Living With Small Fiber Neuropathy

Living With Small Fiber Neuropathy

Millions of Americans suffer from a bizarre complex of symptoms involving widespread chronic pain, tingling and numbness, issues in their G.I. track (such as constipation), dry eyes, or bladder problems. Often, they are diagnosed with fibromyalgia or peripheral neuropathy without being informed as to the causes of these health issues. Commonly prescribed drugs given for treatment include ones like Cymbalta, Lyrica, or Gabapentin. However, the underlying cause of your disorders are not corrected with these drugs. Plus, there is the very real risk of severe side effects. However, new research has uncovered the one cause of these various disorders, and it is actually small fiber sensory neuropathy (SFSN).

living with small fiber neuropathy

The Symptoms of Small Fiber Neuropathy

The first signs of small fiber sensory neuropathy disorder begin with tingling and numbness, which, over time can escalate to more widespread pain, such as burning, itching, stinging, aching, or a jolting shock-like feeling. Normal stimulating sensations can also cause a flare of these symptoms; for example, a woven shirt could cause an area on your chest to feel as if it were being poked with needles. These symptoms can occur at any location of the body, including your face or mouth.

In addition to these uncomfortable sensations, SFSN can affect your autonomic nervous system. The autonomic nervous system is responsible for regulating your blood pressure, heart rate, sexual function, and mucous membranes. Small fiber neuropathy of the autonomic nervous system can also cause additional symptoms, such as dizziness, dry mouth and eyes, G.I. tract complications, and even skin discoloration. Since the symptoms are so broad, they are often dismissed by doctors. This might lead you to believe that it is all just in your head. However, it is not--the symptoms are genuine. It’s all caused by your small fiber sensory nerves. It just needs to be adequately diagnosed and treated.

living with small fiber neuropathy

The Diagnosis of Small Fiber Neuropathy

Many people experiencing SFSN have under gone multiple tests only to have their results come back as inconclusive. This can be very aggravating because their symptoms continue to go untreated. Often, neurologists have "ruled out” peripheral neuropathy as the culprit behind the symptoms. But, the tests they perform are only for large fiber neuropathy, which completely misses any small fiber sensory neuropathy. Usually the test for small fiber sensory neuropathy is a painless minute skin-punch test that is evaluated by the lab for disruption to the small nerves.

living with small fiber neuropathy

What Are the Causes of Small Fiber Sensory Neuropathy, and How Is It Treated?

The most common cause of SFSN is high blood glucose spiking after a meal. This happens with insulin resistance and pre-diabetes, well before diabetes is diagnosed. It is possible that when tested your fasting blood glucose is found to be normal. But research illustrates that individuals afflicted by SFSN will tend to have normal fasting blood levels but show a dramatic spike in insulin and blood glucose levels after eating a meal.

If this post-meal glucose spiking persists over time, the small fiber peripheral nerves can start to be damaged. Conducting a glucose and insulin tolerance test can help determine if these spikes are occurring. Also, a hemoglobin-1C serum test is a method to detect the occurrence of glucose spikes over time.

The next most common cause is a nutrient deficiency, specifically vitamins B6, B12, D3, and folate. Most doctors will test for suspected deficiency with a serum B12. However, this is not enough. You need more accurate testing and treatment. For example, for a B12 deficiency, a better lab test would be serum homocysteine and methylmalonic acid levels. Testing for other additional deficiencies and using targeted natural remedies is vital.

The third most common cause is due to autoimmune disorders that are attacking the peripheral nerves. There are many cases where this cause is overlooked due to a lack of proper screening. If this is the situation, then you need to visit a doctor who specializes in treating autoimmune diseases with a more natural approach. It is important to treat the underlying causes of autoimmune activation, such as a "leaky gut".

It is possible for small fiber sensory neuropathy to be reversed, as long as the underlying cause is discovered by a doctor who specializes in treating such condition. The treatment to reverse involves a comprehensive holistic approach.

There is much more information regarding SFSN and how to treat it, all of which can be discussed in a free consultation at my clinic or one of my FREE workshops—see the events link on the website – Learn how you can get your life back. Many others have done it and so can you! You have nothing to lose but the pain!

About Dr. Greg Fors

Dr. Fors is a 1982 graduate of Northwestern College of Chiropractic, a Board-certified Neurologist (IBCN); nationally certified in acupuncture and certified in Applied Herbal Sciences (NWHSU). He is a recognized expert in the field of chronic pain and brain health lecturing internationally to doctors on a variety of subjects including small fiber neuropathy, chronic pain disorders, autism, ADHD, depression, and neurodegenerative disorders such as Alzheimer's. His clinical experience includes many years of teaching and successfully treating a wide variety of complaints by utilizing alternative therapies.


  1. Judy Rousseau on May 16, 2019 at 9:47 am

    I have recently been diagnosed with neuropathy. One neurologist prescribed gabapentin, but the next neurologist took me off that and suggested a Lidocaine gel. Either seems to make a difference, I am also taking B1 and B12, since they were both low. Would be interested in talking to you to see if there’s more I can do.

  2. Kim Foushée on December 23, 2019 at 10:33 am

    I have Lyme disease and mycotoxin illness. After a 25 minute FSM session, I developed full body neuropathy and full body Allodynia. Is there any way to reverse this? I’m treating for Lyme, but the SFN and Allodynia isn’t improving. I also have sore areas under my skin now where I believe the microcurrent traveled.

  3. Amanda Beatty Sorrow on November 21, 2020 at 2:01 pm

    I was diagnosed with a large fast growing schwannoma brain tumor, cranial nerve 5 in 09. Craniotomy and radiation all done at Emory in Atlanta GA. I deal with Trigeminal Neuralgia Type 2, and had a deep brain stim and facial stim. Both have been removed. In April of 2020 The small fiber neuropathy began. It is hell. Daily. Hell. I’m on pregabalin. But the only thing that helps is my Ativan I have for organic anxiety. I was low in B. Supplementing. Stomach ulcer, Barretts, gastritis. I cannot eat meals during the day for years bc I couldn’t function after I ate. Any help or guidance greatly appreciated.

  4. Sheena on June 14, 2021 at 2:01 pm

    I have been diagnosed with SFSN about 3yrs ago. They said mine was idiopathic. They also diagnosed me before that (11yrs ago) with fibromyalgia. I have tried lots of meds. and have difficulty on some like Lyrica and Gabapentin. Over the pass year my symptoms of with have gotten worse. I became vegan, stopped smoking and cut out as much stress a person can. Is there any advice or help you can give?

  5. Kelly on December 6, 2021 at 3:07 pm

    I finally was diagnosed with snf. I was having problems with it spreading up to my legs. Of course my primary Dr. didn’t listen. So, I switched Drs..I found out that my blood flow was not what it should be. I have intercistal cystitis, fibromyalgia. Plus the Drs. Office lost my neurologist record’s and other specialist.I thought well I’m going to start all over.I have been suffering since June of 2020,with the feet pain.Its hell on Earth.I just found out that I am diabetic.I am really not getting any thing to help me with the horrible pain.Neurotin 800 qid
    It really doesn’t help.I can barely walk.No sleep.Plus your up with the IC voiding.Then you have to plan if you can leave your home because of UC or’s a domino affect.They stop my normal drug formula.I have blurry vision.The need to get their heads together.If the Drs.would just speak to each other and communicate.Todat they don’t have the time.I found a great neurologist.It was a slow long process.Again I got my diagnoses.Have faith Help is out there…Kelly

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