@GSPHUNTER and anyone else in the “I have peripheral neuropathy and don’t know why” camp - There are LOTS of things other than diabetes that can cause peripheral neuropathy and with proper work-up and testing we can usually determine the cause. Some of the other fairly common causes include thyroid disorders, certain medications/toxins, and Vitamin deficiency (B6, B12 and E). There is also a whole list of other more rare disorders.
At a minimum you should have your primary care physician do a thorough exam to determine the extent/pattern of the neuropathy and ensure there is no evidence of more serious issues with your nervous system. They should also obtain basic labs including:
- CBC
- CMP
- Fasting Blood Glucose (if not in CMP)
- TSH
- Vit B12
Your primary could also consider a more advanced test called serum protein electrophoresis to rule out abnormalities of monoclonal proteins (antibodies).
If all that is normal and you still want answers or feel the treatment options are not adequate, then you should be asking to see a specialist, ideally a neurologist.
One other point of clarification - Some in the thread have suggested you could have an issue with your spine, which we would refer to as radiculopathy as opposed to neuropathy. For anyone else that sees this in the future, this distinction is important as it changes how we test and treat the problem. Generally, radiculopathy will follow a dermatome pattern, meaning it affects a certain group of nerves that exit the spine and presents with a predictable pattern of pain in the area those nerves provide sensation to. This is in contrast to neuropathy, which is damage to nerves in general, meaning it occur for a variety of reasons and present in a variety of different ways. The prototypical neuropathy we all think of is peripheral neuropathy from diabetes, which usually affects the longest, smallest nerves first (feet and hands) and then gradually spreads toward the trunk as the damage increases.
For those who like sources, I would suggest the reference article below, though be warned it is dense. I’ve attached a few highlights from it including a list of common medications/toxins that can cause neuropathy and a list of recommended testing as well as the disorders those tests are looking for. Finally, the photo of a man shows general dermatomes to highlight how radiculopathy usually has a specific pattern to the pain/symptoms based on where the spinal nerves are being affected.
Peripheral neuropathy, a common neurologic problem encountered by family physicians, can be classified clinically by the anatomic pattern of presenting symptoms and, if indicated, by results of electrodiagnostic studies for axonal and demyelinating disease. The prevalence of peripheral...
www.aafp.org
Best of luck and hope you get some relief!
