What is alcoholic neuropathy?
Neuropathy is a complicated disorder that causes the nerves in our bodies to malfunction. In simple terms, it is called mononeuropathy when it affects only one nerve and polyneuropathy when it affects multiple nerves.
Alcoholics often succumb to polyneuropathy, when multiple nerves on both sides of the body are severely damaged by alcohol. The neural signals between the body parts and the brain flounder and it leads to skin, muscle and organ dysfunctions. The condition persists, even when they stop drinking. This is generally referred to as alcoholic neuropathy.
Alcoholic neuropathy develops mainly because alcohol is a neurotoxin that naturally damages our nerves. It also destroys and obstructs the absorption of vitamins, minerals and enzymes which are essential for healthy nervous systems. Alcoholics neglect their diets and do not properly replenish lost nutrients.
At first, the person feels a tingling numbness, pain and weakness in the hands or feet only, but it can spread to other parts of the body, including legs, arms and trunk. Over time, additional symptoms appear and all symptoms increase in severity. Because of the discomfort, the alcoholic becomes reluctant to move around or do things, even when sober.
Apart from the pain and the weakness, the symptoms expose them to risks. For example; falling and hurting themselves, due to imbalance and an awkward walking gait. They can burn or cut themselves, because they lack the sense of touch or feeling. They can get infections, because they are unaware of injuries, and so on. They can even contract permanent neural damage.
This disorder affects alcoholics even after they stop drinking and become sober. In some cases, alcoholics actually become acutely aware of it only after they had stopped drinking completely, because they are no longer desensitised by alcohol and are more conscious of bodily discomfort.
Although the first corrective step is to stop drinking, the symptoms may persist until the neural disorder itself is treated. Neurological tests and hospitalisation are required to properly diagnose and remedy the disorder.
As the risk of further, permanent neural damage increases with age and becomes worse when the alcoholic drinks again, psychotherapy is needed to ensure long-term sobriety.
Can alcoholic neuropathy be cured or reversed?
In most cases, even though some damage may be permanent, alcoholic neuropathy can usually be cured sufficiently for a person to resume a normal life. If some permanent damage remains, then they can mitigate it with alleviating medication.
Complete reversal is rare, but possible in the early stages. As nerve cells can be regenerated, it is possible that all the damaged cells can be replaced. However, the body’s ability to regenerate nerve cells is limited, so the degree of success is restricted by the state of the nervous system. The more damage there is, the less the chances of total recovery.
Stopping the alcohol consumption helps to restrict the damage, but the person will also need to undergo various tests and probable hospitalisation to recover, regardless of the level of affliction.
Medication and nutritional supplements (by means of intravenous infusion if they are hospitalised) is a further requirement.
If hospitalised, the patient will have the advantage of constant evaluation and adjustments in medication. It is not a good idea to self-medicate at home, as the combination of alcohol withdrawal and neural remediation is too complicated and risky without medical supervision.
Going forward, the person will need to sustain a healthy diet and make some lifestyle changes. They may also require physical or occupational therapy to correct muscle and movement problems. This can be done with the help of dieticians and therapists.
The neural disorder will return more viciously and cause more permanent damage if the person ever starts drinking again. Also, the older a person gets, the more vulnerable they become. For this reason, it is exceptionally important that they attend psychotherapy to prepare for long-term sobriety.
Good and bad nutrients
Good supplements for neuropathy
The following vitamins are recommended:
- Vitamin A
- Vitamin B1 (Thiamine)
- Vitamin B2 (Riboflavin)
- Vitamin B3 (Niacin / Nicotinic acid)
- Vitamin B5 (Pantothenic acid)
- Vitamin B6 (Pyridoxine)
- Vitamin B7 (biotin)
- Vitamin B9 (Folic acid / Folate)
- Vitamin B12
- Vitamin E
Recommended minerals : Potassium and magnesium
Note: Vitamin B6 must be used with caution
Best to consult your doctor about the dosage.
Good foods for neuropathy
Lean protein: Eggs, fish, lean red meat, lean poultry, liver, low-fat milk, scallops, shrimp, venison, yoghurt.
Vegetables: Artichoke, asparagus, beans, brewer’s yeast, broccoli, brown rice, brussels sprouts, carrots, chard, collards, garlic, green peas, kale, lettuce, onions, potatoes, quinoa, spinach, squashes, sweet potatoes, tomatoes.
Fruits: Bell peppers, blackberries, blueberries, cherries, cranberries, grapefruit, kiwis, oranges, pears, pomegranates, prunes, raspberries, red grapes, tomatoes, watermelon.
Other: Almonds, flax seed, ginger, green tea, legumes, lentils, oats, peanuts, popcorn, pumpkin seed, soybeans, sunflower seeds, tofu, walnuts, whole grain cereal.
Bad foods for neuropathy
Animal derived: Butter, cheese, cream, fatty meat, full cream milk, full-fat ice cream, jellies.
Plant derived: Refined breads, rolls, cakes, candy, cheese, chili, cookies, corn cakes, crackers, croissants, doughnuts, frozen desserts, granola, honey, instant rice, low-fibre cereals, milk chocolate, pancakes, pancake syrup, pasta, pastries, pita bread, pretzels, potato chips, refined grains, relish, rice cakes, sherbet, soft drinks, sugars and sugary foods, tacos, waffles, wheat bread, white bread, white rice.
Other: Fried and deep-fried foods, processed foods, pies, pizzas, salt, salsa, hot sauces.
Peripheral neuropathy diagnosis
Neuropathy is so complex that the diagnostic process can be quite difficult. Apart from probing questions about your condition, the doctor may want to perform various tests to ensure a correct diagnosis.
The tests may include:
- MRI scan
- Blood tests
- Enzymes levels
- Electrolyte levels
- Spinal fluid tests
- Thyroid function
- Urinary / bladder test
- Nerve and skin biopsy
- Nerve conduction tests
- Liver and kidney function
- Electromyography (EMG)
- Upper GI and small bowel series
- Esophagogastroduodenoscopy (EGD)
Symptoms of alcoholic neuropathy
The peripheral nerves affect the extreme parts of the body first, namely the hands and feet, but the nerve damage eventually spreads to other parts, including the torso and organs.
Symptoms and signs may include any of these:
- Tingling, pin pricking sensation in affected areas
- Jabbing, throbbing or freezing pain in affected areas
- Numbness in arms, legs (limbs feel dead, immovable)
- Lost sense of touch (cannot feel the things they touch)
- Sensitive to touch (feels pain when they are touched)
- Burning pain in arms, legs (feels like flesh is tearing)
- Muscle weakness, cramps and twitching
- Muscle atrophy (loss, shrinking of muscle mass)
- Loss of balance, unsteady when standing, walking
- Dizziness, faintness, head spinning
- Uncoordinated movement of hands, feet, limbs
- Unsteady gait (awkward, unstable walking pattern)
- Nausea (also “motion sickness” when moving around)
- Poor bladder control (weak urinating, incontinence)
- Unable to sweat, heat intolerance (sensitive to heat)
- Increased pain sensitivity when temperature drops
- Insomnia, difficulty falling asleep, restless sleep
- Alternating constipation and diarrhea
- Difficulty talking or swallowing
- Cuts, burns, bruises, infections
- Poor personal hygiene
- Difficulty breathing
- Irregular heartbeat
- Organ failure
- Over time, the symptoms become more intense.
Note: These symptoms are specific to alcoholic neuropathy only – the additional symptoms of alcoholism and alcohol withdrawal are not included above.
- Loss of feeling leads to inadvertent cuts, burns, other injuries. Because they can not feel pain or heat, there are no warning signals when they, e.g., step on something or touch warm objects.
- They may be unaware of wounds and develop infections, due to loss off feeling and emotional disinterest in examining themselves for signs of injury.
- Dizziness, loss of balance and poor coordination can cause injuries, due to falling or colliding with objects.
- Relapsing into drinking mode after a period of sobriety, can cause relapse of neuropathy, with more damage than the previous time.
- Postponement of medical treatment may lead to increased and permanent nerve damage, organ damage and other disabilities.
- Avoiding treatment and attempting self-healing at home can result in disability or fatality, due to the complexity of healing multiple serious disorders at once.
- Alcoholics may become addicted to pain killers and other medications. This should be monitored during the healing process.
- With ageing, people become more vulnerable. Alcoholics become even sicker if they start drinking again after a few years.
Taking care of yourself
Ways to avoid or alleviate alcoholic neuropathy:
- Do not use alcohol
- Seek help if unable to stop using alcohol
- Eat healthy and balanced diet meals
- Take vitamin, mineral supplements
- Get professional medical advice, assistance
- Use prescribed medication as indicated
- Get physical therapy for muscle problems
- Get orthopaedic support appliances
- Wear compression stockings
- Sleep with your head elevated
- Check temperature of water (avoid burns)
- Be cautious when moving (avoid falling)
- Inspect yourself for cuts, infections
- Treat injuries to prevent infection
- Use decent footwear for injury protection
Immediate short-term medical treatment is needed to stop further damage to the nerves and to achieve the resumption of normal body and brain functions. This is done by stopping the drinking, getting medical advice and, most probably, submitting to hospital treatment.
Several medications can be used for soothing the normal withdrawal symptoms of alcohol. In the presence of neuropathy, this should be done under medical supervision – it is too complicated and risky to attempt self-medication of the combined conditions at home.
After detoxification and the restoration of nutrients, some of the neuropathic symptoms will fade naturally, whilst others will require further medical treatment. In some cases there may be permanent nerve damage.
Long-term treatment includes eating a good diet and taking health supplements to preserve neural health. Psychotherapy is necessary for maintaining sobriety, as the nerve damage will be more intense and can be permanent if alcohol is used again at any time in the future.
There are medications available for long-term treatment of chronic neuropathy, but it is a very complex science. You will have to consult a neurologist and have several tests done before trying to reverse any remaining damage.
If any chronic pain persists after the initial treatment, you can use over the counter pain killers, such as aspirin. This should only be for short-term pain management. If the pain does not go away, a neurologist can prescribe proper medication. Use it with caution and stick to the prescribed dosage.
After the medical phase, you will need counselling from therapists experienced in alcohol treatment to achieve long-term sobriety. Neuropathic problems become worse as one ages. People who attend treatment in a therapeutic community have better long-term success rates. Nothing will help for neuropathic damage, unless the main culprit, alcohol, is removed forever.