Question about alcoholic neuropathy
 

Hey everyone, have a question. I suffered some small fiber peripheral neuropathy through and injury as well as about 2 years of drinking. I have had then gone 1 1/2 years sober to let things heal.

If I were to start drinking very sparsely , say just on the weekends after I have given such a long period of healing, would
I be hindering further progress? I have no pain or anything, just still a bit of numbness..

I think it's better to not drink at all.
 

There are many ways that excessive alcohol damages nerves. Direct toxicity on nerves, vitamin depletion, liver and kidney damage which causes changes to biochemistry, stomach lining damage which causes gut infections (inflammatory responses). Unless you know for sure how alcohol damaged your nerves it's kind of like Russian roulette.

Also there is the fact that alcohol/drinking is enjoyable and you will always get pressured to drink more.

I can't drink at all due to my anxiety and the meds I take. But even though everyone knows I can't drink at every social event I am constantly getting pressured.

Your question is both easy to answer, and impossible to answer. I don't know how badly your symptoms were, and how deep your problem went... "Alcoholism" is a very negative term, and will be called "substance use disorder" in the DSM V. But no matter how you call it, only you know exactly how bad the problem was last time around.

I'm saying this because even if your PN would not flare up as soon as you have a couple of drinks, I do know that quitting a second time can be a nightmare that is 10 times worse than your first quit. I don't know the reason behind this, but the majority of people who have a few drinks after a long period of total sobriety end up in places they couldn't have imagined the existence of.

I don't know the mechanics behind it, but I do know that in 99% of the cases that's what happens.

To complicate things further, alcohol is an incredible pain killer (I almost don't dare to write this here, but it is true). Drinking half a bottle of whisky can take away the pain completely - well, it did in my case... The problem is of course that it's very short lived, and with the hangover comes the horrible PN pain (it will eventually), and the only short term solution for both is...

Please don't take this as "holier than thou". I've been in serious problems with alcohol before myself, so I'm the last one to judge other people, but please consider not going there, and instead try to protect your sobriety. The odds of not getting into serious trouble are just too slim.

You are sober, and your pain is almost non-existent. A lot of people here would gladly give a small body part ;) to get rid of the excruciating pain that comes with PN. So perhaps the answer was easy all along, even if it might not be what you want to hear.

To respond to this question.....

Maybe and maybe not.

It depends on WHAT you drink, how much and whether your
B1 is in good supply.

If you must drink try to use only filtered quality vodka. This form of alcohol has the chemicals of fermentation called congeners removed. Some of these chemicals are aldehydes and irritating. (alcohol is metabolized by B1 and also leads to aldehydes in the blood. These irritate the nerves and brain causing "hangovers")

Benfotiamine or thiamine B1 is the cofactor in removing these aldehydes, (and the aldehydes from the alcohol itself) from your body.

It might be that you cannot drink at all. Filtered vodkas advertise this. Skyy is one. Smirnoff the other. Avoid martinis as the Vermouth would have the congeners in it.

Aged whiskeys are also problematic.

If you have a "problem" with drinking too much, it is best to not drink at all.

Holy crap. I can't tell you how true this is. I am 600+ days sober after 20+ years of drinking heavily. My life is a complete 180 from before and my health has greatly improved by abstinence.

I will NEVER say that I will never drink again, but I have a good shot at staying sober for the rest of my life.

Question is: Why gamble when you have a good thing going?

Is there a possibility that you have an inherited neuropathy, such as Charcot-Marie-Tooth (CMT) disease, that might cause you to be more susceptible to nerve damage from alcohol? There is debate about whether people with CMT are more susceptible to nerve damage from drinking alcohol, and perhaps it differs depending on the type of CMT. In my experience, it think it is highly likely that amounts of red wine with dinner that would be no problem for others contributed to nerve damage.

Moderate consumption of alcohol generally has no ill effects for a CMTer. However, it can affect your balance and coordination and over consumption of alcohol is not recommended. It has been taken off the medical alert list. Of course over consumption of alcohol isn't good for anyone.

Kitt
Charcot-Marie-Tooth (CMT)

I know it was taken off the list so I tried to word my comment carefully. Given the details of my history, I'm convinced that it was a factor for me. Of course, I might be wrong, but in view of my experience and family history I suspect that for a few genetically susceptible individuals the risk that modest consumption of alcohol poses for the nerves might be underestimated. Much as I'd like to have an occasional glass of wine, I have given up drinking alcohol altogether. I wonder if there might be a difference in regard to alcohol sensitivity between the different types of CMT. Do you happen to know of any research on the topic and/or the background of the decision to remove alcohol from the list? Also, in view of what Mrs. D. said, the particular type of alcohol (red wine) and/or B1 status might have been factor(s) for me.

Mrs. D., are products of fermentation in products other than wine associated with a risk of nerve damage?

I only just discussed this topic with my doc and nuero. Both agreed it is very very difficult to quit, they also agreed with my desire to have a few and I really mean as few, not 10 not 50 :p

so I still have 3-4 beers some nights and no ill effects or change in PN symptoms however let me say that I was a chronic alcoholic my whole life and 3 beers never even registered back then

Most of the cogeners are aldehyde in nature, as that is what yeast produce. There can be other chemicals in the drink as well.

I think people who are low in B1, will have more trouble with aldehyde metabolism. And people vary in response to environmental chemical sensitivities.

Just like sugar and other toxins, I just stay away from things that cause neuropathy. It is easier to heal and have good health with the best foods and staying away from toxins.

They tell you to consult your physician concerning alcohol and your particular situation. Everyone is different. They do update the list often. They encourage people to contact them. Alcohol was taken off the list in July of 2004.

Sensorimotor axonal polyneuropathy seems to be what you have posted. There doesn't appear to be a definite diagnosis of CMT. Correct?

Yes, that is correct. I was diagnosed with idiopathic sensorimotor axonal polyneuropathy. The neurologist had a strong suspicion of CMT, due to the exam and nerve conduction test results along with the context of deformities of the feet that I have had since birth (partially corrected by casts during infanthood). He said it was very likely that I have CMT but discouraged me from pursuing further evaluation. A podiatrist and a physical therapist who specializes in people with deformities of the lower extremities also told me that they thought it very likely that I have CMT. I was diagnosed with club feet at birth, but in the wake of my neurological problems, I've been told that was likely a misdiagnosis and that my deformed feet are most likely due to CMT. I'm researching to find a neurologist who is interested in investigating this because I think it could be important for me and others in my family to be sure, especially because of the risks of drugs on the list for people with CMT.

Thanks for your replies everyone.

When I say a few I'm talking like 2-3 beers on weekends.

The period where I drank heavily was a very dark period in my life. I strongly believe it was very *situational* alcohol abuse. I am in a massively better headspace now and I don't believe it will be an issue. Evidence of this is that before that negative period I would only socially drink and it was never a problem.