I appreciate the input !

The most likely cause my doctors have come up with is anxiety. That does make sense in a way as I and a hypochondriac. I have noticed that symptoms more consistent with small fiber neuropathy have started (sensations in the palms of my hands) or increased (buzzing in the bottoms of my feet) since I started researching small fiber neuropathy. It's possible the disease is progressing, but that seems a little coincidental.

I've got an appointment with a neurologist in a month and, hopefully, the skin biopsy soon after.

I've been seeing a therapist for about a year (since these sensations started) and I think I'm going to start on anti anxiety medication. If that offers relief, at least I'll have greater assurance that this mostly caused by anxiety.

If it is not anxiety, it's going to be a struggle not to let my anxiety take over and become convinced that I'll have to quit work and be bed ridden in a year, but I'll cross that bridge when I come to it.

It is good to see stories of people managing small fiber neuropathy as that certainly gives some hope !