Q: I sure wish that you would answer my letter. I have neuropathy in both of my legs. What can do to stop the pain? Both legs pain me all the time.

A: Peripheral neuropathy is the result of nerve damage from infection, exposure to toxins, a traumatic injury, and metabolic issues such as diabetes. One nerve or many nerves may be affected. Depending on the cause, many symptoms can improve or lessen by addressing the underlying condition. Those nerves that may be affected include motor nerves that control muscle movement, sensory nerves that receive messages regarding pain, touch, or temperature and autonomic nerves that are in charge of regulating blood pressure, digestion, bladder function and heart rate.

As a general rule, peripheral neuropathy begins in the long nerves that reach the toes. Symptoms may include sharp burning pain, a lack of coordination, muscle weakness, and lack of sensitivity to touch. If the autonomic nerves are affected, heat intolerance and blood pressure changes that cause dizziness and lightheadedness may be present. If the motor nerves are affected, muscle weakness or even paralysis may be present.

Bacterial infections and the medications prescribed may be to blame for peripheral neuropathy. Unfortunately, the conditions for which medication is prescribed likely outweighs the (hopefully) temporary diagnosis of peripheral neuropathy. Ditto autoimmune diseases. Rheumatoid arthritis, Guillain-Barre syndrome, lupus, and others could be the culprit. Vitamin deficiencies such as B, E and niacin are easy enough to identify and may be the cause of your neuropathy. Hypothyroidism, liver/kidney disease and a number of connective tissue disorders may be to blame. And, so it continues.

Peripheral neuropathy has many potential causes and for that specific reason, it may be difficult to diagnose and may be a diagnosis of exclusion. You don’t indicate your age or any other possible medical conditions you may have but my guess is it’s time to bite the bullet, so to speak. Visit your primary care physician for a complete examination, medical history, laboratory testing, perhaps even imaging studies and a visit to a neurologist for an examination so he or she can hopefully detect the underlying cause. Testing such as a lumbar puncture, nerve biopsy or even a skin biopsy may be ordered. Looking on the bright side, you may have been suffering all too long because of a vitamin deficiency, a condition that can be very simply remedied by a good one-a-day supplement. Don’t waste any more precious time in pain. Make that appointment soon.

Other readers who would like related information can order Dr. Gott’s Health Report “Managing Chronic Pain” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order payable to Peter H. Gott, MD Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.

Q: I am an 89-year-old senior and I have been depressed because I can’t seem to get any help from my doctor. I told him about the numbness in my legs and he tells me it is nerves. I went to another doctor and she told me the same thing. If they both said the same thing, then why aren’t they helping me? I am not a nervous person and I don’t understand why they are saying it is my nerves.

I was in the hospital for two weeks and had pneumonia. Even the doctors there didn’t do anything for me. I use a walker to get around because my legs get weak. Please help me if you can.

A : Numbness of the extremities can have a number of possible causes that include having a herniated disk, pressure on peripheral nerves that can result from enlarged blood vessels, scar tissue, infection, a lack of adequate blood supply to the extremities, diabetes, a vitamin deficiency to include B12, specific medications, and still more.

While you may not be happy with your physician because you perceive you aren’t getting the help you need, I recommend you return to him or her with a family member or friend accompanying you. It may be that you have a condition known as peripheral neuropathy which is damage to the peripheral nervous system that sends information from the brain and spinal cord throughout the body. Because every single peripheral nerve has a specific function to perform in a specific portion of the body and because there are more than 100 different forms of peripheral neuropathy, nerve damage could certainly disrupt your normal daily activities. Tingling, numbness, muscle weakness and an uncomfortable feeling may occur. This is not implying you are a nervous person but that your nerves are damaged and they are the cause of your problems. This is where your family member or friend can be of assistance in understanding what the doctor is saying. Two sets of ears may be better than one in this instance. .

Your condition could have been coming on for several years with symptoms being subtle and progressing slowly. Some individuals may experience periods when their symptoms appears to be under control, only to be followed by an exacerbation that is difficult to deal with. So, could you have peripheral nerve damage? Yes, you certainly could, especially since muscle weakness is the most common symptom of the condition and you have indicated you are using a walker for assistance.

If indeed you do have peripheral neuropathy, it may have been brought on by a vitamin deficiency, an underactive thyroid gland, a hormonal imbalance, kidney disorder, or a metabolic disorder. Further, you don’t indicate if you are on any medications – prescription or over-the-counter. Some drugs could cause the symptoms you describe. If you are seeing more than one physician such as a cardiologist for a heart issue, perhaps your primary care physician is unaware of all the medications you are on. There could be a cross-over between drugs that is to blame.

How long has it been since you had laboratory testing, a chest X-ray or other imaging? Perhaps it is time for a complete examination, blood work, EKG and more. Get to the bottom of the problem so you can awaken refreshed and hopefully without symptoms.

Because a vitamin deficiency could be to blame, readers who would like related information can order Dr. Gott’s Health Report “Vitamins and Minerals” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Peter H. Gott, MD Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.