BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuMetabolic neuropathiesNeuropathy - metabolicMetabolic neuropathies are nerve disorders that occur with diseases that disrupt the chemical processes in the body. Causes Nerve damage can be caused by many different things. Metabolic neuropathy may be caused by:A problem with the body's ability to use energy, often due to a lack of enough nutrients (nutritional deficiency) Dangerous substances (toxins) that build up in the body Diabetes is one of the most common causes of metabolic neuropathies. People who are at the highest risk for nerve damage (diabetic neuropathy) from diabetes include those who have:Diabetic neuropathyNerve damage that occurs in people with diabetes is called diabetic neuropathy. This condition is a complication of diabetes.ImageRead Article Now Book Mark Article Damage to the kidneys or eyes Poorly controlled blood sugar The longer one has diabetes, the more likely they are to get neuropathyOther common causes of metabolic neuropathies include: Alcohol use disorder (alcoholic neuropathy) Alcoholic neuropathyAlcoholic neuropathy is damage to the nerves that results from excessive drinking of alcohol.ImageRead Article Now Book Mark Article Low blood sugar (hypoglycemia) HypoglycemiaLow blood sugar is a condition that occurs when the body's blood sugar (glucose) decreases and is too low. Blood sugar below 70 mg/dL (3. 9 mmol/L) i...ImageRead Article Now Book Mark Article Kidney failure Inherited conditions, such as porphyria PorphyriaPorphyrias are a group of rare inherited disorders. An important part of hemoglobin, called heme, is not made properly. Hemoglobin is a protein in ...ImageRead Article Now Book Mark Article Severe infection throughout the body (sepsis) SepsisSepsis is an illness in which the body has a severe, inflammatory response to bacteria or other germs.ImageRead Article Now Book Mark Article Thyroid disease Liver disease Vitamin deficiencies (including vitamins B12, B6, E, and B1) B12Vitamin B12 is a water-soluble vitamin. Water-soluble vitamins dissolve in water. After the body uses these vitamins, leftover amounts leave the bo...ImageRead Article Now Book Mark Article B6Vitamin B6 is a water-soluble vitamin. Water-soluble vitamins dissolve in water so the body cannot store them. Leftover amounts of the vitamin leav...ImageRead Article Now Book Mark Article EVitamin E is a fat-soluble vitamin. Your body stores vitamin E in fatty tissue and the liver.ImageRead Article Now Book Mark Article B1Thiamin is one of the B vitamins. The B vitamins are a group of water-soluble vitamins that are part of many of the chemical reactions in the body....ImageRead Article Now Book Mark Article Some metabolic disorders are passed down through families (inherited), while others develop due to various diseases. Symptoms These symptoms occur because nerves cannot send proper signals to and from your brain:Difficulty feeling in any area of the body Difficulty using the arms or hands Difficulty using the legs or feet Difficulty walking Pain, burning feeling, a pins and needles feeling or shooting pains in any area of the body (nerve pain) Weakness in the face, arms, legs, or other areas of the body Dysautonomia, which affects the autonomic (involuntary) nervous system, resulting in symptoms such as rapid heart rate, exercise intolerance, low blood pressure when standing, abnormal sweat patterns, stomach problems, abnormal functioning of the pupils of the eye, and poor erectionThese symptoms often start in the toes and feet and move up the legs, eventually affecting the hands and arms. Exams and Tests Your health care provider will examine you and ask about your symptoms.Tests that may be ordered include:Blood and urine tests Electrical test of the muscles (electromyography or EMG) Electromyography or EMGElectromyography (EMG) is a test that checks the health of the muscles and the nerves that control the muscles.ImageRead Article Now Book Mark Article Electrical test of nerve conduction Nerve conductionNerve conduction velocity (NCV) is a test to see how fast electrical signals move through a nerve. This test is done along with electromyography (EM...ImageRead Article Now Book Mark Article Nerve tissue biopsyNerve tissue biopsyA nerve biopsy is the removal of a small piece of a nerve for examination.ImageRead Article Now Book Mark Article Treatment For most metabolic neuropathies, the best treatment is to correct the metabolic problem.Vitamin deficiencies are treated with diet or with vitamins by mouth or by injection. Abnormal blood sugar level or thyroid function may need medicines to correct the problem. For alcoholic neuropathy, the best treatment is to stop drinking alcohol.In some cases, pain is treated with medicines that reduce abnormal pain signals from the nerves. In some cases, lotions, creams, or medicated patches can provide relief.Weakness is often treated with physical therapy. You may need to learn how to use a cane or walker if your balance is affected. You may need special ankle braces to help you walk better. Support Groups These groups can provide more information on neuropathy:Neuropathy Action Foundation -- www.neuropathyaction.org The Foundation for Peripheral Neuropathy -- www.foundationforpn.org Outlook (Prognosis) The outlook mainly depends on the cause of the disorder. In some cases, the problem can easily be treated. In other cases, the metabolic problem cannot be controlled, and nerves may continue to become damaged. Possible Complications Complications that may result include:Deformity Injury to feet Numbness or weakness Pain Trouble walking and falls Prevention Maintaining a healthy lifestyle can reduce the risk for neuropathy.Avoid excess alcohol use. Eat a balanced diet. Quit smoking. Visit your provider regularly to find metabolic disorders before neuropathy develops. If you have neuropathy in your feet, a foot doctor (podiatrist) can teach you how to inspect your feet for signs of injury and infection. Proper fitting shoes can lessen the chance of skin breakdown in sensitive areas of the feet.Open ReferencesReferencesGoodman BP. Neurologic manifestations of nutritional disorders. In: Aminoff MJ, Josephson SA, eds. Aminoff's Neurology and General Medicine. 6th ed. Cambridge, MA: Elsevier; 2021:chap 15.Katirji B. Disorders of peripheral nerves. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 106.Ralph JW, Aminoff MJ. Neuromuscular complications of general medical disorders. In: Aminoff MJ, Josephson SA, eds. Aminoff's Neurology and General Medicine. 6th ed. Cambridge, MA: Elsevier; 2021:chap 60.Smith AG, Shy ME. Peripheral neuropathies. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 388.AllVideoImagesTogCentral nervous system and peripheral nervous system - illustration The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.Central nervous system and peripheral nervous systemillustrationSuperficial anterior muscles - illustration Superficial muscles are close to the surface of the skin. Muscles which lie closer to bone or internal organs are called deep muscles.Superficial anterior musclesillustrationDeep anterior muscles - illustration Muscle tissue is composed primarily of contractile cells. Contractile cells have the ability to produce movement.Deep anterior musclesillustrationCentral nervous system and peripheral nervous system - illustration The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.Central nervous system and peripheral nervous systemillustrationSuperficial anterior muscles - illustration Superficial muscles are close to the surface of the skin. Muscles which lie closer to bone or internal organs are called deep muscles.Superficial anterior musclesillustrationDeep anterior muscles - illustration Muscle tissue is composed primarily of contractile cells. Contractile cells have the ability to produce movement.Deep anterior musclesillustrationRelated Information Review Date: 12/31/2023 Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. 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Metabolic neuropathiesNeuropathy - metabolicMetabolic neuropathies are nerve disorders that occur with diseases that disrupt the chemical processes in the body. Causes Nerve damage can be caused by many different things. Metabolic neuropathy may be caused by:A problem with the body's ability to use energy, often due to a lack of enough nutrients (nutritional deficiency) Dangerous substances (toxins) that build up in the body Diabetes is one of the most common causes of metabolic neuropathies. People who are at the highest risk for nerve damage (diabetic neuropathy) from diabetes include those who have:Diabetic neuropathyNerve damage that occurs in people with diabetes is called diabetic neuropathy. This condition is a complication of diabetes.ImageRead Article Now Book Mark Article Damage to the kidneys or eyes Poorly controlled blood sugar The longer one has diabetes, the more likely they are to get neuropathyOther common causes of metabolic neuropathies include: Alcohol use disorder (alcoholic neuropathy) Alcoholic neuropathyAlcoholic neuropathy is damage to the nerves that results from excessive drinking of alcohol.ImageRead Article Now Book Mark Article Low blood sugar (hypoglycemia) HypoglycemiaLow blood sugar is a condition that occurs when the body's blood sugar (glucose) decreases and is too low. Blood sugar below 70 mg/dL (3. 9 mmol/L) i...ImageRead Article Now Book Mark Article Kidney failure Inherited conditions, such as porphyria PorphyriaPorphyrias are a group of rare inherited disorders. An important part of hemoglobin, called heme, is not made properly. Hemoglobin is a protein in ...ImageRead Article Now Book Mark Article Severe infection throughout the body (sepsis) SepsisSepsis is an illness in which the body has a severe, inflammatory response to bacteria or other germs.ImageRead Article Now Book Mark Article Thyroid disease Liver disease Vitamin deficiencies (including vitamins B12, B6, E, and B1) B12Vitamin B12 is a water-soluble vitamin. Water-soluble vitamins dissolve in water. After the body uses these vitamins, leftover amounts leave the bo...ImageRead Article Now Book Mark Article B6Vitamin B6 is a water-soluble vitamin. Water-soluble vitamins dissolve in water so the body cannot store them. Leftover amounts of the vitamin leav...ImageRead Article Now Book Mark Article EVitamin E is a fat-soluble vitamin. Your body stores vitamin E in fatty tissue and the liver.ImageRead Article Now Book Mark Article B1Thiamin is one of the B vitamins. The B vitamins are a group of water-soluble vitamins that are part of many of the chemical reactions in the body....ImageRead Article Now Book Mark Article Some metabolic disorders are passed down through families (inherited), while others develop due to various diseases. Symptoms These symptoms occur because nerves cannot send proper signals to and from your brain:Difficulty feeling in any area of the body Difficulty using the arms or hands Difficulty using the legs or feet Difficulty walking Pain, burning feeling, a pins and needles feeling or shooting pains in any area of the body (nerve pain) Weakness in the face, arms, legs, or other areas of the body Dysautonomia, which affects the autonomic (involuntary) nervous system, resulting in symptoms such as rapid heart rate, exercise intolerance, low blood pressure when standing, abnormal sweat patterns, stomach problems, abnormal functioning of the pupils of the eye, and poor erectionThese symptoms often start in the toes and feet and move up the legs, eventually affecting the hands and arms. Exams and Tests Your health care provider will examine you and ask about your symptoms.Tests that may be ordered include:Blood and urine tests Electrical test of the muscles (electromyography or EMG) Electromyography or EMGElectromyography (EMG) is a test that checks the health of the muscles and the nerves that control the muscles.ImageRead Article Now Book Mark Article Electrical test of nerve conduction Nerve conductionNerve conduction velocity (NCV) is a test to see how fast electrical signals move through a nerve. This test is done along with electromyography (EM...ImageRead Article Now Book Mark Article Nerve tissue biopsyNerve tissue biopsyA nerve biopsy is the removal of a small piece of a nerve for examination.ImageRead Article Now Book Mark Article Treatment For most metabolic neuropathies, the best treatment is to correct the metabolic problem.Vitamin deficiencies are treated with diet or with vitamins by mouth or by injection. Abnormal blood sugar level or thyroid function may need medicines to correct the problem. For alcoholic neuropathy, the best treatment is to stop drinking alcohol.In some cases, pain is treated with medicines that reduce abnormal pain signals from the nerves. In some cases, lotions, creams, or medicated patches can provide relief.Weakness is often treated with physical therapy. You may need to learn how to use a cane or walker if your balance is affected. You may need special ankle braces to help you walk better. Support Groups These groups can provide more information on neuropathy:Neuropathy Action Foundation -- www.neuropathyaction.org The Foundation for Peripheral Neuropathy -- www.foundationforpn.org Outlook (Prognosis) The outlook mainly depends on the cause of the disorder. In some cases, the problem can easily be treated. In other cases, the metabolic problem cannot be controlled, and nerves may continue to become damaged. Possible Complications Complications that may result include:Deformity Injury to feet Numbness or weakness Pain Trouble walking and falls Prevention Maintaining a healthy lifestyle can reduce the risk for neuropathy.Avoid excess alcohol use. Eat a balanced diet. Quit smoking. Visit your provider regularly to find metabolic disorders before neuropathy develops. If you have neuropathy in your feet, a foot doctor (podiatrist) can teach you how to inspect your feet for signs of injury and infection. Proper fitting shoes can lessen the chance of skin breakdown in sensitive areas of the feet.Open ReferencesReferencesGoodman BP. Neurologic manifestations of nutritional disorders. In: Aminoff MJ, Josephson SA, eds. Aminoff's Neurology and General Medicine. 6th ed. Cambridge, MA: Elsevier; 2021:chap 15.Katirji B. Disorders of peripheral nerves. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 106.Ralph JW, Aminoff MJ. Neuromuscular complications of general medical disorders. In: Aminoff MJ, Josephson SA, eds. Aminoff's Neurology and General Medicine. 6th ed. Cambridge, MA: Elsevier; 2021:chap 60.Smith AG, Shy ME. Peripheral neuropathies. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 388.