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Suggest Treatment For Symptoms Of Peripheral Neuropathy
Question: Im not doing as good as I should. I went to the neurologist and he ordered a series of tests for me. He thinks I have a small fiber neuropathy. H e believes its from pre diabetes. I took my blood sugar this morning it was 93 fastening. My H1ac came in at 5.9. have been on a low carb diet and the burning of my feet seems to b improving. My anxiety however id worse. Am seeing psychologist who believes I have a health anxiety. The neurologist ordered an egg which i feel is ridiculous in his note he said i has diminished distal reflexes as well as slight sensory loss and slight ataxia. H e completely ignored that I had a rod in my right femur a crushed heal from the accident i had in 2012. The orthopedic]edist I saw said my reflexes were normal and the ataxia iis because of my shorter leg and no sensory loss that he could tell. I had a sudo scan days ago and the tech says it was fine no sign of small fiber loss which would have explained the burning sensation in my feet. Cliniclly I have no real sign of large fiber loss And feel the mg would be of no benefit. I wake seven miles th e other day have no muscular weakness and am not ataxic, What really bothers me is that he told me to stop the b complex because too much b6 can cause neuropathy go on low carb diet and he has yet to pos the results of mu sudo scan. He completely ignores the sleep apnea issue the anxiety issue all which would have relevancy in a situation like this, I am going to have the glucose tolerance test and the vitamin levels as well as the sep and the antibody tests but I really don't see the relevancy based on my near to normal cup and glucose levels. Confused troubled and worried which only makes my symptoms worse.Your thoughts would be greatly appreciated.
Brief Answer:
Burning feet
Detailed Answer:
Sorry to learn about your bothersome symptoms.
I understand your concerns.
Neuropathy can be a complex and puzzling medical condition to diagnose and treat. I am sure he has considered checking you for several potential causes of neuropathy, if indeed he has confidently attributed your symptoms to nerve problems.
Sometimes thyroid and vitamin D issues can cause leg complaints.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) 12 hour Fasting Lipid profile
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Burning feet
Detailed Answer:
Sorry to learn about your bothersome symptoms.
I understand your concerns.
Neuropathy can be a complex and puzzling medical condition to diagnose and treat. I am sure he has considered checking you for several potential causes of neuropathy, if indeed he has confidently attributed your symptoms to nerve problems.
Sometimes thyroid and vitamin D issues can cause leg complaints.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) 12 hour Fasting Lipid profile
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Had all the blood tests kidney liver thyroid all perfect Vitamin d low 25 ldl low 37 ldl 145 triglycerides 80 total chol 206 electrolytes perfect cbc normal and I was examined by my doctor an orthopedist and neurologist he is repeating the cmp and did a sudo scan which was normal he is leaning toward pre-diabetes because my h1ac is 5.9 my glucose fasting is now 93 was 109. Thats it I just want my feet to stop burning after I exercise.
couldn't it be it is not neuropathy but a local problem like metatarsalgia yesterday no problem at all wake uo no burning at all exercised that day next morning burning it is alway worse when I am anxious and heard that my obstructive sleep apnea ca cause symptoms of peripheral neuropathy. Stated using my cap machine again had been bad with it.
couldn't it be it is not neuropathy but a local problem like metatarsalgia yesterday no problem at all wake uo no burning at all exercised that day next morning burning it is alway worse when I am anxious and heard that my obstructive sleep apnea ca cause symptoms of peripheral neuropathy. Stated using my cap machine again had been bad with it.
Brief Answer:
Follow up
Detailed Answer:
1 Pre diabetes has been shown to cause neuropathy, although it is fairly uncommon to see this ie neuropathy associated with pre-diabetes.
2 Vitamin D needs to be replenished to normal. Ask your doctor about the best way to go about this
3 Sleep apnea, to my knowledge, is not known to directly cause neuropathy. However it can lead a host of problems, so treating it well is important regardless.
Sometimes a second opinion of another neurologist is helpful.
Follow up
Detailed Answer:
1 Pre diabetes has been shown to cause neuropathy, although it is fairly uncommon to see this ie neuropathy associated with pre-diabetes.
2 Vitamin D needs to be replenished to normal. Ask your doctor about the best way to go about this
3 Sleep apnea, to my knowledge, is not known to directly cause neuropathy. However it can lead a host of problems, so treating it well is important regardless.
Sometimes a second opinion of another neurologist is helpful.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Is it not possible that that with a normal sudo scan a blood sugar in am fasting of 93and the fact after an hour of exercise on my feet yesterday and pained buriningof my feet the ball of the foot and under big toe the original diagnosis of metatarsalgia is the correct one.I have been supplementing with b complex for weeks 5000mg of vitamin D but when i increase my physical activity thats when it hits. I f I rest it for a couple of days the symptoms disappear some mornings I wake up and it feels completely normal.
Brief Answer:
Second follow up
Detailed Answer:
This is indeed perplexing. Perhaps getting evaluated comprehensively by an Internist is in order to explore other possible causes.
Second follow up
Detailed Answer:
This is indeed perplexing. Perhaps getting evaluated comprehensively by an Internist is in order to explore other possible causes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I did that and all the tests the only thing left is a glucose tolerance test.
Brief Answer:
Third follow up
Detailed Answer:
So please go ahead and do that. Best wishes for good health
Third follow up
Detailed Answer:
So please go ahead and do that. Best wishes for good health
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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