Brief Answer:
Has your neuropathy been fully worked up as to CAUSE?

Detailed Answer:
Good evening young lady....I am several years your XXXXXXX ...not much...both of us may very well enjoy The Beatles, Led Zeppelin, and even The Eagles and Hotel California...am I right? LOL....I am a neurologist from XXXXXXX Ohio and would like to make several pointed comments about peripheral neuropathy.

First of all, was the diagnosis made with special attention to the gamut of known causes to rule out? I ask this for one reason.....Treating a Cause is so much more rewarding AND EFFECTIVE than treating a symptom. Unfortunately, there are so many more UNKNOWN CAUSES o peripheral neuropathy compared to known ones that the truth is that even after fully working up this entity there is still about an 80-85% chance that we will not know what is causing the problem and be left with having to do our best at treating the symptoms.

Secondly, what dose of gabapentin are you on since the most logical way to treat someone for symptoms of pain with an agent such as gabapentin is to start at a reasonable or standard dose but then, to TITRATE UPWARD over time until either a maximum ceiling is reached by edict of the manufacturer which happens to be somewhere in the neighborhood of 3600mg. daily in divided doses vs. a maximum dose depending upon side effects affecting the patient and intolerability as what happened with Lyrica.

Thirdly, #2 has not been max'ed out just yet then, my suggestion is that you speak to your provider and ask what the plan may be for giving you a schedule to use so that you can be a bit proactive in your care without having to depend on return visits to your PMD which can take weeks to months to accomplish in places where there are constraints on time frames that are required before patients can return to their doctors or how quickly medications can be titrated etc.

Typically, I will titrate gabapentin by 100-300mg. per dose per week looking for the "break even point" for therapy vs. side effects. The standard dose that most patients find helpful for bad peripheral neuropathy is 600-900mg. daily in 2 or 3 divided doses.

As far as trying to diagnose the specifics of what could be causing your neuropathy I believe that as a neurologist I find that detail to be highly overlooked....sometimes even by neurologists themselves. It is a bit tedious, requires more lab testing than many insurance companies or government care systems are willing to pay for, and will definitely require some "heads up" on the physicians' part to be suspicious for certain metabolic processes that could be afoot.

The most commonly looked for causes of neuropathy are:

1. Diabetes mellitus
2. Medication side effects
3. Nutritional deficiencies such as B12, Folate, Vit. D
4. Metabolic disorders such as Disorders of Copper and hemoglobin metabolism
5. Radiation treatments
6. Cancers and other related disorders known as PARANEOPLASTIC DISEASES
7. Hereditary types of problems such as Charcot-Marie-Tooth disease and other genetic types of disorders

I hope you are able to use the above suggestions to your benefit and maybe even in discussion with your primary care doctor.

I hope this answer satisfactorily addresses your question. If so, may I ask your favor of a HIGH STAR RATING with some written feedback?

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