Causes of peripheral neuropathy

In England, diabetes is the most common cause of peripheral neuropathy.

The condition can also be caused by other health conditions, and by certain medications.

Diabetes

Neuropathy that is associated with diabetes is called diabetic polyneuropathy. Between 10% and 20% of people who are newly diagnosed with diabetes have diabetic polyneuropathy.

The longer you have diabetes, the greater your chances of developing diabetic polyneuropathy. It is estimated that half of all people who have been living with diabetes for 25 years or more have diabetic polyneuropathy.

Other risk factors for diabetic polyneuropathy include:

• smoking
• high blood pressure (hypertension)
• heavy consumption of alcohol
• being 40 years of age or over
• having poorly controlled diabetes

It is thought that diabetes damages the peripheral nervous system in two main ways:

• The high levels of glucose associated with diabetes triggers a number of biological changes that cause your nerves to break down.
• The high levels of glucose damage the blood vessels that supply your nerves, which accelerates the breaking down of the nerves.

Other causes

As well as diabetes, there are a number of other potential causes of peripheral neuropathy.

Health conditions

Health conditions that can cause peripheral neuropathy include:

• chronic liver disease
• chronic kidney disease 
• HIV or AIDS
• prolonged and excessive alcohol misuse
• nutritional deficiency (not having the right levels of different nutrients in your diet), particularly a vitamin B deficiency
• lymphoma – a cancer of the lymphatic system (a series of glands that are part of the immune system)
• multiple myeloma – a cancer of a type of blood cell called plasma cells
• Lyme disease – a bacterial infection that is spread by ticks
• Charcot-Marie-Tooth disease – a genetic condition that causes nerve damage, particularly in the lower limbs
• having high levels of toxins in your body, such as arsenic, lead or mercury
• Guillain-Barré syndrome – a rare and poorly understood condition that damages the peripheral nervous system
• diphtheria – a bacterial infection that is rare in England but common in other parts of the world, particularly in developing countries such as Haiti and Vietnam

Medication

A number of medications are known to cause peripheral neuropathy as a side effect in some people. These include:

• antiretrovirals – a group of different medications that are used to treat HIV infections
• microtubule inhibitors – a type of chemotherapy medication that is used to treat a number of different cancers, such as advanced breast cancer and lymphoma
• metronidazole – a medication that is used to treat infections caused by parasites
• thalidomide – a medication that is used to treat multiple myeloma
• phenytoin – a medication that is used to treat epilepsy
• disulfiram – a medication that is used to treat people who are dependent on alcohol