Thanks for your reply, Mrs. D. Your insight is invaluable. Is there any data showing these MTHFR variants aid in the cause of neuropathy?

Also I'm at a crossroads with my current neurologist at Washington University in St. Louis. My third punch skin biopsy since 2011 came back in the normal range. I have both sensory and autonomic symptoms occurring and when I asked him if I had SFN, he stated that his best guess based on my information was yes. My blood work has all come back normal and when I asked him if there was another neurologist that I could talk with about my other symptoms, he recommended MAYO. My question is, "Is MAYO the gold standard of places to go".

Tony

I recently went to Mayo after being told by several doctors to go there. It seems like that is in the mind of most doctors. Mayo pushed for another EMG (even though I had no symptoms besides pain. They also did a Sweat test without insurance approval. I asked for a skin biopsy and they did not feel like it was indicated. The neurologist did not even believe my symptoms.

Mayo is very efficient and will do the high cost tests and most likely start all over again.

Later, I had a skin biopsy that revealed marked nerve fiber loss in lower extremities (SFN).

I also know from the boards that a negative skin biopsy does not mean that you don't have SFN. It can be diagnosed from exam.

Good luck with your decision. It is a crap shoot with SFN knowledge. Even well renowned Neurologists don't seem to get SFN.

My 2 cents.

Good luck to you!