Hello!
I have been diagnosed with small fiber neuropathy possibly due to impaired glucose tolerance (two doctors disagree about that).
The specialist wants me to come in for autonomic sensory testing. Has anyone heard of/experienced it? What are they looking for in conjunction with SFN?
So far I am being treated with Lyrica 300mg and hydrocodone. My feet still feel like they have been through meat grinders . The doctors assure me that it just takes time for the Lyrica to work. (it has been 3 weeks).
thank you!
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ACDF C5-6 Feb 2008
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I have SFN, unkown reasons but I also have pre-diabetes so the neuro decided maybe treating with metformin would help. I am on 1000mg. per day I have not had any relief of the neuropathies at all but my fasting BG has come down alittle, its been a couple of months now. Only good things since metformin for me is I've lost 15 lbs, but when I started the metformin I also was tapering off Lyrica which wasn't doing anything anymore. I take tegretol,celexa,metformin,vicaden,citrac al with D and minerals, ferrious sulfate. This is alot less crap than I used to take. I have Fibro, trigeminal neuralgia, Ibs, SFN, etc. etc. Sorry if I sound alittle sarcastic but I have just had it, I've been to neuro, rheumy,internist, psychologist,opthamologist,now its off to the gastro doc. I have taken nearly every drug you have probabley generally heard of for nerve pain, I have been on every diet, been prescribed every vitamin/mineral thing on the list.
I don't have or didn't have any weight problem until I started Lyrica, and like I said now thats coming off, I follow a low carb diet pretty strictly and have been alittle disappointed that my numbers have not gotten alot better.
I wish you luck, but I have to say, and I don't mean to be a bummer but, relief of your neuropathic pain may not be easy to find. Treating and watching that sugar problem is essential for your long-term health though so please do take care of that.
Hi Beada, we have 3 types of nerves, motor, sensory & autonomic, the autonomic nerves job is to control internal functions like control sweating, blood pressure, blood flow.
Autonomic testing helps determine if someone is suffering from certain diseases that attack the autonomic nervous system, don't worry its a painless proceedure.
There are many reasons for neuropathy, impaired glucose tolerance or prediabetes can certainly be a cause in some people and it can be reversed with low carb diet, exercise and loose any excess weight if any, I wouldn't be taken any notice of that doctor that disagrees
of the possability.
good luck with it anyway.
Hi all,
I have been on lyrica for neuropathy for a while now .Initially I had a good response but that has tapered. Last visit to my RA doc i took a two and a half year old test result of a glucose tol test with insulin levels. He was not concerned that the gluc levels were slightly elevated but he freaked at the high insulin levels. He checked my history and believes that it is a genetic factor. He also believes that compications from insulin resistance are just as deadly as those from diabetes. He did vit and history blood glucose levels to confirm that it was neither diabetes or vitamins out of whack causing my problems. He has written to my gp rec metformin ,low carb low gi diet and an excercise regime in line with my abilities probably water based. He thinks that it is possible some of my neuropathy may be reversed. Given that I have had documented impaired glucose tolerance since my thirtys and I am now 59 I don't expect miracles but control would be nice. Ron.
Ugh, I am so sorry for everyone's pain. I don't think it is easy to for anyone who isn't experiencing it to understand how debilitating it is.
I called the doctor back because it is unbearable. She upped my lyrica by 150. And said if I don't feel better by the autonomic function test (7/21) she will add in tramadol.
Does tramadol do something special for SFN pain? I looked it up and it seems to be weak pain killer. The doctor is being so careful about prescribing it that it made me wonder if it has some special effect on SFN?
I go back to school as a teacher of young students with disabilities at the end of Aug. I really don't know what I am going to do if I don't get some relief.
I have been swimming for exercise and watching my diet. I am on the verge of making a commitment to change my diet in a major way. It is something I have to prepare for mentally..... sounds weird I know...
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ACDF C5-6 Feb 2008
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Hi Beada - I am fairly new to having SFN, so can relate to how scary and confusing it is in the beginning. What I learned from this board and web research is that the pain of neuropathy, including SFN, is quite often treated with a combination of an anticonvulsant drug and a tricylic antidepressant. The Lyrica you are taking is an anticonvulsant and is similar to the Gabapentin I take. Antidepressants are prescribed not because someone is depressed, but because it somehow works on your brain so you don't feel the pain. Gabapentin was the first med I took, but it was hard to tell if it was working because the SFN seemed to be getting worse. Also, when I tried upping the dose of Gabapentin, I was so lethargic and foggy-headed I had to cut back on the dosage. Where I found real pain relief is when I started taking Cymbalta, which is a tricylic antidepressant. I tell you all this to say that now I am pretty much pain free and feel almost normal. Not that I forget I have SFN, because the numbness in my feet and hands is progressing. Just wanted to give you some encouragement that some people with SFN can find meds that work. Mine are working for now, and when they don't I'll try others. I've found other people with SFN on this site who work and control their pain to the extent that they have a good quality of life. Good luck and hope you get that right med combo in time to enjoy your young students. - Ruby
Hi Beada, just weighing in with my thoughts. I have had SFN for over 3 years now. I have rheumatoid arthritis and glucose impairment. I think it is absolutely imperative to get the sugar numbers under control, whether by diet or with the help of medication. I overhauled my diet, strictly controlled my sugar intake and carbohydrates, and lost 25 lbs. I wish I could tell you that my nerve pain lessened right away. But sadly that didn't happen. I struggled to find the right combination of medications that could help me.
You may have to try several medications. I did, until my rheumatologist and my Neurologist both said they felt there wasn't any point in trying anymore meds. I had tried Lyrica, Neurontin, Topomax, Elavil, Tramadol and Cymbalta. I spent so much time getting, filling and discarding prescriptions that I practically lived at the pharmacy. At her wits end with what to do with me, my GP gave me plain codeine and 10 mg of nortriptyline a low dose of a tri-cyclic antidepressant. I feel as if I may have turned a corner now. But don't give up hope please. While you may never be completely free of pain, you will find a combination that works for you!
Keep up with the water work outs too if you can. Working out in water is fantastic! No pressure on the joints.
Come often to these boards. You can ask questions and get honest answers from fellow sufferers. I learned so much from all of the posters here. Or just vent!
But do work on getting the glucose impairment under control!! It is so important for all of your organs!
I wish you all the best. Daisy
Hello!
I have been diagnosed with small fiber neuropathy possibly due to impaired glucose tolerance (two doctors disagree about that).
The specialist wants me to come in for autonomic sensory testing. Has anyone heard of/experienced it? What are they looking for in conjunction with SFN?
So far I am being treated with Lyrica 300mg and hydrocodone. My feet still feel like they have been through meat grinders . The doctors assure me that it just takes time for the Lyrica to work. (it has been 3 weeks).
. The doctors assure me that it just takes time for the Lyrica to work. (it has been 3 weeks).
Re: Autonomic sensory testing 
