Question for all you knowledgeable folks from a newbie: Is it normal for Small Fiber Neuropathy to progress from no symptoms to high level of pain, tingling, major symptoms within 2 months?

I did notice a tiny problem with both toes when sheets touched them about 6 months ago (toes felt weird), but on 1/4/11 had pedicure and had pain in entire procedure. Been treated by podiatrist since then and he did a skin biopsy on 2/1 which showed 3.4 fibers (positive for moderate neuropathy). Now one month later symptoms are much worse, and now include some motor functions including overall unsteadiness on feet (using a cane to help). Getting nerve conduction test next week.

I am a 49 year old female, diagnosed as Type 2 diabetic 9 years ago, but sugar levels have been in controlled range always. I know that diabetic neuropathy is usually large fiber, not small fiber. I also have Hypothyroidism for 20 years and took statins for 20 years. In fact, Dr. increased my pravastatin last year - doubled dose. So I know any of those things could be the cause of the SFN.

Does it matter what the cause is?

Help with both questions would be appreciated!

Brenda
Atlanta, Georgia

I am not as knowledgeable as others on this site, but I will try to answer to the best of my knowledge, understand though, I may be corrected by others.

I believe from what I have read Diabetic Neuropathy can be small or large fiber.

The cause matters in some ways and not in others, the treatment of pain is the same for any cause, however, controlling the cause is a way of lowering the damage and symptoms of the neuropathy. In your case keeping a very tight control on your sugar levels would benefit your health in many ways (as I am sure you are aware of), neuropathy being one of them.

Im no expert either but I have learnt that P/N can be rapid if its toxic. You may have multiple causes. In the last few months have you been exposed to anything new? below is cut n paste google

Causes
Drug abuse and chemical exposure in the workplace are the most common causes of toxic neuropathy. Exposure to lead, mercury, arsenic and thailum in the workplace makes you more vulnerable to toxic neuropathy. In addition to drug abuse, sniffing substances like glue can lead to toxic neuropathy. Herbal medicine remedies, especially Chinese remedies, can be another cause of toxic neuropathy because herbal medicines can contain dangerous chemicals.

--that involve a farily rapid onset and progression, and can involve more than the small, unmyelinated fibers:

http://neuromuscular.wustl.edu/nothe...etes.htm#acute

True difficulties in motor function do imply some larger fiber involvement (all motor nerve are myelinated large fiber).

But, as the other posters mentioned, you may be co-morbid--it's possible that other factors beyond diabetes are contributing to the neuropathy. This is not all that unusual--once the nerves have been assaulted in one way, they are much more vulnerable to other assaults--the so-called "double crush hypothesis", in which two agents combine to act and increase symptoms to a greater degree than the sum of their parts would imply.

It may be well worth further investigation (and I, too, wonder about the statins being involved).

Welcome to NeuroTalk.

I would definitely suspect the statin.

Are you supplementing with CoQ-10? Eventually your body will run out since statins block its synthesis in the liver.

http://neurotalk.psychcentral.com/thread122889.html

[QUOTE=mrsD;749941]Welcome to NeuroTalk.

I would definitely suspect the statin.

Are you supplementing with CoQ-10? Eventually your body will run out since statins block its synthesis in the liver.


Mrs D,

Thanks for the info. I stopped taking the statin (the dr. had doubled my dosage last spring - not too long before initial toe tingles - suspicious!). I am not supplementing yet, just found your website so I need to print out the sticky about that then buy those items.

Appreciate the help and words of encouragement.

The last year has been a real b**ch. I had frozen shoulder, several horrendous dental surgeries, a double hernia operation, found out I have dupuytren's contracture (hereditary hand problem) and I quit smoking.

Brenda

Hi Brenda. I don't have diabetes, but my (so far idiopathic) PN progressed fairly rapidly over about six months. Not as rapid as yours, but still alarmingly fast. It seems to have leveled off somewhat in the last year or so but sounds like the first signs I had were very much like yours, e.g., sheets bothering my toes. I hope yours at least levels off too.

The talk of toxins has made me wonder again about something I've never voiced before: could exposure to toxins say, 30 years ago, have had a dormant effect that only surfaced in the last few years? I'm thinking that's pretty unlikely, but the list of stuff I was exposed to would make you say ! Heavy-duty solvents, arsenic, asbestos, just to name a few. I was a walking toxic dump in my 20's. I'm often amazed that I made to 40.

Anyway, welcome to our family, Brenda. Didn't mean to sidetrack your thread.

Hmmmm let me think on your toxic waste dump!

It is possible to accumulate toxins and reach a critical mass... some are removed well when we are young...some are stored in fat cells, waiting to be released when you lose weight... etc.

I too was exposed to benzene and other solvents working in the chem labs. I did use a hood most of the time...but it was in the air alot. Once I was exposed to heavy xylol solvents in art school, and I did feel that one for about a week. But I never connected it to my feet/hands when I was in my early 30's.
That is when my thyroid started going south, so I just assumed it was that.

I might ask for some toxin tests when I go to the doctor on Mar 16th. But now I am pretty low in symptoms, so it might be a waste...I'll see what the doctor says then.

brendaingram, all that non related trauma may also have played a role in your neuropathy developing. There is some literature showing that surgical trauma may be an independent risk factor for peripheral neuropathy development. I'll try to find the reference and post. Meanwhile, follow the recommendations here for supplementation. My symptoms worsened acutely about 14 months ago similar to your experience. I have found some improvement by following the advice here. It is a treasure of a community

" Herbal medicine remedies, especially Chinese remedies, can be another cause of toxic neuropathy because herbal medicines can contain dangerous chemicals."

who would of thought that? seems P/N is caused by just about anything