The Small Fiber Neuropathy Network
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📚 Evidence-Based Information: All medical content on this website is backed by peer-reviewed journals, systematic reviews, clinical trials, and reputable medical organizations. We carefully summarize, paraphrase, and reference only credible scientific literature from leading medical institutions. View our comprehensive sources page with 70+ citations from top-tier medical journals. Spotted any discrepancies or questionable sources? We'd love to hear from you.

Causes of Small Fiber Neuropathy

Understanding the various causes and risk factors that can lead to SFN

🎯 Common Causes

Small Fiber Neuropathy can result from various underlying conditions. In some cases, the exact cause remains unknown (idiopathic SFN).

🍭 Metabolic Causes

Diabetes Mellitus

Most common cause - Both Type 1 and Type 2 diabetes can damage small nerve fibers through high blood sugar levels.

  • Affects up to 50% of diabetic patients
  • Often the first sign of diabetic complications
  • Can occur even with well-controlled diabetes

Prediabetes & Glucose Intolerance

Impaired glucose tolerance can cause SFN even before full diabetes develops.

Metabolic Syndrome

Combination of high blood pressure, blood sugar, and cholesterol abnormalities.

🧬 Autoimmune & Inflammatory

Sjögren's Syndrome

Autoimmune condition affecting moisture-producing glands, commonly associated with SFN.

Sarcoidosis

Inflammatory disease that can affect multiple organs including the nervous system.

Celiac Disease

Gluten sensitivity can trigger nerve damage in susceptible individuals.

Lupus & Other Connective Tissue Disorders

Various autoimmune conditions can target small nerve fibers.

💊 Medications & Toxins

Chemotherapy Drugs

Certain cancer treatments can cause peripheral neuropathy:

  • Taxanes (paclitaxel, docetaxel)
  • Platinum compounds (cisplatin, oxaliplatin)
  • Vinca alkaloids
  • Bortezomib

Other Medications

  • Statins (cholesterol medications)
  • Certain antibiotics (metronidazole, fluoroquinolones)
  • Antiretroviral drugs (HIV medications)
  • Anti-seizure medications

Toxins & Substances

  • Alcohol (chronic excessive use)
  • Heavy metals (lead, mercury, arsenic)
  • Industrial chemicals
  • Vitamin B6 toxicity (excessive supplementation)

🧪 Nutritional Deficiencies

Vitamin B12 Deficiency

Essential for nerve health; deficiency can cause irreversible nerve damage.

Other B Vitamins

  • Thiamine (B1) - especially in alcoholism
  • Folate deficiency
  • Vitamin B6 deficiency (paradoxically, excess is also harmful)

Other Nutrients

  • Vitamin E deficiency
  • Copper deficiency

🧬 Genetic Factors

Hereditary Neuropathies

Genetic mutations affecting nerve function:

  • Fabry disease
  • Hereditary sensory and autonomic neuropathies (HSAN)
  • Tangier disease

🦠 Infections

Viral Infections

  • HIV
  • Hepatitis C
  • Epstein-Barr virus
  • Varicella-zoster virus

Other Infections

  • Lyme disease
  • Leprosy

❓ Idiopathic SFN

Up to 50% of SFN cases are idiopathic - meaning no underlying cause can be identified despite thorough investigation.

This doesn't mean the condition is less serious or treatable. Research continues to identify new potential causes and mechanisms.

🛡️ Prevention & Risk Reduction

Blood Sugar Control

Maintain healthy glucose levels through diet, exercise, and medication compliance.

Limit Alcohol

Moderate alcohol consumption to prevent alcohol-related nerve damage.

Nutrition

Ensure adequate intake of B vitamins and other nerve-supporting nutrients.

Medication Awareness

Discuss neuropathy risks with your doctor before starting new medications.