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Thread: Alcoholic Neuropathy newbie

  1. #1

    Alcoholic Neuropathy newbie

    Hi
    I'm a newbie here and this is my first post and I have a few questions. I have all the classic symptoms of Alcoholic Neuropathy. Early numbness of the soles followed by pins n needles and then the unbelievable burn. Although it started in the right foot the symptoms progressed to the left however the left foot has now only minor symptoms being a slight burn and slight tingling and minor numbness on tips of toes. If anything it seems to have reversed where as the right foot has gone Ballistic!!! I have never experienced this level of mind blowing Pain. again all the classic symptoms affecting my whole foot up to the ankle and absolutely no way to walk other than crutches and using my left leg for support. I'm not a diabetic and have self tested electronically at home to confirm .I am a 46 year old male and a heavy life long drinker but not any more! 3 days and not the slightest desire and besides this has scared the crap out of me.
    A few quesations

    1. Isn't this disease supposed to affect both feet?
    2. I live in Bangkok and go into hospital in a few days for tests. You don't need a script here you just go into the chemist and buy anything you want so I have been taking 600gm of neurontin for the last 3 days and it has done little for my pain but helps me fall asleep. What should I do with the dosage whilst I'm awaiting my hospital diagnosis?

    Thanks in advance

    1.

  2. #2
    Senior Member
    Join Date
    Nov 2004
    Location
    Florida
    Posts
    1,322
    Good that you stopped using alcohol! That is the first step. Next, wait for the neurontin to work. It is not a pain pill that works within a few hours. You have to be patient. It is more like an antidepressant. It takes a while to feel the benefit. I wish you success with kicking your alcohol habit!

  3. #3
    Thanks for your encouragement SoFla. I will quit just like with the ciggies cold turkey, besides with all this squirming in pain I would spill more than I would drink

  4. #4
    Senior Member
    Join Date
    Nov 2004
    Location
    Florida
    Posts
    1,322
    Ah, you haven't lost your sense of humor during the course of detox. I will bring it one step further. Spilling your adult beverage could be considered yet another form of alcohol abuse.

  5. #5

    Sounds like neuropathy

    It does sound like you may have a peripheral neuropathy - an injury of your peripheral nerves that can give you sensations of numbness, pain ("pins and needles", burning etc...), or hypersensitivity to stimuli that normally shouldn't cause pain (eg. the sheets at night just touching your feet cause pain). Your history of heavy alcohol use for years certainly is a frequent cause of such painful neuropathies. The best thing you could do for your life and health is to stop drinking. If you have developed a neuropathy secondary to alcohol use, it is likely you have developed other medical problems as well. This may be your lucky day that this new problem may motivate you to change your life. You can do it!

    Yes, it is common for alcoholic neuropathy to affect both feets, and is not uncommon for your feet/legs to be affected asymmetrically (eg. one worse then the other). Over time, as the disease progresses, in can creep further up your legs, and then you can start developing symptoms in your hands. Neuropathy can not only cause changes in sensation/pain, but can also cause weekness and difficulty walking due to these changes. All bad stuff.

    Fortunately, there is a solution. For many people with alcohol related neuropathies, it improves when you stop drinking. Also, it is common for people who are heavy drinkers to have poor nutrition, and often - vitamin deficiencies - so it is important to correct these as well. So start eating a balanced diet, start taking a daily multivitamin and thiamine 100mg a day, and additional B12 and folate may be helpful.
    You can discuss this with the physician that you will see soon. Improving nutrition is very important, as deficiencies in these vitamins can cause neuropathy as well.

    You should be seen by a neurologist for proper work-up and assessment. There are many other causes of neuropathy in addition to alcohol, so you should have at least a few other possible causes looked at as well, since there are also treatable. You should have a proper test for diabetes (not just a home sugar check) - such as a fasting blood sugar check and a hemoglobin A1c test, as well as a B12 level, folate level, and thyroid function tests at a minimum. In the US, it would be typical to also have a nerve conduction test performed by a neurologist or a physiatrist. This is a test that looks at how well your nerves respond to stimulation - to better characterize what type of neuropathy you have, and how severe it is.

    Neurontin is a very good medicine for peripheral neuropathy pain. Are you taking 600mg once a day? Usually we divide the medicine into three separated doses a day (morning, noon, night), and increase it slowly over time, as needed. For example, starting at 300mg, three times a day is a reasonable starting dose, but certainly I agree that you should give this at least 1-2 weeks before increasing it more. It often takes time for your body to adjust to it and for you to see its best effect. And also, you should be doing this under the guidance of a doctor, who needs to check your kidney function (this should be done before starting the medicine, because if your kidneys aren't working normally, neurontin wont be excreted properly and you can build up some toxic side effects). When you see the doctor, you can discuss what is the best way to increase the medicine if you aren't seeing a reasonable improvement.

    And finally, you must be careful when stopping alcohol "cold turkey". As you may be aware, you can start to go through a very uncomfortable withdrawl (tremors, nausea/vomiting, fast heart rate), and if you body is used to significant amounts of alcohol daily, there is a risk of seizures in the first couple days with worsening symptoms (confusion, hallucinations etc..). So get to ther nearest emergency room if those become prominent. It is fairly straightforward to treat them with the class of medicines called benzodiazepines (ativan, valium etc...), and once you get through them, you'll feel a whole lot better. You mentioned that you haven't had a drink for 3 days - if that's so, and you haven't had any of these withdrawl symptoms, then you are fortunate. So hang in there, and take your vitamins, and stick with your new lifestyle.

    Good luck.

  6. #6
    Thanks hlh for a very informative post. I am having a head to toe examination tomorrow with every scan possible. I will certainly make a booking with a neurologist as well. No problems with stopping drinking so far and in any case how would I notice any of the symptoms you mention when I'm to busy biting the pillow from this incredible pain . That's my first priority is to try and control the pain and obviously not being able to walk is taking its toll both physically and now mentally. I'm taking 2x300 neurontin morning and night. I am having a diabetes check as well and Will post back tomorrow with more info

  7. #7
    Oh by the way my right foot has swollen a little but just a little and I'm not concerned however when attempting to stand the blood rushes down and it turns a deep red nearly light brown whilst my other foot is white. It feels like it will explode so I lay down again. My question being is it possible that anti inflammatories may help with the pain?

  8. #8
    I doubt the anti inflammitories will help if you're suffering from neurpathy. Some people do better with Lyrica, I took Gabapentin for a year and a half with little relief. I get better results with the Lyrica, but I don't think I'd try anything else without seeing the doctor.

  9. #9
    Typically, the medicines that work best for neuropathic pain are medicines that were originally developed for other purposes, and we discovered later that they were helpful for nerve pain. These include the anti-epileptic medicines (ex. neurontin/lyrica, topomax, tegretol, keppra) and the tricyclic anti-depressants (ex. nortriptyline and desipramine have the fewest side effects of that family). Occasionally, in severe cases they are combined with medicines from the morphine family. It's best to discuss with your doctor where to start and how to titrate up, as all of these medicines have side effects, and it is often quite individual which is the best choice. Fortunately, it is likely that many of them will work for you. So hang in there... Neurontin is definitely a good starting place. I'm sorry this is so painful for you.

    While I have seen a rare person who has some benefit from anti-inflammatories, or even tylenol, these are not typically very effective for nerve pain. But if taking a couple tylenol before you go to sleep while you are waiting to see your doctor this week sounds reasonable to you, it probably couldn't hurt and you might sleep a little better. But while you're at the doctor, make sure they check your liver function tests too... to make sure the alcohol hasn't caused problems with your liver. You should be wary of using tylenol until you are sure your liver is doing well.

  10. #10
    IM posting this from my hospital bed. Did 8 hours of tests yesterday and alcoholic Neuropathy is confirmed as most likely. My Liver test came back as normal, how bizar is that? I also have sever gout in my knee and feet and apparently neuropathy and alcohol withdrawal bring on the gout which you can imagine makes the pain unbearable. I had zero response to reflex test to knee and ankle although EMG triggered a response and Doc said zero hammer response may was possibly due to my body being so inflamed.

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