--has never been a fan of skin biopsy--I suspect it's at least partly becasue they didn't come up with it or play a big role in its development. (Mayo tends to be very competitive with Hopkins, Cleveland Clinic, Columbia Presbyterian, etc., and skin biopsy was developed at Hopkins with assistance from Columbia and Mass General).

There are other tests, as you've mentioned, that can reveal small-fiber neuropathy, but the skin biopsy has come to be the current "gold standard" as presence of reduced intraepidermal nerve fiber density rather definitively points to neuropathy. The other tests rely more on patient self-reporting, and while sensitive are not as specific--abnormal results on many of them can be from small-fiber neuropathy but also from other syndromes.

As far as what I'm doing to get re-enervation--supplements, exercise, and time. Nerve fibers can regenerate given the proper conditions, especially when the neuropathy is acute onset, as mine was. No cause has ever been found for mine, though an autoimmune molecular mimicry process is suspected. In many such acute neuropathies, the process is monophasic--the theory is that once the immune system wipes out all the targets, the process stops. Still, that's no to say I'm asymptomatic (though better than at the height of this in 2003)--I'm still prone to "flares" and the regrwoth of nerve fibers in new patterns means I'm prone to parastheses and other weird symptoms by any number of compressive forces--even muscle-building from weightlifting!