Alcoholic Neuropathy

What is Alcoholic Neuropathy?

Alcoholic neuropathy is damage to the nerves that results from excessive drinking of alcohol. The exact number of people affected by this condition is not known, but studies have shown that up to 66% of patients with chronic alcohol use disorder may have some form of the disease. The cause is multifactorial, from both nutritional deficiencies and alcohol metabolism’s direct toxic effects on neurons.

Because of the diverse effects of alcohol on the body, these patients should be managed by an interprofessional team. The management of alcoholic neuropathy is not satisfactory. The treatment rests on abstinence from alcohol and the replacement of key nutrients. Unfortunately, patient compliance is poor and the condition often progresses leading to poor quality of life. Even in patients who quit alcohol, residual neuropathy is common.

Alcoholic Neuropathy
Alcoholic Neuropathy is damage to the nerves that results from excessive drinking of alcohol.

Causes of Alcoholic Neuropathy 

In addition to the aforementioned facts, excessive alcohol consumption can cause a variety of malnutrition-based side effects. Alcohol blocks the absorption of vitamins, minerals, and enzymes essential for overall organ and body health.

People struggling with Alcoholism may not maintain healthy diets daily, therefore many advanced alcoholics are extremely malnourished. Even when the person stops drinking, the malnutrition cycles may continue because behaviorally the cycle of proper nutrition has not been adjusted to a restorative level to be recovering the body adequately. 

According to the scientific piece ‘Alcoholic Neuropathy’, Sadowski A, Houck RC., published by, “Studies have shown that up to 66% of patients with chronic alcohol use disorder may have some form of Alcoholic Neuropathy. The cause is multifactorial, from both nutritional deficiencies and alcohol metabolism’s direct toxic effects on neurons”.

Alcoholic Neuropathy
In addition to the aforementioned facts, excessive alcohol consumption can cause a variety of malnutrition-based side effects.

Alcoholic neuropathy generally only develops in those who have drunk excessively. It usually takes years to reach this point. Alcohol consumption may not necessarily directly cause neuropathy, but it can contribute to it. Alcohol abuse has also been associated with some other conditions that have neuropathy as a primary symptom, i.e., alcoholic peripheral neuropathy and diabetic neuropathy. Alcoholic neuropathy is more common among those who drink alcohol excessively.

In another article of the same kind, ‘Alcoholic Neuropathy’, Koike, Haruki, Sobue, Gen., published by Current Opinion in Neurology, this conclusion is reinforced, and in addition, they conclude that the thiamine deficiency represents a common aspect of people suffering from this condition. “Nutritional deficiency, as well as the direct neurotoxic effects of ethanol or its metabolites, can cause alcoholic Neuropathy. Although clinicopathologic features of the pure form of alcoholic Neuropathy are uniform, they show extensive variation when thiamine deficiency is present”.

Alcoholic Peripheral Neuropathy

Your peripheral nerves help your body manage important sensory and motor functions including:

  • Bowel and urinary elimination
  • Walking
  • Sexual arousal
  • Arm and leg movement
  • Speech

Alcoholic neuropathy is the result of damage to these nerves. The damage may be the direct result of long periods where you drank too much alcohol. Nutritional problems linked to alcohol use, such as vitamin deficiency, can also cause nerve damage.

How Much Alcohol Causes Neuropathy

Both the toxicity of alcohol and nutritional deficiencies in those who drink heavily have been linked with the nerve pain in alcoholic neuropathy. Alcoholic neuropathy is one of the most common but least recognizable consequences of heavy alcohol use. People with a long history of alcohol misuse might experience pain, tingling, weakness, numbness, or loss of balance as a result of alcoholic neuropathy.

Alcoholic Neuropathy Symptoms

Alcoholic Neuropathy may start with a tingling, numbness, pain, and weakness often in the hands or feet. However, it may spread to other parts of the body, including legs, arms, and torso. This condition affects sensation, but also can affect the movement of your body once it spreads. Over time, additional symptoms appear and increase in severity.

This discomfort makes it harder to move around or do things, even when sober. “Nerve damage from this condition is usually permanent. Your symptoms are likely to get worse if you don’t stop drinking. This could lead to disability, chronic pain, and damage to your arms and legs. However, if caught early enough, you can minimize the damage from Alcoholic Neuropathy. Avoiding alcohol and improving your diet can sometimes lead to a moderate to full recovery”.

These are the main areas of the body Alcoholic Neuropathy can affect:  

  • Arms and Legs
    • Numbness
    • Tingling and burning
    • Prickly sensations
    • Muscle spasms and cramps
    • Muscle weakness and atrophy
    • Loss of muscle functioning
    • Movement disorders
  • Urinary and Bowel
    • Incontinence
    • Constipation
    • Diarrhea
    • Problems starting urination
    • Feeling that the bladder hasn’t been emptied fully
  • Other
    • Sexual dysfunction
    • Impotence
    • Impaired speech
    • Difficulty swallowing
    • Heat intolerance, particularly following exercise
    • Vomiting and nausea
    • Dizziness or lightheadedness

Diagnosing Alcoholic Neuropathy

To detect this condition, a physician must perform a thorough examination. Also, the patient needs to disclose a detailed and accurate history of any drug or alcohol abuse to get an accurate diagnosis. The doctor will have to discount other potential causes for your symptoms. Tests that may identify other potential causes of neuropathy include:

  • Nerve biopsy
  • Nerve conduction tests
  • Upper GI and small bowel series
  • Neurological examination
  • Electromyography
  • Esophagogastroduodenoscopy (EGD)
  • Kidney, thyroid, and liver function tests
  • Complete blood count (CBC)
Blood Tests Can Also Identify Vitamin Deficiencies That Are Linked To Both Nerve Health And Alcohol Use. Your Physician May Test For The Following Levels:
  • Niacin
  • Thiamine
  • Folate
  • Vitamins B6 and B12
  • Biotin and pantothenic acid
  • Vitamins E and A

Preventing Alcoholic Neuropathy 

It is possible to avoid this condition by:

  • Abstaining from Alcohol use
  • Ceasing drinking if you have any symptoms of neuropathy
  • Seeking professional treatment if you find it hard to avoid alcohol
  • Eating a balanced and healthy diet
  • Taking physician-recommended supplements if needed

Alcoholic Neuropathy Treatment

The most important thing you can do to treat this condition is to stop drinking. Treatment may first focus on problems with alcohol use. For some people, this may require inpatient rehab. Once alcohol use has been addressed, your doctor can focus on the neuropathy itself. Symptom management is important. Nerve damage can also make it difficult for you to carry out the functions of daily life. Nerve damage may even make injuries more likely.

Every person’s needs are different. Treatment for neuropathy may involve one, or many, different types of care. These include:

  • Vitamin supplements to improve nerve health (folate, thiamine, niacin, and vitamins B6, B12, and E)
  • Prescription pain relievers (tricyclic antidepressants and anticonvulsants)
  • Medication for people with problems urinating
  • Physical therapy to help with muscle atrophy
  • Orthopedic appliances to stabilize extremities
  • Safety gear, such as stabilizing footwear, to prevent injuries
  • Special stockings for your legs to prevent dizziness
Alcoholic Neuropathy
The most important thing you can do to treat this condition is to stop drinking. Treatment may first focus on problems with alcohol use. For some people, this may require inpatient rehab.

Treatment should be focused on therapy to stop alcohol abuse. The overall prognosis is favorable. Abstinence for several months up to a few years has shown both clinical examination and electroneurographic improvements, with most patients showing complete regain of function. Additional treatment includes replacing nutrients such as thiamine, vitamin-B12, and folic acid. Psychiatry referral, alcohol abstinence abuse programs, and support groups have shown favorable ways to help patients recover from alcohol use disorder. Physical therapy and occupational therapy can play a role in supporting the patient as they regain movement and perform everyday functions.

Once the alcohol problem has been addressed, treatment goals include:

  • Controlling symptoms
  • Maximizing ability to function independently
  • Preventing injury
  • It is important to supplement the diet with vitamins, including thiamine and folic acid.

Physical therapy and orthopedic appliances (such as splints) may be needed to maintain muscle function and limb position. Medications may be needed to treat pain or uncomfortable sensations. People with alcoholic neuropathy have alcohol use problems. They will be prescribed the smallest dose of medication needed to reduce symptoms. This may help prevent drug dependence and other side effects of chronic use.

The positioning or the use of a bed frame that keeps the covers off the legs may help reduce pain. People with lightheadedness or dizziness when standing up (orthostatic hypotension) may need to try several different treatments before finding one that successfully reduces their symptoms. Treatments that may help include:

  • Wearing compression stockings
  • Eating extra salt
  • Sleeping with the head elevated
  • Using medicines

Bladder problems may be treated with:

  • Manual expression of urine
  • Intermittent catheterization (male or female)
  • Medicines

Impotence, diarrhea, constipation, or other symptoms are treated when necessary. These symptoms often respond poorly to treatment in people with alcoholic neuropathy.

It is important to protect body parts with reduced sensation from injury. This may include:

  • Checking the temperature of bath water to prevent burns
  • Changing footwear
  • Frequently inspecting the feet and shoes to reduce injury caused by pressure or objects in the shoes
  • Guarding the extremities to prevent injury from pressure

Alcohol must be stopped to prevent the damage from getting worse. Alcoholism treatment may include counseling, social support such as Alcoholics Anonymous (AA), or medications.

Reclaim Your Life From Alcoholic Neuropathy

This is a condition you can recover from, as long as it is addressed properly and on time. If you’re suffering from Alcoholic Neuropathy and feel like you just can’t stop drinking, we can offer the support you need. We Level Up Washington can provide you, or someone you love, the tools to treat alcoholism professionally and safely. Feel free to call us to speak with one of our counselors, we can inform you about this condition by giving you relevant information, our specialists know what you are going through. Have in mind that each call is private and confidential.