weakness to paralysis, constipation, digestion problems and the list is nearly if not endless since there are over 100 types of Neuropathy.
Best of luck,
Jake

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So, does knowing that PN may be causing the problem, alter the method chosen for treatment of the condition? For example, if PN is causing the constipation, would it be recommended to not bother with a muscle stimulant, because the nerves controlling the peristalsis are defective?
Not one doctor that I have seen has ever seemed to take into account my underlying PN. Perhaps, there is nothing different to do in the treatment, but I would appreciate an acknowledgement that the PN is possibly underlying the presenting problem.

I don't know if its worthwhile to return to the neurologist who diagnosed my PN 18 years ago, if there is nothing to be done.

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@allwheeldrive

his was my diagnosis about 18 years ago. I was told by the neurologist that this won't kill you; see you in 20 years!
My diminishing sense of balance and my lack of strength and stamina in all physical activities are the predominant symptoms causing me to readjust my lifestyle.
Any tips on how to keep more active and safe? I also have osteopenia, high blood pressure and persistent constipation. Does PN affect the muscles of the digestive system?

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Hello @allwheeldrive and welcome to Mayo Clinic Connect. I thought you might benefit from joining a current discussion on the topic of Idiopathic SFN, so you will notice I have moved your posts here:
- Idiopathic Small Fiber Neuropathy Research: https://connect.mayoclinic.org/discussion/mayo-clinic-and-idiopathic-small-fiber-neuropathy-research/

Members such as @lecowing @bb0753 and @dot1 have shared about their symptoms and experiences.

Have you considered a second opinion or would you prefer to go back to the neurologist who originally diagnosed you?

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@allwheeldrive

So, does knowing that PN may be causing the problem, alter the method chosen for treatment of the condition? For example, if PN is causing the constipation, would it be recommended to not bother with a muscle stimulant, because the nerves controlling the peristalsis are defective?
Not one doctor that I have seen has ever seemed to take into account my underlying PN. Perhaps, there is nothing different to do in the treatment, but I would appreciate an acknowledgement that the PN is possibly underlying the presenting problem.

I don't know if its worthwhile to return to the neurologist who diagnosed my PN 18 years ago, if there is nothing to be done.

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I think it’s useful to have a neurologist as specialized eyes on your care, regardless if he doesn’t have all the answers; none of them do when it comes to neuropathy sadly. Sometimes I feel like a ping pong ball - my GI, cardiologist, or dermatologist will hit me back to my neurologist when I have an issue I think falls into their court. Just stay on top and help all of them as much as you can to connect the dots!

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Some of us have gone to many places to find out what's going on and I'm one of them. Why this, why that? I've been to Mayo in MN, Johns Hopkins, several other top-level neuro docs in PA and I think the teaching hospitals have some of the best docs which includes the neuro depts. I feel it is important to have a neuro doc on board with your health care. Who knows what might come along to help you. They also follow the progression and pattern. The right doctor will listen to you and offer suggestions based on your symptoms.

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@allwheeldrive

So, does knowing that PN may be causing the problem, alter the method chosen for treatment of the condition? For example, if PN is causing the constipation, would it be recommended to not bother with a muscle stimulant, because the nerves controlling the peristalsis are defective?
Not one doctor that I have seen has ever seemed to take into account my underlying PN. Perhaps, there is nothing different to do in the treatment, but I would appreciate an acknowledgement that the PN is possibly underlying the presenting problem.

I don't know if its worthwhile to return to the neurologist who diagnosed my PN 18 years ago, if there is nothing to be done.

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@allwheeldrive I had this same question about neuropathy , constipation, and medications for gut motility. I asked my gastroenterologist this, why something like Motegrity would work if my nerves aren’t functioning correctly. His answer was “it’s complicated”. He was not being sarcastic or dismissive, he was being truthful. I had already read some research articles about gut motility, and it was basically like reading a medical textbook. It’s complicated! As I told my gastroenterologist, I don’t need to know all this, he does! Together we are trying different ideas.
One idea I saw here recently is ColonMax. I’m intrigued, and ordered some from Amazon. I may have wasted another $20, but we’ll see!

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My GP has recommended a Mayo referral. So far, I am waiting to see if the neurologist np will submit the referral. What process did you go through to get a Mayo appointment? I have struggled with SFN for several years and my GP believes it has advanced to autonomic neuropathy. It is all very frustrating. Many thanks for any helpful tips for getting on the Mayo list.

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