Small fiber peripheral neuropathy and alcohol

Posted by jeffrapp @jeffrapp, Jun 6, 2019

I'm fairly new to the forum. I've searched for this topic in previous discussions, but I've been unable to find it. If I've goofed, perhaps @johnbishop can direct me. Also , I'd appreciate directions as to how to search the forum in the future.
At any rate, I'm 74 y/o, diagnosed with idiopathic small fiber PN about 2 years ago. I've had the million doctor w/u at UCSF, including a positive skin biopsy, so I'm 98% certain that the diagnosis is correct, although, of course, I'm still searching and hoping for a specific, treatable diagnosis. My symptoms are mostly allodynia manifesting as sometimes severe burning of the feet when wearing shoes and/or socks, and burning or irritation of the legs when wearing heavy pants like jeans or even from bed sheets. I'm on multiple meds. The only thing that helps for sure is warm weather.
My question involves alcohol. At least one of my many MD's think it's likely that the cause of the PN is drinking. Others disagree. My consumption had been 3-4 drinks per evening for many years (a martini and 2 or 3 glasses of wine). As a trial, I stopped drinking completely for about 3 months, yet the PN progressed up my legs and got worse. Currently, I reduced my consumption to a martini and glass of wine (2-3 drinks per evening). My diet is pretty good. I'm active and productive.
Does anyone have an informed opinion or experience similar to mine. In particular, I would appreciate a reference to a good article which addresses this subject.
I understand that alcohol is a neurotoxin, so the simplest answer would simply be to stop drinking. However, I enjoy my martini and glass of wine. Furthermore, my evening drinks distract me somewhat from the pain. At my age, I'd hate to give them up if it's not really going to make a difference. On the other hand, I would do so gladly if I were convinced that it would stop the progression of the PN, or even allow my nerves to heal somewhat.
An additional question is if anybody can refer me to a practitioner (not necessarily an MD) somewhere near me who they have had a good experience with. I live in the wine country north of San Francisco. @johnbishop may want to convert this to a separate topic.
Thanks in advance.

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How is it going now in 2025?

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@roger50

How is it going now in 2025?

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If this question is directed at me, the PN is progressive, but not on a straight line. Some days are much better than others. I'm finding that stress, such as with the recent political situation, appears to play a bigger role.
As for alcohol, I'm still having one glass of red wine with dinner, with a very rare martini on special occasions. I still don't know if it makes any difference.
I'll be 80 this month.

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@jeffrapp

If this question is directed at me, the PN is progressive, but not on a straight line. Some days are much better than others. I'm finding that stress, such as with the recent political situation, appears to play a bigger role.
As for alcohol, I'm still having one glass of red wine with dinner, with a very rare martini on special occasions. I still don't know if it makes any difference.
I'll be 80 this month.

Jump to this post

Hi, Jeff. Each of us is different.... and our neuropathies may not be caused by the same things. In my case, they say "idiopathic".... which means they don't know. One neurologist said it might be radiculopathy instead..... but he didn't recommend any surgery or treatment. I have not found any doctors to be extremely helpful. I've learned of many things through this support group and I do take supplements. I hope they are helping, but since there has been little change, I can't really tell. I still have a glass of red wine or a beer on occasion, and I don't notice any immediate difference when I do. My balance is off, and I began wearing AFOs when I have a lot of walking to do, as they do seem to help with balance. I recently found some compression socks on Amazon that have no toes in them. I'm trying those, and so far they SEEM to be helping a bit. Everything is trial and error.... and great ideas from this wonderful support group!! Best wishes! Mike

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I have the exact same philosophy and drinking pattern as you. My neuropathy in my feet is very symmetrical I assumed something systemic, such as my moderate but daily drinking , was the cause, but my new neurologist says my EMG’s actually show Radiculopathy. So I don’t want to entirely eliminate something I enjoy in the evening when it may or may not contribute, but I have cut back.

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