Hi Tarheel,
I don't see why you shouldn't ask for another skin biopsy. As you know, there is little pain with the process. Also my understanding is the is relatively small risk of infection.
I use melatonin for sleep. I'm not familiar with Nuvoxil. When I originally was diagnosed with SFN my neurologist had me try Elavil. It aids in sleep and helps with depression. Just a suggestion. I stopped taking it because I was too tired the next day.

I then started Cymbalta for the nerve pain and it worked. Have u tried this SSRI?
Unfortunately, I have come to the conclusion that fatigue is part of all this and is not going away. Have you had your thyroid tested?

If IVIG is being offered to you. Have your doctor apply to your insurance for it. It may take a while to get it approved. In the mean time you can do your research on it. Most research states that the sooner you begin the treatment for neuropathy the better the results. I do get IVIG once a month. It does not last very long. Maybe ten days. The most significant result for me is help with leg weakness.

Mrs. D will be the best to offer all the supplements. I personally take R lipoic acid , CoQ10, Krill oil.

I hope this helps a little. I know how hard it is to be in the medical field and not be able to figure this all out. I am a nurse and that has always driven me crazy. I have had SFN for 6 years now. I have been on IVIG for about 8 months. I think probably not early enough.

I hope this helps. Keep coming to the site. Even if you don't want to write there is a lot of good information to read. You are at the right place