Originally Posted by glenntaj

--that exercise can be a CAUSE of small-fiber neuropathy, or indeed any kind of neuropathy, unless that exercise puts one in positions that exacerbate an already existing tendency towards nerve compression. Certainly, pressure on nerves can produce neuropathic symptoms, but this usually happens with weightlifters, or others who to exercises that cause muscle and/or connective tissue to expand and shift (i.e., long distance runners and cyclists, who assume particular positions for long periods of time while doing what they do).

Now, anybody with neuropathy in which the signals get disrupted, or erroneously register sensations, may have increased fatigue. One gets tired much more quickly with pain or numbness just compensating and trying to adjust to those. And, of course, neuropathy can directly affect fibers that go the muscles, causing those signals to be disrupted and resulting in much quicker fatigue. as the muscle fibers are recruited, in a given task, to a lesser degree.

I'm not sure what you mean by neuropathy "caused" as opposed to perhaps symptoms brought on by exercise; can you clarify?

Originally Posted by glenntaj

--is common with neuropathy, although spontaneous pain is as well.

Anything that adds stress or compressive forces to already compromised nerves might make them hurt more, but that doesn't mean the exercise is causing the pain.

What other investigations into cause have you had recently? The skin biopsy can document that there is damage to small fibers, but, as you know, it generally does not reveal an etiology.

Originally Posted by mrsD

Anyone with weakness or exercise intolerance should try acetyl carnitine. This has proven beneficial effects in the elderly anyway and the HIV community has used it for over a decade now.

Body builders use it in high dose, but people like us may see improvements at just 250mg a day or so. (up to 2 grams if necessary in divided doses). I use Puritan's Pride form, as it it pretty affordable from them.

Carnitine enables mitochondria to use fatty acids when glucose is low. It helps transport the fatty acids across the mitochondria membranes for metabolic energy. I found it very helpful back when I was going to the gym alot, but now I don't use a gym, but still the carnitine helps with stamina and climbing stairs for me now. If I skip a day or two now, I really feel the difference!