As a result of excessive and chronic alcohol consumption, alcohol neuropathy affects the nerves. A variety of symptoms can be experienced, ranging from mild to severe, including numbness, tingling, pain, weakness, and difficulty moving and sensing. As well as affecting digestion, urination, sexual function, and temperature regulation, alcohol neuropathy can also affect autonomic nerves.
Alcoholic neuropathy has no known cause, but it is known to be caused by heavy and long-term alcohol consumption. Alcohol can damage nerve tissue and impair the transmission of signals between the brain, spinal cord, and body. In addition, alcohol can affect the levels of certain nutrients essential for nerve function, including thiamine (vitamin B1), folate (vitamin B9), niacin (vitamin B3), vitamin B6 (pyridoxine), and vitamin B12 (cobalamin).
Often, heavy alcohol consumption is associated with poor nutrition. There is evidence that decreased thiamine levels may contribute to alcoholic neuropathy, while others suggest that nutritional deficiencies may also contribute. Alcoholic neuropathy can, however, also occur without malnutrition.
The symptoms of alcoholic neuropathy depend on which nerves are affected and how severe the damage is. Some common symptoms include:
Numbness or tingling in the arms or legs
Pain or burning sensation in the arms or legs
Muscle spasms or cramps
Muscle weakness or atrophy
Loss of muscle functioning
Movement disorders
Urinary or bowel incontinence
Constipation or diarrhea
Problems starting urination
Feeling that the bladder hasn’t been emptied fully
Sexual dysfunction (impotence or reduced libido)
Impaired speech or swallowing
Difficulty breathing (heat intolerance)
Vomiting or nausea
Dizziness or lightheadedness
The symptoms usually begin as mild and may worsen over time as the condition progresses. The symptoms typically affect both sides of the body symmetrically.
To diagnose alcoholic neuropathy, your doctor will need to examine you and ask you about your medical history and alcohol use. Your doctor will also need to rule out other potential causes for your symptoms by performing some tests. These tests may include:
Nerve biopsy: A small sample of nerve tissue is taken from an affected area and examined under a microscope for signs of damage.
Nerve conduction tests: These tests measure how fast electrical signals travel along your nerves.
Upper GI and small bowel series: These tests use X-rays to take pictures of your upper digestive tract and small intestine for signs of inflammation or obstruction.
Neurological examination: This exam involves checking your reflexes, coordination, balance, sensation, strength, and function of different parts of your body.
Electromyography: This test records the electrical activity of your muscles using electrodes attached to your skin.
Esophagogastroduodenoscopy (EGD): This test uses a thin tube with a camera to examine your esophagus (the tube that connects your mouth to your stomach) and duodenum (the first part of your small intestine) for signs of ulcers or inflammation.
Kidney function tests: These tests measure how well your kidneys are working by checking for levels of creatinine (a waste product) in your blood.
Liver function tests: These tests measure how well your liver is working by checking for levels of enzymes such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in your blood.
Blood count (CBC): This test measures how many different types of blood cells you have in your blood.
As well as looking for vitamin deficiencies linked to nerve health and alcohol abuse, blood tests can also detect thiamine, folate, niacin, vitamin B6, vitamin B12, vitamin E, glucose, cholesterol, electrolytes, calcium, magnesium, potassium, sodium, urea nitrogen levels.
The treatment options for alcoholic neuropathy depend on the severity of the condition and the underlying cause. The main goal of treatment is to stop or reduce alcohol consumption, which can prevent further nerve damage and improve symptoms. Some possible treatments include:
Medications may help with pain, numbness, tingling, muscle spasms, or other symptoms. Examples include anticonvulsants, antidepressants, opioids, and topical creams.
Exercises and techniques taught by a physical therapist will prevent muscle atrophy, contractures, and deformities.
In order to maintain good posture and alignment of your body, you may need orthopedic devices such as splints, braces, or casts.
In some cases, surgery is needed to repair or decompress damaged nerves or blood vessels. Surgery can also relieve pain and weakness associated with severe nerve compression.
The prevention of alcoholic neuropathy involves avoiding excessive drinking of alcohol and maintaining a healthy lifestyle. Some of the preventive measures include:
Not drinking alcohol if you have symptoms of alcoholic neuropathy
Seeking help if you are having trouble avoiding alcohol
Eating a healthy and balanced diet that provides adequate amounts of vitamins and minerals
Taking vitamin supplements if you have deficiencies (always talk to your doctor before taking supplements)
Quitting smoking
Managing chronic conditions such as diabetes or high blood pressure
Exercising regularly
Protecting your feet from injury or infection
