Neuropathy, peripheral - Causes of peripheral neuropathy

Diabetes is the most common cause of peripheral neuropathy in the UK.

Neuropathy can also be caused by other health conditions and certain medications, although in some cases no cause is identified.

Diabetes

Neuropathy caused by diabetes is called diabetic polyneuropathy. It's estimated around 60% of people with diabetes are susceptible to peripheral neuropathy and up to one in every four people with the condition have experienced some pain caused by nerve damage.

Peripheral neuropathy can be caused by either type 1 diabetes or type 2 diabetes, and becomes more likely the longer you have had diabetes.

If you have diabetes, your risk of polyneuropathy is higher if your blood sugar is poorly controlled or you:

smoke
have high blood pressure (hypertension)
regularly consume large amounts of alcohol
are over 40 years old

It's thought diabetes leads to peripheral neuropathy because the high levels of glucose in your blood damage the blood vessels that supply your nerves.

If you have diabetes, your feet will usually be examined at least once a year to check for ulcers (open wounds or sores) as well as signs of possible nerve damage, such as reduced sensation.

Other causes

As well as diabetes, there are many other possible causes of peripheral neuropathy. If no cause is found, it is called an idiopathic neuropathy.

Health conditions

Some of the health conditions that can cause peripheral neuropathy include:

excessive alcohol drinking for years
low levels of vitamin B12 or other vitamins
physical damage to the nerves, such as from an injury or during surgery
an underactive thyroid gland (hypothyroidism)
certain infections, such as shingles, Lyme disease, diphtheria, botulism and HIV
inflammation of the blood vessels (vasculitis)
chronic liver disease
chronic kidney disease
monoclonal gammopathy of undetermined significance (MGUS) – the presence of an abnormal protein in the blood
certain types of cancer, such as lymphoma (a cancer of the lymphatic system) and multiple myeloma (a type of bone marrow cancer)
Charcot-Marie-Tooth (CMT) disease and other types of hereditary motor sensory neuropathy – genetic conditions that cause nerve damage, particularly in the feet
having high levels of toxins in your body, such as arsenic, lead or mercury
Guillain-Barré syndrome – a rare condition that causes rapid onset of paralysis within days
amyloidosis – a group of rare but serious conditions caused by deposits of abnormal protein called amyloid in tissues and organs throughout the body
conditions caused by overactivity of the immune system, such as rheumatoid arthritis, lupus or Sjogren's syndrome

Medication

A few medications may sometimes cause peripheral neuropathy as a side effect in some people. These include:

some types of chemotherapy for cancer (especially for bowel cancer, lymphoma or myeloma)
some antibiotics, if taken for months (metronidazole, nitrofurantoin)
phenytoin (a medication used to treat epilepsy), if taken for years
amiodarone and thalidomide