Doctor K: Diabetes not only cause of neuropathy

DEAR DOCTOR K: I have peripheral neuropathy. I know that people with diabetes often get neuropathy, but I’m not diabetic. What else can cause this condition? And what can I do about it?

DEAR READER: Neuropathy is a medical term that means nerve damage. The type of nerve damage that people with diabetes get involves specific nerve fibers in all nerves, particularly the nerves that travel to the legs and feet.

The symptoms of peripheral neuropathy include numbness and tingling. Some cases cause burning, shooting or stabbing pain.

Diabetes is the most common cause of peripheral neuropathy. But neuropathy can result from other causes as well. These include:

• Excessive alcohol intake.

• Hypothyroidism. In this condition, the thyroid gland does not produce enough thyroid hormone.

• Amyloidosis, a disease in which an abnormal protein accumulates in the body.

• Vitamin deficiencies, particularly vitamin B1, B12 and folate deficiency.

Diagnosing peripheral neuropathy is best done by electromyography and nerve conduction studies. Such testing often is not necessary, as your symptoms, your medical history and your doctor’s physical examination make the likelihood of diagnosing peripheral neuropathy high enough that such testing is unnecessary.

Treatment of peripheral neuropathy begins with treating the underlying cause of the condition. For example, let’s say your neuropathy is related to heavy drinking. You should severely restrict, or better yet abstain from, alcohol. If your neuropathy is caused by hypothyroidism, treatment with replacement doses of thyroid hormone should help.

The other goal of treatment is to relieve symptoms. In particular, treatment targets pain caused by peripheral neuropathy. Several medications can help. Gabapentin, an anticonvulsant medication, is usually effective. Tricyclic antidepressants can also effectively relieve pain.