Neuropathy questions, answered
What causes neuropathy if it's not diabetes?
By Dr. Jill Althoff, DC, founder of Althoff Wellness Clinic in Cheyenne, Wyoming. In practice since 2003 and author of two books on neuropathy.Short answer
Diabetes is a common contributor to peripheral neuropathy, but it is rarely the whole story, and many people with neuropathy don't have diabetes at all. Poor circulation, body-wide inflammation, gut and nutrition problems, certain medications, and blood sugar swings below the diabetes range can all play a part. Most of the time it is several of these together, which is why a thorough evaluation matters.
Diabetes is a piece, not the whole puzzle
I see a lot of people with diabetes who have neuropathy, so it is absolutely a big contributor. But in my experience, diabetes is usually one piece of what's happening, not the one thing that caused it. It's more like a perfect storm: a few problems stack up until the nerves can't keep up.
The other causes I see most often
- Circulation. Nerves need a steady supply of blood, oxygen, and nutrients. When circulation to the feet and legs is poor, the nerves suffer. This is one of the biggest pieces I look at.
- Inflammation throughout the body. Ongoing inflammation makes it harder for nerves to heal. One source I look at closely is gut health. When the gut isn't working well, it can feed inflammation and keep the body from absorbing the nutrients nerves need.
- Blood sugar swings, even in people who have never been told they have diabetes.
- Medications, past illnesses, and surgeries. Some medications are known to affect nerves, and some people's symptoms start after an illness or procedure.
- Nutrient problems, when the body isn't getting or absorbing what nerves need to repair.
"They told me it's idiopathic"
Many of my patients have been told their neuropathy is idiopathic. That word simply means the cause is unknown. It confirms you have neuropathy, but it doesn't tell you why. In my experience, there is usually more to find when you look at the whole person.
Why one cause is rarely the answer
Most people don't have neuropathy for just one reason. That's why our process is so thorough: detailed paperwork before your first visit, a long conversation about your history, and an exam that looks at circulation, nerve function, and balance. The goal is to find all of the pieces, not just the most obvious one. You can read more about what happens at a neuropathy evaluation.
When to see your medical doctor
Numbness that comes on suddenly, weakness, symptoms on only one side of the body, or a foot wound that isn't healing all need prompt medical attention. We work alongside your physician.
More from Dr. A on neuropathy
This page is educational and is not a substitute for medical advice. Individual results vary.