In 2020, 10% of persons over the age of 12 had alcohol use disorder in the United States. Characterized by excessive alcohol consumption, this condition contributes to various problems. These include chronic disease, injury, violence, economic burden, job loss, and death.
In some cases, alcohol abuse leads to disease through the destruction of tissues. Specifically, when nerve cells are destroyed, a condition called alcoholic neuropathy occurs. This consequence of abusing alcohol results in a painful, crippling condition.
What is Alcoholic Neuropathy?
Alcoholic neuropathy (or alcoholic-related neuropathy) happens when nerve cells become damaged due to alcohol abuse. Studies have estimated that up to 66% of chronic drinkers have alcoholic neuropathy. Classic symptoms involve pain in the extremities that can progress to life-threatening impairment.
The specific causes of alcoholic neuropathy are unclear. However, research has revealed certain risk factors and potential contributing factors.
Risk Factors
A literature review of over eighty studies conducted on humans related to alcoholic neuropathy identified several risk factors.
The risk factors associated with the condition include:
• Alcohol Consumption – Higher rates of neuropathy were observed among continuous drinkers (those who drank almost daily) and frequent heavy drinkers (those who drank more than three times/week). In addition, duration of use was significant in that symptoms were evident after a relatively brief period. However, severe neuropathy was seen after ten years or more.
• Sex – Some studies showed that males are at higher risk than females. But females may be at higher risk for more severe diseases, and males may have milder cases.
• Genetics – Although a clear genetic link has not been established, research showed that persons who abused alcohol and had neuropathy were more likely to have a parental history of alcoholism.
• Alcohol Type – One study showed wine drinkers scored worse on nerve conduction studies than those who drank only beer or other alcohol. This may be due to wine drinkers consuming more ethanol or the impurities of wine.
Diagnosis & Symptoms
Confirming that someone has alcoholic neuropathy may begin with a physical examination. Tests to assess for vitamin/mineral deficiency and other body function tests, including nerve health assessments.
Diagnosis
After performing an exam and evaluating the patient’s symptoms, the following tests may be administered:
• Vitamin & Mineral Deficiency Tests – These tests help to screen for various vitamin B deficiencies, which may be prevalent in someone with alcoholic neuropathy.
• Body Function & Nerve Tests – An EMG (electromyography) test examines muscle and nerve health. In addition, other organ and system tests may be performed to assess overall body function. A nerve biopsy may also be completed.
Symptom Progression
Three main types of nerves – motor, sensory, and autonomic – are involved in alcoholic neuropathy. Sensory nerves send sensory information from the extremities to the brain and spine. Motor nerves use data from the brain and spine to tell the muscles how to perform. And autonomic nerves are involved in other involuntary functions like regulating heart rate and blood pressure.
Alcoholic neuropathy progresses slowly over months or years and becomes more severe over time. Symptoms may start with sensory pain in the hands, legs, and feet; then, motor symptoms may develop.
Here is a listing of some of the common signs and symptoms:
• Burning pain
• Numbness
• Loss of balance
• Loss of coordination
• Difficulty walking
• Difficulty swallowing
• Muscle cramps, spasms, twitches
• Muscle weakness
• Incontinence
• Impotence
• Constipation
• Diarrhea
Causes
It is uncertain whether direct alcohol consumption or secondary variables associated with heavy drinking are responsible for alcoholic neuropathy. It is true that possible contributing factors have been identified. However, how they interact and how each affects the nervous system complicates defining a causal relationship. However, some of the recognized variables are indicated below:
• Alcohol Toxicity – Due to the positive relationship between severity of neuropathy and total lifetime dose of ethanol, direct toxicity is implicated as a probable cause.
• Nutritional Deficiency – Persons who consume excessive amounts of alcohol generally lack essential nutrients or have poor absorption of nutrients due to insufficient diet. Inadequate nutrition can diminish nerve health. Specifically, thiamine deficiency is a likely contributor, as ethanol negatively affects thiamine function.
• Oxidative Stress – Alcohol consumption can cause oxidative stress, leading to nerve damage.
How Alcohol Interferes with Nerve Health
Ethanol is the substance in alcoholic drinks that causes intoxication. When consumed in excess, it can also be responsible for injury to the body. Below are some of the harms caused by ethanol:
• Toxicity – Ethanol taxes the body’s filtration system. It acts as a direct and indirect toxin by damaging nerve cells and changing neurons, negatively impacting nerve health.
• Vitamin & Mineral Deficiency – Ethanol adversely affects how the body can absorb, store, and use essential nutrients, including B vitamins.
• Oxidative Stress – Ethanol interferes with the body’s ability to combat free radicals, which leads to tissue damage.
• Chronic Inflammation – Excessive drinking creates an environment where an overactive immune system attacks healthy tissues causing damage.
Treatments for Alcoholic Neuropathy
Treating alcoholic neuropathy can be difficult as most methods do not completely resolve neuropathy. But the treatment focuses on stopping further nerve damage and restoring existing damage. However, less severe cases offer the greatest promise for full restoration, so getting help early is key. Here are some approaches for healing nerve damage that is informed by research:
• Abstinence – Seeking professional treatment to stop drinking is recommended. When alcohol consumption is discontinued and a normal diet is resumed, improvements are seen, but neuropathy may not completely resolve. Once addiction has been addressed, efforts can be focused on other areas. Such as controlling symptoms, preventing injury, and improving quality of life.
• Supplementation – Supplementation with B vitamins has shown positive outcomes in those with alcoholic neuropathy. However, taking vitamins while continuing to use alcohol is not beneficial. Additional supplements that may be useful are alpha-lipoic acid, acetyl -L-carnitine, vitamin E, myo-inositol, amino acids, zinc, omega-3 fatty acids, magnesium, curcumin, and glutathione.
• Topical Application – Animal and human studies have shown that applying capsaicin C cream delivered positive results for treating neuropathy. But the treatment’s effectiveness needs to be explicitly evaluated for alcoholic neuropathy.
• Drug Therapies – Antidepressants and anticonvulsants may be useful for pain relief in other types of neuropathies. Therefore, they may help with alcoholic neuropathy. There is a concern, however, that these drugs only provide symptom relief and may pose a danger of addiction.
• Address Chronic Inflammation – By participating in regular exercise, consuming an anti-inflammatory diet, minimizing environmental toxins, and engaging in activities to mitigate stress, such as yoga, meditation, and prayer, can help to reduce inflammation.
Getting Help for Alcoholic Neuropathy
New Method Wellness is a treatment facility that offers a holistic approach to care. This whole-person focus is vital for addressing the many facets of alcoholic neuropathy. Contact us to learn more about how excessive alcohol use affects the body and how our program can help.
