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I have neuropathy in my fingers and toes and other places…

I have neuropathy in...

I have neuropathy in my fingers and toes and other places such as my face. I get chills every day in the late afternoon. I had the flu B a couple of months ago and then had a severe rash from poison ivy and was put on high potency steroid cream. My CBC, CMP, thyroid function tests, vitamins were all normal. I do not have Diabetes nor HIV. Neuropathy seems to fit the description of stocking-glove although I have it in other places. Sometimes my chest hurts. My heart rate goes into the high 90's sometimes. I am usually around 68. Sometimes my extremities cold. What could be causing my symptoms?

Doctor's Assistant: Do you know if your family has a history of heart disease? In general, how would you describe your health lately?

I was checked out with echo last year and stress test, and stress echo. Everything is normal. I have been on steroids for chemical lung exposure in December so I am wondering if this could be sometime kind of adrenal insufficiency?

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

One time that I was on steroids in the past I had to have an ACTH challenge and stay on the steroids longer because my cortisol was slightly low. Although i have never heard of neuropathy being a symptom of adrenal problems. I am 48 years old so I am peri-menopausal

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Answered in 4 minutes by:
3/22/2018
Dr. Mark
Dr. Mark, Physician / Surgeon
Category: Medical
Satisfied Customers: 12,325
Experience: U.S. Surgeon / Neurological Surgery
Verified

Hello -

Have you been evaluated by a neurologist?

Did you have EMG and nerve conduction studies performed?

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Customer reply replied 1 month ago
no I have not

OK.

Well, I think that would be the next best step for you.

Seeing a neurologist will help to get an answer to your question.

You've had a lot of stuff ruled out already, which is good. But the neurologist would be the doctor to evaluate the neuropathy -- parasthesias you are having everywhere, and the EMG and nerve conduction test can help to identify if there is a neuropathy affecting your arms and feet.

(Adrenal insufficiency in acute cases can cause shock, vomiting, weakness, confusion, fever, coma -- but in more chronic cases cause fatigue, weight loss, nausea, muscle and joint pains. Not generally neuropathy.)

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Customer reply replied 1 month ago
I was just wondering if it could be caused by something. Since it started 2 months ago and has gotten progressively worse. Could it be caused by an infection? (lyme's disease, etc.) Does it sound like a vasculitis? I am on Gabapentin which I started 2 days ago because the pain particularly at night is terrible

It doesn't sound like a vasculitis.

Lyme's disease -- when it affects the nerves -- more typically affects specific parts of the nervous system, and would cause meningitis, nerve irritation of the cranial nerves (causing facial weakness, for example), but could theoretically cause an all around neuropathy. Regardless, it is easy to figure out if this is a potential cause with bloodwork, which the neurologist would be ordering.

Dr. Mark
Dr. Mark, Physician / Surgeon
Category: Medical
Satisfied Customers: 12,325
Experience: U.S. Surgeon / Neurological Surgery
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Vasculitis causing neuropathy is more patchy, affecting a part of one leg, then another part of another leg, for example -- not usually all of your arms, hands, feet at once - like in your case.

Best of luck.

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