Brief Answer:
Your answers as follows.

Detailed Answer:

Hi,

The symptoms of tingling and numbness most commonly are due to peripheral neuropathy, peripheral nerve damage. Other possible causes would be the lack of blood flow, electrolyte alterations, thyroid dysfunction or anxiety.

As for how alcohol affects the condition, that may happen in a couple of ways. First alcohol is one of the main causes of neuropathy, its abuse is known to predispose to nutritional deficiencies and nerve damage. Second, it causes dilation of blood vessels in the skin and pooling of blood in the periphery, given you mentioning diminished circulation in the lower limbs it may cause a drop in blood pressure and flow in the toes.

As for ways to live with it first I would suggest to verify the cause. I consider neuropathy to be the likely origin but it must be confirmed through nerve conduction studies test. Also once confirmed some routine blood tests for diabetes, vitamin levels in particular B12 and electrolyte panel are needed. Neuropathy can have different causes, management depends on the cause.

The two simplest and cheapest remedies would be avoiding alcohol, adding vitamin B12 and folic acid supplements. Further possible remedies depending on whether some other issue is found on tests, say if there are changes indicating diabetes or electrolyte alterations those will be addressed accordingly.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Olsi Taka, Neurologist

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Brief Answer:
Read below

Detailed Answer:

Hi,

The dosage of vitamin B12 depends on whether there are a deficiency and its degree, it would be advisable to test its level first. That dosage is fine for prevention and mild deficiency, but if a moderate/severe deficiency enough to cause neuropathy then initially vitamin B12 shots may be used.

Folic acid is a vitamin involved in many functions as it is involved in DNA synthesis and cell regeneration. It is very important in the development of the nervous system. Regarding neuropathy, it plays a lesser role but is advised when vitamin B12 deficiency is suspected as their deficiency is often encountered together.

As for reversibility in order to assess that one must first properly diagnose it. Research is usually done for subtypes of neuropathy as it is a very broad field. Neuropathy means simply nerve damage, it doesn't say anything about the cause, the nerve fibers involved, whether damage to nerve axons or their myelin sheath, damage degree etc. That is why I said in my first answer that some tests are needed at least nerve conduction studies. While alcohol is the second most common damage after diabetes the list of potential causes and tests is very long. In 25% of cases, no cause can be found even after extensive testing. Usually, it is not completely reversible, it is aimed simply to stop its progression in time by removing the cause when found, but some damage persists.

Hope I have answered your query.

Regards,
Dr. Olsi Taka, Neurologist

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