I have small fiber neuropathy. At the time of diagnosis, there were potential red flags if you will related to three areas:

- blood sugar levels that frequently were in the pre-diabetic range

- history of excessive alcohol use

- moderate positive ana on more than one occasion

With regards to the alcohol, I have not had a drink in approximately 11 months, and over that time, based on a comparison of a skin biopsy this November compared to November 2011, my small fiber neuropathy has gotten worse. I should also point out that there have been a couple of other things that have transpired over this time such as the discovery of small pleural and pericardial effusions that point a little more in the direction of an autoimmune issue going on.

Getting to my question -- since I have not had a drink in 11 months and my sfn has gotten worse, do is it stand to reason that something other than alcohol is the primary culprit related to the small fiber neuropathy? Second, would you think it would be o.k. to engage in MODERATE (1-2 beers) weekend drinking given the above information? I would like to have a beer to two on the weekends, but I'm trying to make sense of all this before I make a decision to break this period of abstinence.

I surely would appreciate any thoughts/opinions anyone might have on this, understanding of course that there is no way you can know for sure.

Thanks so much.

It is your choice.

I have vodka(unflavored) once in a while. Beer and esp wines, really bother my PN, but vodka does not. I think it is the other things in those fermented products---which are called congeners-- that are irritating. Red wine is the worst for me, for example.

Whiskeys also have congeners from the aging in wood barrels.

Alcohol increases circulation, and in that regard if done moderately may improve blood flow, and not bother PN.

I think it helps to take B1 either as thiamine or benfotiamine if you are going to drink alcohol. It improves metabolism of it, and reduces aldehydes, which as byproducts cause tingling etc.

I had a history of alcohol abuse, I haven't had a drink in about the same length of time as you, and I certainly haven't noticed my PN get any better. I haven't had a biopsy or anything clinical to check and see if it's gotten worse, but if it has, I haven't noticed it. Pretty much the same. They also said it may have been a deficiency in B1, B6, B12, etc. and I've been taking plenty of 1 and 12, with about 100% daily dose of B6 on most days. Nothing. The old bromide of 'taking the toxin away' from your body to help the neuropathy get better just doesn't hold for my situation.

I have little doubt my PN was caused by alcohol, I was a trainwreck and something finally happened to me, and it was this. Seems like it did its damage, I quit, and the damage is permanent, although it will probably never get better or worse - it's been contained to just my feet since it started about 4 years ago, although I didn't get diagnosed until this year. Good luck, like Mrs. D says, a drink every once in awhile probably won't make any difference. If you're dying for a beer - don't kill yourself just because of the PN. IMO only.

I appreciate your thoughts on this.

My neurologist seems to think that if alcohol were the underlying cause that by quitting drinking for close to a year the nerves would have showed some regeneration or not gotten worse. Had my first biopsy in early Nov. 2011; drank very lightly from that time until the end of that calendar year and then quit entirely. Had second biopsy at beginning of Nov. 2012; so alcohol had been removed entirely for a period of 10 months I guess if you do the math. Anyway, biopsy results showed definite worsening. I also have some "red flags", if you will, for an autoimmune disorder, postitve ANA, pleural & pericardial effusions, something about the way my capillaries look under my fingernails. They have not been able to pin down anything specific there.
And of course I have a blood sugar situation that is often pre-diabetic fasting, but the A1C has been consistently in the normal range.

Anyway, it's all very confusing and, of course, frustrating. If I ever were drink again, I KNOW WITHOUT A DOUBT, I would never go back to drinking heavily. Those days are over and had been for quite a while before I stopped entirely. But with the holidays coming up it would be nice to have a beer or two, or glass or two of wine, and not be eaten up wondering if I'm making things worse. Just something I guess I'll have to come to terms with one way or another. It's a catch 22 in a way -- drinking lightly on some weekends would enhance the quality of my life in terms of enjoyment, but would it be hurting the quality of my life from the standpoint of this wretched small fiber neuropathy?

Again, thanks for the input.

In my younger days I had my fair share of drinking. As an adult, not so much. I only ever did it socially. But as with eating certain food, I can not seem to do anything that could possably make my pn worse.

Im not judging you at all. I know how hard it is to give up something we love. I loveee bread, pasta and carbs. And before I had pn I tried to give them up with the atkins diet to lose weight and never could. However there seems to be a mechanism in me that triggered when I got PN and now....I can give up those things I love easily.

It really is quite amazing and my close family are amazed with me new resolve. In the past I couldnt do it to lose weight but the fear of making my pn worse keeps me on the straight and narrow path. I baked cherry cheese cake and other delicious foods for my family yet I do not take a bite or even lick my fingers while baking.

So I believe we all have something that motivates us in special ways. If drinking were to make your pn worse, would it really be worth it?

The answer will give you a decision.

Good luck, I know its so hard.

I have PN too. I on occasion have some wine or a beer. It has made no difference in the pain or the condition. My doctor said as long as I don't over do it, she doesn't believe it is bad. I go to a physiatrist pain specialist. ginnie