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Peripheral Neuropathy
Neuropathy is nerves starved of fuel, blood flow, or protection. We look upstream at blood sugar, B12, toxins, autoimmunity, and inflammation, then retrain the brain.
What you may be noticing
Your feet burn at night or feel like they are wrapped in cotton. Tingling creeps up from the toes. You feel less sure on uneven ground and may not notice a pebble in your shoe. Sheets brushing your skin can hurt. Some days the sensations change with meals. You may have been told that neuropathy only moves in one direction.
Why it is rarely one thing
Peripheral neuropathy is not a single disease. It is a final common outcome of many injuries to the longest, most energy-demanding nerves in your body. Those nerves depend on steady blood flow, stable blood sugar, specific vitamins, and a healthy myelin coating. When any of these falter, the farthest ends, the feet and then the hands, signal first.
Many people are told the cause is unknown. Very often, it has not been looked for comprehensively. Toxic burden deserves a place in that search: metals, solvents, alcohol, and certain medications all add to the same bucket.
Neuropathy also changes the brain. As the feet send weaker or distorted signals, the brain maps them less clearly. Balance worsens, and pain can become amplified centrally. So recovery involves both the nerve and the brain that reads it.
Patterns we look for
- Blood sugar and insulin. Diabetes and prediabetes are leading causes, and nerve changes can begin before diabetes is diagnosed.
- Vitamin B12 status, including methylmalonic acid, a more sensitive marker than B12 alone.
- Other nutrients: B1, B6 (both deficiency and excess), folate, copper, and vitamin E.
- Thyroid function.
- Autoimmune and inflammatory patterns, including celiac disease and Sjogren syndrome.
- Toxic burden: alcohol, heavy metals, solvents, and certain medications such as some chemotherapy agents.
- Small fiber neuropathy, which can cause burning pain and autonomic symptoms with normal standard nerve tests.
- Autonomic and meal-related patterns: blood pressure, glucose, and electrolytes around eating.
- Mitochondrial function and circulation in the nerve.
- Spinal causes: nerve root compression in the low back or neck.
How I evaluate it
A comprehensive functional neurological exam maps vibration, position sense, temperature and light touch, reflexes, strength, and balance. It distinguishes peripheral patterns from spinal or central patterns and shows how much your balance has adapted.
Functional labs may include fasting glucose, insulin, and HbA1c, B12 with methylmalonic acid and homocysteine, B6 and B1, a thyroid panel, inflammatory and autoimmune markers, celiac screening, and heavy metal testing when history suggests exposure. When symptoms shift with meals, I also check lying-to-standing vitals and glucose behavior around eating. Referral for nerve conduction studies or a skin biopsy for small fiber neuropathy is arranged when needed.
Seek urgent care for rapidly spreading weakness, numbness rising up the legs over days, or loss of bladder or bowel control.
How we address it
- Identify and remove the driver: blood sugar, nutrient gaps, toxins, or immune activity.
- Open drainage pathways before any detoxification, then lower toxic burden at a pace your body tolerates.
- Restore circulation and microvascular health with movement and targeted nutrition.
- Support nerve energy and myelin with categories of mitochondrial and B vitamin support matched to your labs, and calm inflammation.
- Retrain the brain with sensory re-patterning (gentle tapping and brushing, controlled joint circles, and eye tracking), balance work, and vibration-based rehabilitation that sharpens its map of your feet and hands.
Nerves respond to the conditions around them. Improve the conditions, and the signal can grow clearer.
Book your Comprehensive Functional Medicine Eval/Neurological Exam today to discover what the contributing root causes are that are underlying your health concerns.