Possible Alcoholic Neuropathy
 

Hi guys. I am new to this forum and looking for some advise. Over the last 5 years I have been experiencing weakness, numbness and hypersensitivity in my toes. It mainly happens when driving when putting pressure on the brake pedal and holding my foot on the accelearator for long periods of time and also when walking. I can hardly even stand barefoot as my feet feel really sensitive and weak when standing with no footwear, especially on hard surfaces. Also, lieing down without my feet resting on anything I get alot of tingling sensations in my toes and they feel very sensitive. I can't stand in the shower as it feels like my toes are so weak and like they are going to spasm, I have to have a bath instead :(

I used to drink heavily mostly 2 or 3 nights per week but over the past year I have tried to cut down and rarely exceed 6 units in a single week. The reason I decided to cut down is because a year ago, in addition to my usual symptoms, I noticed I could hardly walk the day after a night of heavy drinking. My toes in my left foot would go all stiff and feel really sensitive with every step. For days after the attack I would still experience shooting pains,weakness and hypersensitivity when walking even short distances.

Over the past year my symptoms have improved dramatically since cutting down alcohol but I still struggle a little. My doctor but me on amitriptilyne - whether thats the thing thats helped or the fact I have cut down alcohol I have no idea. But my doctors persist that my issues have nothing to do with alcohol even though I have explained to them that my symptoms have been worse the day after drinking heavily. I still eat ALOT of sugar and sometimes feel it is my substitute for not drinking alcohol. But I am thinking that proberbly isn't helping.

What do you think? Does it sound like I have alcoholic neuropathy? is the only way I can beat the symptoms by giving up alcohol for good, even the 6 or so units I drink per week? I do notice things improve when I don't drink as much. I have been feeling slightly frustrated because there a part of me that believes alcohol could be the cause of my symptoms but it seems really hard to get a diagnosis for this sort of thing. Doctors just say my blood test results were fine and I am not lacking any vitamins. They say I proberbly have a neuroma or a trapped nerve but I think there is alot more to this. Any advice will be appreciated.:confused: I have tried to explain my symptoms and the scenarios the best I can. Many thanks for reading.

Hi UKGuy35

Welcome :).

Well done for cutting down on alcohol; I am glad that your symptoms have improved. You might have some alcohol-induced PN though this can vary a lot. In my case it is in my hands only and is stable/decreasing since I stopped drinking.

I am a bit surprised that your doctor prescribed amitriptyline. It is a tricyclic antidepressant; I have never heard of it being prescribed in circumstances similar to yours. Perhaps you could discuss the reasons for the prescription with your doctor.

Best wishes.

Hi Kiwi,

My doctor prescribed amitriptyline as it has been known to relieve nerve pain. However I feel no investigation has really been done to work out the source of the nerve pain. I have been doing a bit of reading on Alcoholic Neuropathy and it seems it is something that is very difficult to diagnose. I think I have Alcoholic Neurpoathy, based on my symtoms being worse the days following drinking alcohol. Throughout my late 20's and into my early 30's I used to drink very heavy 1-2 nights per week. Although my symptoms have improved I still feel I have a reduced quality of life as I can't walk as far and be on my feet for too long. The symptoms are worse when it is cold weather.

Today I have decided I am so fed up of this miserable condition. As much as I enjoy alcohol I am certain now is the time to turn my back on alcohol 100%. I really want to commit to this as so far my efforts to remove alcohol from my diet has been very half hearted if you know what I mean. I have still been having the odd few pints, the odd binge here and there but I feel as much as I have reduced my alcohol intake it has not reversed my symptoms completely.

I will post regular updates to my progress roughly every 3 months. This is day one. I want to reverse and fight this.

UKGuy35, please keep us all up-dated.

I think that stopping drinking is a good plan. I did it some time ago and my PN (which is in my hands) has been stable/decreasing since then.

Apart from that my overall health has improved as has my bank balance.

Welcome UKGuy,



It is one of the possible tools in the toolkit against PN. I have taken it a couple of years back because I got reduced effect from the tramadol I was taking. So I tapered that down and started taking Ami. It does work, oddly enough, but the side effects were horrible to me, so after a few weeks I started tapering off again and went back to tramadol.

Some of the meds that are used with PN are antidepressants and/or anti-seizure meds of some sort. Lyrica* is now first choice for diabetic PN, but it's primary role is supposed to be an anti-seizure. Note that I tried that too, but it had nowhere near the effect amitriptyline had on me, and that is about 100 times cheaper.


* back in 2010, the neurologist who put me on Lyrica had to declare in writing that I also had a depression, and had tried all other meds, otherwise he could not prescribe it to me - no doubt a local quirk.

Just wanted to give an update on my progress. I am sure that I will not be judged on this but unfortunately I have not managed to completely remove alcohol from my diet. However I have managed to cut down dramatically. I never exceed the recommended guidelines, well nowhere near. I am pleased to report that since my last post, a significant improvement has been made especially since we have had the warmer weather. I can walk alot further, I have been walking for over 30 minutes per day during my lunch breaks at work and I do not feel the condition is stopping me from going out and doing the things I want to do. Bare in mind that 5 months ago I could barely walk for 3 minutes but during this time I was still drinking quite heavily. Just hoping things do not revert back during the winter months again but if I can stay out of trouble and keep away from alcohol maybe the symptoms will be more manageable.

That all sounds like definite progress to me UKGuy35.

Taking advantage of the warmer weather to walk regularly is a good plan if only to improve your aerobic fitness.

Do you think that it would help if you worked out a plan for dealing with the colder winter weather?

Hi Kiwi,

I will definately be putting a plan together for dealing with the winter months as they are always alot more challenging than the spring, summer and autumn months. In addition to regular exercise during the summer months I think I still need to do a bit more work on my diet and reducing the alcohol further. Its not easy but I am trying to just eat the things I enjoy in moderation and taking a more gradual approach to cutting down on things like sugar. If I can get my weight down as much as possible that would be a plus. I have a few months to sort of more suitable clothing - the socks I have currently I guess just aren't suitable for the colder months and also heat warmers usually help a bit so will stock up on them. I need to make sure I do as much as possible to keep my feet warm in the challenging months. Definately taking advantage of this warmer weather I think exercise is essential for things to improve. We can only do our best hey.

Thanks, this is very helpful. I am just now experiencing some of the tingling, cool feeling in my calf area. Not 100% sure it is NP, but think so, have a nero appt on Sept 17th. Not my feet so much or my hands. Started noticing some soreness in my legs about 2 months ago, and did some research to find out about PN. So shut it down 2 weeks ago, not 1 drink until after the Dr appt.

My question, is if you have 2-3 beers every once in awhile, that shouldn't make the condition worse right? It is the excess alcohol that does the damage?

Hi JTP, cutting down my alcohol intake to just a few beers now and again and staying within the recommended guidelines has certainly helped stabalise my condition. But I believe it may differ from person to person. Some websites suggest that the only way to recover from this is to stop alcohol completely. I am not a doctor or anything but can only speak from my own experience and say I think it depends on the person. My advice would be to stay within the recommended guidelines (14 units per week / max 4 units per day) and if this doesnt help then try to cut out alcohol completely.

Just to update, two weeks ago I managed a 1.5 hour walk which was incredible considering I could barely walk earlier this year.

update
 

Even though it is getting colder, I am still making great progress and abe to walk pretty much anywhere and any distance. Feels like a miracle to say this time last year I was hobbling everywhere. I have slashed my alcohol consumption right down.

Thanks UK, that is helpful and a good thought. Agree, seems to be a lot of differing opinions on the topic. Assume some of it has to be due to the fact that many are unable to stick to the guidelines once they start drinking again.

I have dramatically scaled back myself. My symptoms seem to be a bit better, but definitely good days and bad days. Had an EMG a couple of weeks ago, so awaiting those results, but the dr performing the test said all was normal. So guess I will see what is next.....

Just a quick update. Almost a year since my original post and I am very pleased to say there has been a massive improvement overall. The improvement has been gradual since I started taking amitriptyne and cut down on alcohol at the start of last year, it has has got better and better. I am also able to stand and walk barefoot even on harder surfaces with very minor discomfort! This is somewhat a miracle. In terms of alcohol intake I have kept within the recommended guidelines but still not managed to give up completely.

Hi UK Guy,

Probably 36 by now! I can do the Maths, see a fellow Brit, and reason we call it Maths is because we do it more than once!

I have a couple of questions for you..

1, What does Amitriptyline do for you? I am still awaiting diagnosis and all hospital appointments are on hold. What symptoms does it alleviate?

2. If you were diagnosed with early liver cirrhosis would you continue drinking, even in moderation? I say this because there is a clear widely understood causality between drinking alcohol and liver cirrhosis. The relationship between alcohol and Peripheral Neuropathy is on the other hand not clear and not widely known.

However Alcoholic Neuropathy exists and is a bedfellow of liver cirrhosis.

And can be just as bad.

You have a history of symptoms related to alcohol. You're on medication just to help you stand up. At 36.

So my second question is this, is alcohol really worth it?

Atty

Complete reversal of symptoms. No issues with walking or anything. Been walking for hours every day to exercise.

Atty in response to your questions.

Firsly. I must point out that in response to this:

'You have a history of symptoms related to alcohol.'

I have not strictly had a diagnosis from a medical professional, although it has appeared obvious to me that alcohol causes my symptoms to worsen. I just wanted to make that clear first of all. The doctor's struggled to come to any form of diagnosis, I was told it could be Mortons Neuroma, it could just be my nerves are over sensitive and thats just how they are etc.. But no doctor or medical professional has diagnosed me with PN as a result of alcohol.

In reponse to your questions:

1. Amitriptyline is used for nerve pain and various other chronic conditions such as arthritis. My understanding is it relaxes the muscles. It has also be used for the treatment of anxiety and depression. As I have been a rather anxious person for some time, my doctor believes it may have helped reduce some of the anxiety which in turn can also help the muscles relax.

2. No. Alcohol is not worth it, even in moderation. Since the lockdown and closure of all pubs and bars I have not consumed alcohol at all and surprise surprise my symptoms have completely gone. It seems obvious to me that alcohol was the cause or just didn't help my condition. But like I said, I never had a proper diagnosis and it is very hard to get one.

Oh, one other thing I forgot to mention. I have lost 20 pounds in weight since the start of lockdown. From 236 pounds down to just above 216 pounds. Possibly this helped too :)

Higher temperatures since the end of April / start of May could also have helped so I will continue to monitor the situation especially when we enter the winter months.

"Complete reversal of symptoms. No issues with walking or anything. Been walking for hours every day to exercise."

Hey UK Guy,

Great to hear that you've had such success. Congratulations and well done on avoiding alcohol. That gives me real hope and I dare say other readers too.
I believe exercise to be of great benefit in recovery. Are you able to offer any insights on what helped you?

Atty

Hi Attitcus,

The things that have helped most are exercise and weight loss. Also maintaining a healthy diet, especially cutting down on sugar. I would advise anyone suffering simular symptoms to be patient as recovery is slow. Nerves take a very long time to heal. Keep a diary/log of progress, the reason this is a good idea is that sometimes it will seem like you are not making progress but when you look at your progress as a whole over time you can see how things have improved. You will still have bad days but as time goes on you will have far less bad days and wont even be thinking about the problem anymore.

Hey UK Guy,

A symptoms diary, interesting. What helps me is not to dwell on my symptoms, to ignore them and just carry on ( could I be more English?). I was playing golf the other day and I noticed my hands were numb whilst putting. I am a notoriously bad putter, but I actually sunk a few (and I don't mean beers). Putts I wouldn't normally get, so I intend to sit on my hands before the next game!

Thanks for the reminder about patience. Lockdown has given me time to rest and recuperate and reflect. It has given me the time to research and adopt the ideal lifestyle to promote recovery. I agree about exercise and diet and I would add rest /sleep. It is also important to make a connection with family and friends. I feel closer to people than I have for years. Above all PN has given me a sense of purpose, almost a new lease of life. I am grateful for that.

I wish you well UK Guy

Atty