The Painful, Potentially Permanent Reality of Alcoholic Polyneuropathy

What is alcoholic polyneuropathy? “Neuropathy” describes when one of your peripheral nerves—those that branch off your spine to different parts of the body, like your arms and legs—is damaged.1 “Polyneuropathy” means multiple peripheral nerves are malfunctioning at the same time. Alcoholic polyneuropathy occurs when excessive drinking leads to the nerve damage.

Does Alcohol Cause Polyneuropathy?

Studies show that 25-66% of chronic alcohol users have neuropathy.2  This research indicates that alcohol misuse is a significant risk factor for developing nerve damage, including alcoholic polyneuropathy.

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How much do you have to drink to get alcoholic polyneuropathy? That is a difficult question to answer since the exact cause of the disease is not clear. Research suggests two primary possible causes: 1) alcohol itself may damage the nerves or 2) alcohol misuse may lead to malnutrition, making you more vulnerable to nerve damage.

Nerve Damage

Research suggests the possibility that alcohol is directly toxic to your nerves. Alcohol is quickly absorbed into tissues all over your body and may potentially damage your liver, central and peripheral nervous systems, and cardiac muscles. 2

Malnutrition

Some researchers believe the connection between alcohol misuse and poor nutrition may lead to alcoholic polyneuropathy.

Alcohol impairs the absorption of thiamine (vitamin B1), and other vitamins, in your intestine. Vitamin deficiencies, especially thiamine, have been linked to developing alcoholic polyneuropathy.

The central nervous system has the blood-brain barrier to defend against the toxic influences of alcohol for some time, but the peripheral nervous system lacks such a protective barrier.2

Who Is at Risk?

Studies show that a few factors are associated with an elevated risk of developing alcoholic neuropathy. These factors include if you:2

  • Are malnourished, specifically if you have a thiamine deficiency
  • Experience the direct toxicity of alcohol
  • Have a family history of alcohol misuse and/or a family history of neuropathy, which can have genetic factors
  • Have used large amounts of alcohol chronically for a long period of time

Studies have also found that two groups of people show a higher rate of alcoholic neuropathy than others.

Women

Studies have also found that two groups of people show a higher rate of alcoholic neuropathy than others. Women have a higher occurrence of diagnosed polyneuropathy.2

Research has not found a cause for this, however, gendered differences in medical conditions can occur for many reasons. For example, if more women seek treatment on average for nerve issues than men, it may appear that more women have the condition because men are not reporting the symptoms to their doctors.

Heavy Drinkers

Frequent, heavy drinkers also develop neuropathy more often than occasional drinkers.2  Researchers believe this is due to the potential direct nerve damage or malnutrition causing nerve damage related to chronic alcohol misuse.

The Centers for Disease Control and Prevention (CDC) defines heavy drinking as 15 drinks or more per week for men and 8 drinks or more per week for women.3

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What Are the Symptoms of Alcoholic Polyneuropathy?

You may be wondering at what age does alcoholic polyneuropathy start, and what does the progression of the disease look like? The symptoms can show up at any age but usually the progression is gradual. You may experience a sudden onset of symptoms, but most likely, you will notice signs after years of heavy alcohol use.

The beginning stages of polyneuropathy are often described as “sporadic feelings of pain or numbness.”

Over time your symptoms will probably grow stronger and more consistent. Alcoholic polyneuropathy symptoms vary, but may include:4

  • Losing feelings in your legs and arms
  • Feeling sensations like “pins and needles” in your feet or legs, hands or arms
  • Intense pain
  • Muscle weakness, cramps, or spasms, which could be related to a secondary condition such as alcoholic myopathy
  • Heat intolerance
  • Impotence
  • Constipation or diarrhea
  • Urination problems
  • Stomach issues, including nausea or vomiting
  • Problems with the throat, including swallowing or talking
  • Feeling unsteady when walking
  • Bruises, cuts, sores, or skin infections on the toes, feet, or fingers
  • Dizziness or lightheadedness

How Is Alcoholic Polyneuropathy Diagnosed?

If you experience alcoholic polyneuropathy symptoms, ask your doctor to do some exams to determine if you have alcoholic neuropathy. Your doctor may run blood tests to check for a deficiency in vitamins and minerals caused by alcohol misuse.

Common lab tests include:4

  • Thiamine, also known as vitamin B1
  • Pyridoxine, also known as vitamin B6
  • Pantothenic acid and biotin
  • Vitamin B12
  • Folic acid
  • Niacin, also known as vitamin B3
  • Vitamin A

Your doctor may order an electromyography (EMG) nerve test that measures your muscle’s response to nerve stimulation. During this test, the electrical activity in your nerves is measured by stimulating areas of concern. You may be asked to move your arms or legs during the test to provide additional information on how your muscles and nerves are responding.

How Is Alcoholic Polyneuropathy Treated?

Alcoholic polyneuropathy can improve with some treatments, although damage already done to your nerves may be irreversible.

The main thing you can do to stop progression of any alcohol-related nerve damage, including alcoholic polyneuropathy symptoms, is to stop using alcohol.

You can find alcohol rehab treatment centers that will help with the detox process and provide ongoing care for your substance misuse.

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In addition to becoming abstinent from alcohol, many doctors recommend nutritional education and supplements to ensure you are not deficient in vitamin B12, folate, vitamin E, and thiamine.5

Your treatment plan may include:4

  • Physical therapy and orthopedic appliances to help with muscle function
  • Pain management through medication
  • Medication to treat alcohol cravings or withdrawal symptoms associated with alcohol use
  • Compression stockings or medicines to aid in dizziness
  • Intermittent catheterization or medicines to help with bladder problems
  • Psychotherapy as part of alcohol addiction treatment

You may require medical professionals to help care for you at home if you have advanced nerve damage. Some of the things they may assist you with are:

  • Assessing the results of your treatments along with your pain and function levels
  • Helping reduce the risk of injury due to loss of sensations (e.g., burns or pressure sores)
  • Assisting you in using mobility equipment
  • Providing nutrition and condition-related education
  • Making adjustments to medications or other parts of your treatment plan

How Do You Prevent Alcoholic Polyneuropathy?

The best way to prevent all alcohol-related nerve damage, including alcoholic polyneuropathy symptoms, is to avoid excessive use of alcohol.

If you have difficulty controlling how often or how much alcohol you drink, schedule a screening for alcohol addiction with your doctor or a mental health provider.

There are treatment options available to help you. Call 800-839-1686Who Answers? to speak to a specialist about alcohol addiction treatment options.

Resources

  1. National Institute of Child Health and Human Development. (2018, October 01). What are the parts of the nervous system?.
  2. Chopra, K. & Tiwari, V. (2012). Alcoholic neuropathy: possible mechanisms and future treatment possibilities. British journal of clinical pharmacology, 73(3), 348–362.
  3. Center for Disease Control and Prevention. (2021, February 16). Alcohol and Public Health.
  4. U.S. National Library of Medicine. (2022, February 18). Alcoholic neuropathy. MedlinePlus.
  5. Zeng, L., Alongkronrusmee, D., & van Rijn, R.M. (2017, January 20). An integrated perspective on diabetic, alcoholic, and drug-induced neuropathy, etiology, and treatment in the US. Journals of Pain Research, 2017(10), 219-228.

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