The first step in treating alcoholic neuropathy includes stopping alcohol use altogether. If your drinking is out of your control, know that many treatment options are available. This article reviews alcoholic neuropathy and its symptoms, causes, and treatment. Alcohol-related neuropathy can go away if you stop consuming alcohol and follow your treatment plan. However, severe alcohol-related neuropathy may cause permanent nerve damage. The sooner you stop drinking alcohol, the more favorable your outlook is if you have alcohol-related neuropathy.

Diet and Peripheral Neuropathy

Human studies have also suggested a direct toxic effect, since a dose-dependent relationship has been observed between severity of neuropathy and total life time dose of ethanol [6, 13]. The exact mechanism behind alcoholic neuropathy is not well understood, but several explanations have been proposed. Therefore, alcoholic neuropathy may occur by a combination of the direct toxic effects of ethanol or its metabolites and nutritional deficiencies, including thiamine deficiency. The precise mechanisms responsible for toxicity on the peripheral nervous system, however, have not yet been clarified. The amount of ethanol which causes clinically evident peripheral neuropathy is also still unknown. Benfotiamine (S-benzoylthiamine O-monophoshate) is a synthetic S-acyl derivative of thiamine (vitamin B1).

Alcoholic neuropathy

• However, some people notice an improvement in symptoms a few months after discontinuing alcohol intake.
• Neuropathy in the feet can be a form of peripheral neuropathy, which affects nerves outside the brain and spinal cord.
• These can affect both your controlled and involuntary movements, as well as sensations.
• Malnutrition has been implicated in the pathology of alcohol-related neuropathy by several authors.
• In agreement with this, one recent study has confirmed the efficacy of TCAs in central pain [116].
• A mechanism of cisplatin chemotherapy-induced peripheral neuropathy was elucidated in an in vitro mouse model.

Some tests can be performed by a doctor to rule out other causes of neurologic symptoms. Fetal alcohol syndrome can occur when a person is exposed to alcohol before birth. Cerebellar degeneration caused by alcohol occurs when neurons in the cerebellum deteriorate and die. The cerebellum is the part of the brain that controls coordination and balance.

Alcoholic Neuropathy Symptoms

A deficiency of vitamin B1 in chronic alcoholics can be due to inadequate dietary intake, reduced capacity for hepatic storage, inhibition of intestinal transport and absorption or decreased formation of the active coenzyme form. In an animal study, it has been found that chronic alcohol consumption in rats resulted in a significant depletion in thiamine diphosphate (TDP), the active coenzyme form of thiamine. Supplementation with benfotiamine significantly increased concentrations of TDP and total thiamine compared with supplementation with thiamine HCl [96]. An 8 week, randomized, multicentre, placebo-controlled, double-blind study compared the effect of benfotiamine alone with a benfotiamine complex (Milgamma-N) or placebo in 84 alcoholic patients. Parameters measured included vibration perception in the great toe, ankle and tibia, neural pain intensity, motor function and paralysis, sensory function and overall neuropathy score and clinical assessment. Although benfotiamine therapy was superior to Milgamma-N or placebo for all parameters, results reached statistical significance only for motor function, paralysis and overall neuropathy score.

What is the most common treatment for peripheral neuropathy?

Due to the breadth of the literature surrounding this topic, this review shall focus exclusively upon peripheral neuropathy, without discussing autonomic neuropathy. Alcoholic neuropathy is damage to the nerves that results from excessive drinking of alcohol. The damage may affect the autonomic nerves (those that regulate internal body functions) and the nerves that control movement and sensation. If your doctor confirms a diagnosis of alcoholic neuropathy, they will discuss treatment options, including help for alcohol use disorder.

87 articles were included in this review, 29 case–control studies, 52 prospective/retrospective cohort studies and 2 randomised control trials, 1 cross sectional study, and 3 population-based studies. The prevalence of peripheral neuropathy amongst chronic alcohol abusers is 46.3% (CI 35.7– 57.3%) when confirmed via nerve conduction studies. Alcohol-related peripheral neuropathy generally presents as a progressive, predominantly sensory axonal length-dependent neuropathy. The most important risk factor for alcohol-related peripheral neuropathy is the total lifetime dose of ethanol, although other risk factors have been identified including genetic, male gender, and type of alcohol consumed. Alcoholic polyneuropathy is a neurological disorder in which peripheral nerves throughout the body malfunction simultaneously. It is defined by axonal degeneration in neurons of both the sensory and motor systems and initially occurs at the distal ends of the longest axons in the body.

Signs and symptoms of alcoholic neuropathy

There are many different ways that peripheral neuropathy can happen, so this condition is common. Fennelly and colleagues evaluated the response to vitamin therapy in 29 individuals with alcohol-related neuropathy [30]. Patients were admitted and treated with a diet containing thiamine, nicotinic acid, pantothenic acid, pyridoxine, folic acid, and vitamin B12. This study found that the response to treatment depended upon the severity of neuropathy and whether there was severe cirrhosis.

The most common findings are sensory-related and vary, including pain, numbness, and paresthesias. Pain seems consistent in the literature as 1 of the most common complaints and can be the first clinical indication of the disease. Keeping this disease process high on the differential with the right history is essential.

A wide range of support networks and medical treatments are available. A systematic review suggests that 46.3% of people who engage in chronic heavy alcohol use have alcoholic neuropathy. Speak with a healthcare professional if you experience symptoms of alcohol-related neuropathy or are struggling to stop drinking. alcohol neuropathy stages However, nerve damage is sometimes permanent, and your symptoms are likely to worsen if you don’t stop drinking. This could lead to disability, chronic pain, and damage to your arms and legs. Abstaining from alcohol can help restore your nutritional health, improve your symptoms, and prevent further nerve damage.

What Causes Neuropathy in Feet?

• It has been recognized that spinal cord glial cells, astrocytes and microglia are activated by neuropathic pain or peripheral inflammation [42].
• A systematic, computer-based search was conducted using the PubMed database.
• Alcoholic neuropathy is a condition in which the nerves become damaged as a result of years of heavy alcohol consumption.
• There are also direct toxic effects of alcohol and its metabolites on neurons, affecting cellular cytoskeletons and demyelination of neurons.

Thus, it is clear that all the above pathways are potential targets for novel pharmacological agents for the treatment of alcoholic neuropathy. The only way to prevent alcoholic neuropathy is not to drink excessive amounts of alcohol. Treatment for alcoholism may include counseling, social support such as Alcoholics Anonymous (AA), or medicines. It is important to supplement the diet with vitamins, including thiamine and folic acid. Symptoms can include numbness in hands and feet, digestive issues, and loss of balance due to loss of nerve function.