Small Fiber Polyneuropathy

B6 toxicity is Small Fiber Polyneuropathy (SFPN). Small Fiber Polyneuropathy is also called Small Fiber Neuropathy as well as Peripheral Neuropathy. We know through the research done at Massachusetts General Hospital by Dr. Anne Oaklander that B6 is one of the causes of Small Fiber Polyneuropathy. Dr. Oaklander explains in this video that “polyneuropathy means all or most of the nerve fibers are sick”.



Small Fiber Polyneuropathy attacks sensory, autonomic and motor nerves. The attack on the sensory nerves includes the symptoms of pins and needles. The attack on the autonomic nerves means that all that is automatic is no longer automatic. The attack on the motor nerves is muscle wasting, heaviness and weakness.

The sensory nerves attack is the pain in your feet and hands, head, face and other body parts. It is pins and needles. It is burning. It is zapping. It hurts. It numbs. It stings. This is B6 toxicity that is known by some doctors and discussed in most of the literature.

The second set of nerve damage is to the autonomic nervous. What should be automatic in your body is no longer automatic. You have temperature issues, sweating issues, irregular heartbeats, blood pressure issues, thirst, hunger, dry eyes, dry mouth, bladder issues, digestive issues including upper GI (nausea, vomiting after meals, reflux) and lower GI (constipation or diarrhea).

The third set of nerve damage is damage to motor nerves. Basically, your nerves stop talking to your muscles. Your body feels heavy. You can barely get from one place to the next. It takes a huge amount of effort. You also have the muscles wasting with this set of nerve damage.

Dr. Anne Oaklander also explains that blood vessels are lined with small fiber nerves. An attack on these nerves in our blood vessels gives us heart rate and blood pressure issues. The attack on our blood vessels is responsible for your low blood volume. Low blood volume effects on muscles include shortness of breath, fatigue and poor exercise tolerance. The low blood volume effects on the brain are dizziness, lightheadedness, headaches, migraines and the all too familiar brain fog.

Dr. Anne Oaklander’s website, Neuropathy Commons, has been significant in our understanding of Small Fiber Polyneuropathy. Her list of blood work shows that B6 toxicity is one of the tests used to determine the causes of Small Fiber Polyneuropathy.

Dr. Oaklander has an updated YouTube video (below). It discusses and expands on the information from the first video. These are both good videos for you and your support system to watch.

Although at the beginning of the group we relied heavily on Neuropathy Common’s information concerning SFPN and vitamin B6 toxicity, there have been more articles published over the past few years. The website linked below mentions excess B6 as a cause of Small Fiber (Poly) Neuropathy.

The London Clinic: Small Fibre Neuropathy Treatment

This next article (below) helps explains that Small Fiber Polyneuropathy can be diagnosed as a totally different disease. The following paragraph was taken directly from the article.

“The differential diagnosis includes other conditions that can cause pain including multiple sclerosis or myelopathy, Reflex Sympathetic Dystrophy, Regional Pain Syndrome (RSD), polymyalgia rheumatica, fibromyalgia, Erythromelalgia, Raynaud syndrome, restless leg syndrome, neuroma, fasciitis, or somatic pains resulting from anxiety or depression.15–21 Patients are sometimes diagnosed as having neuropathic pain, although that requires demonstration of the underlying disease or lesion.22 Autonomic symptoms can be misdiagnosed as being due to cardiac arrhythmia, colitis or irritable bowel syndrome, chronic bladder infections, skin allergies or emotional stress.”

The question we have is how many have a diagnosis of any of these syndromes with no possible cure when in fact it could be B6 toxicity with a cure?

Therapath Neuropathology: Small Fiber Neuropathy Overview

This next article has a story all too familiar to many of us. The author of the story, William Schwalbe, went from healthy to barely being able to function almost overnight. He has Small Fiber Polyneuropathy.

Washington Post: Pains, chills, fatigue, vomiting and vertigo plague me. Small fiber neuropathy causes it all.

If you have idiopathic Small Fiber Polyneuropathy, please remember the bottom-up research that was done in the Facebook group. We know that B6 blood volume goes down quickly (two to four weeks) after you decrease your incoming B6 to RDA and get hydrated. Once you removed the excess B6 from the blood, doesn’t mean you’ve removed it from the nerve cells. We know from our group that it takes a year plus to remove excess from the nerve cells. Your idiopathic Small Fiber Polyneuropathy could be B6 toxicity. Unfortunately, there is no test to measure the B6 in your nerve cells. At this point, the only way you would know if you can cure your SFPN is to follow the B6T Protocol.

Small Fiber Neuropathy: Disease Classification Beyond Pain and Burning

Another powerhouse in the Small Fiber Neuropathy field is Todd Levine. In the article below he further breaks down SFN into subclasses. Also, note that the two drugs he recommends for treatment (tricyclic antidepressants and serotonin-norepinephrine reuptake inhibitors) are both vasoconstrictors.

Small Fiber Neuropathy: Disease Classification Beyond Pain and Burning

One of the latest papers from Dr. Anne Oaklander: Scientific Advances in and Clinical Approaches to Small-Fiber Polyneuropathy

The link below is a paper that shows how to diagnose and the treatment of pain in Small Fiber Neuropathy. It also discussed several treatment options for the pain associated with Sensory Neuropathy.

Diagnosis and Treatment of Pain in Small Fiber Neuropathy

Current View of Diagnosing Small Fiber Neuropathy

The video below is a good explanation of the peripheral nervous system.

Learn About the Peripheral Nervous System

Any unlinked research can be found in our Index of Sources.

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