Alcoholic neuropathy

Continuing with the posts on the neurological manifestations of alcoholism, I shall cover the topic of alcoholic neuropathy here. Simply put alcohol is a neurotoxin especially when it is consumed in excess. People who consume large amounts of alcohol on a chronic (daily) basis frequently develop neuropathy. It does not depend upon the kind of alcohol consumed (top of the shelf Scotch whisky Vs a cheap rum) rather it depends upon the amount and frequency of use. Patients develop a predominantly sensory neuropathy and have complaints of pain, burning, tingling, pins and needle sensation in the feet and sometimes in the finger tips. Rarely if the neuropathy is severe patients may also develop peripheral weakness (motor symptoms).

Alcoholic neuropathy is also thought to be not entirely due to alcohol, rather it is a nutritional neuropathy and occurs due to lack of essential nutrients and vitamins in the marginal diets of alcoholics. It is uncertain whether the neuropathy would develop in an alcoholic who supplements his diet with essential nutrients and vitamins. Alcoholic neuropathy is more commonly seen in patients who have other neuropathic conditions like diabetes. In this subgroup of patients, alcohol acts as an additional neurotoxin and makes the neuropathy worse. The same principle applies to cancer patients been treated with neurotoxic chemotherapy medications or an HIV patient been treated with neurotoxic antiretroviral medications.

Thus the message is simple.

Drink alcohol in moderation applies to all of us.

People who have diabetes should avoid alcohol if possible or if that is not possible consume as little.

Patients been treated with neurotoxic medications should also avoid alcohol.

Supplement your diet with at least one to two tablets of a good multivitamin every day.

Alcoholic neuropathy is treated much the same as any other neuropathy (see my post on diabetic neuropathy

Nitin Sethi, MD

4 thoughts on “Alcoholic neuropathy

  1. Dear Dr. Sethi,

    Thanks so much for the article on Alcoholic Neuropathy. May I have permission to reprint it in the Yolo Co. PN News – a monthly newsletter reporting on presentations
    at our support groups and information from the internet and popular press about neuropathy and wellness issues.
    The Yolo Neuropathy Groups are part of a network of 40 or so neuropathy support groups across Northern California under a 501 c 3 umbrella, the Northern California Chapter of The Neuropathy Association that is about ten years old.
    They have a web site at some of the YNG and NCCNA newsletters and other info resources can be found at the site. See especially the Publications and CAM resource lists

    Your statement on AN is one of the best I’ve seen as it answers common questions raised in our groups.

    And, could you tell me about you?

    Warmest best wishes,
    Martha Chandley, YNG Coordinator

  2. I found your site on technorati and read a few of your other posts. Keep up the good work. I just added your RSS feed to my Google News Reader. Looking forward to reading more from you down the road!

  3. Dear Alex,
    thank you for your words of encouragement. Good to hear from you.
    Personal Regards,
    Nitin Sethi, MD

  4. Thank you for writing in. Patients with neuropathy have what we doctors refer to as allodynia (even nonpainful stimuli feel painful. So for example the socks you are wearing, the bed sheets under which you sleep at night shall seem uncomfortable when they touch your feet). They also have hyperpathia (an exaggerated response to a painful stimulus). These symptoms are difficult to treat but do respond to medications used to treat neuropathic pain such as gabapentin (Neurontin), pregabalin (Lyrica) and some anti-convulsants such as carbamazepine (Tegretol).

    Personal Regards,
    Nitin Sethi, MD

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