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Q. Are weakness in hands, tremors and strange feeling in feet symptoms of alcoholic neuropathy?

Answered by
Dr. Aida Quka
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 07, 2019

Hello doctor,

I am 29 years old. What would be the specific symptoms of alcoholic neuropathy? I am having some nerve issues, they conducted two separate neurological exams (no conductivity testing just the general exam) but the neurologist did not find anything abnormal. I am a mild to moderate drinker and have been drinking for about six years. I do not binge drink or drink more than a glass or two of alcohol every other day or so. I eat very healthfully and work out. I have had all sorts of bloodwork and nothing has come up (Ac1, B12, thyroid, etc.). My MRI is scheduled in five weeks to rule anything else out.

Doctor says my symptoms are anxiety but want to make sure. Symptoms include some weakness in my hands when I wake up, tremors at night, feelings that have changed over time in my feet. No official pins or needles, just some general "strange" feelings in my feet that come and go and change from foot to foot. I only had a feeling of burning in my feet twice. Sometimes there is a region that feels like there is something in my shoe. This has all come up in the past two months. Would alcoholic neuropathy take longer? Will it have more consistent symptoms? Will it show up on a neuro exam?

The neurologist insists that I do not need conductivity testing. I just want to rule out alcohol before I drink anything again. It seems like from the literature I have read that alcoholic neuropathy develops after a lot of drinking and poor nutrition. And it seems to be pain that is constant that develops first. Is it true? I am currently taking Spironolactone, Yaz, and Urex.

Dr. Aida Quka



Welcome to

I read carefully your question and would explain that your symptoms are not typical of alcoholic neuropathy. Anyway, tremor is very common after years of alcohol intake. I would first recommend checking vitamin B1 plasma levels and vitamin D plasma levels for possible deficiency. I agree with your neurologist, on the fact that when reflexes are present we can exclude peripheral neuropathy. But sometimes, single-fiber EMG (electromyography) would give more information on possible small fiber neuropathy. In the meantime, I would recommend taking magnesium supplements in order to help to improve your situation. You should discuss it with your doctor on the above tests.

I hope this helps.

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Thank you doctor,

My vitamin D levels were normal and I supplement with B vitamins (they did not test for B1 but I eat healthily and supplement so should be fine?). Yes, all my reflexes, etc., are normal. I think the MRI is just to rule out say something like MS. But I do not have any other symptoms of that. I did take Macrobid when this all started and Macrobid does have reports of neuropathy. But I took it for only three days and have taken many times before for UTIs without a problem. I mentioned conductivity testing to my doctor but he said he did not agree with the need for it. I assume that is because he is very confident about my exam is normal. He has referred me to a psychologist for anxiety medication which is fine. I just do not want to drink and do any further damage, but it does seem alcohol would be unlikely unless I am very unlucky.

Dr. Aida Quka



Welcome back to

I think anxiety is playing an important role in this clinical situation. For this reason, anxiety medication will help improve your situation. A brain MRI (magnetic resonance imaging) would help exclude MS (multiple sclerosis) or brain atrophy. But I do not think that it is an urgent situation, as your symptoms are really not very concrete or suggestive of MS. I recommend trying magnesium supplements too. A healthy diet (rich in vitamins and proteins) and regular physical activity are helpful too.

I hope this helps.

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