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What causes recurrent muscle weakness post alcohol withdrawal?

Answered by
Dr.
Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2263 Questions

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Posted on Sat, 20 Aug 2016 in Brain and Spine
Question: I have bin having symptoms of alcoholic neuropathy for 7 weeks now and I have not bin drinking for about 6 weeks. I never want to drink ever again I'm only 30 years old . My symptoms are Lessening but there's still a bit debilitating . It comes and goes throughout the day and it's mostly muscle weakness my thighs and my shins get hot and then my shins hurt. I am eating a very balanced diet and taking a supplement design for neuropathy. I however have all feeling in my feet and hands no pins and Needles pain or anything in my hands or feet . Could this be alcoholic myopathy Instead of alcoholic neuropathy? Will this go away with complete and total abstinence from alcohol and a healthy diet and vitamins? Also I'm looking into amino acid therapy which I already have had the blood work done for. I have an appointment with the doctor after my blood results are done. This is mentally getting to me and I just want some answers. The doctors say my liver numbers are fine but I'm afraid there might be a chance I have cirrhosis. Should I demand a liver biopsy to find out for sure? My last visit to the doctor I was told she does not think it's neuropathy and I have an appointment to see a neurologist in seven more weeks. In the morning I have almost no weakness or pain the past couple of days and then it gradually my legs get weak as I use them more.
doctor
Answered by Dr. Neeraj Kumar 48 minutes later
Brief Answer:
Take steps as advised

Detailed Answer:
Hello,
I have gone through your question and understand your concerns.
Alcohol related neuropathy, liver damage improves to much extent after discontinuation of alcohol.
The neuropathic symptoms are mostly distal in limbs with tingling, burning and numbness.
Myopathy can occur due to vitamin D deficiency.
You can get CPK-MM, Thyroid profile, vitamin D tested for suspected weakness in thigh and hip region.
You can also get a nerve conduction study for evaluation.
The liver function is assessed by blood test, ultrasound and then biopsy if required.
If primary work up is negative for cirrhosis then no need for biopsy as it's invasive.
The treatment for alcoholic cirrhosis is abstinence and symptomatic treatment.
Hope you found the answer.
Do get back to me for further queries.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Neeraj Kumar 26 hours later
I do seem to have a lot of weakness in my hips and thighs. Can alcohol make it harder for my body to absorb vitamin d? it feels like I ran to much all the time I have heard of some alcoholics getting weakness in the legs. If it is myopathy from alcohol and its the chronic form of alcoholic myopathy how long will it take for me to recover and will I regain all my strength back as well? I imagine this could take months is that correct? If it is a thyroid condition will it go away with treatment?
doctor
Answered by Dr. Neeraj Kumar 36 minutes later
Brief Answer:
Take treatment as advised

Detailed Answer:
Hello,
If you have difficulty in arising from squatting or sitting position and walking upstairs you are definitely having myopathy.
The symptoms improves after alcohol cessation and intake of vitamin D and calcium.
Thyroid supplementation in case of Thyroid disorder leads to improvement too.
The duration may take around 6 months for recovery.
Get investigations as advised to confirm diagnosis.
Alcohol causes mucosal injury and malabsorption leading to poor absorption of vitamins like vitamin D, vitamin B 12.
Wishing you good health and early recovery.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Neeraj Kumar 46 hours later
I understand that a thyroid test for a T1, T2. and T3 can appear normal but I may still have a thyroid issue. Is there another test that can be done to confirm that my thyroid is functioning adequately. Also, when I was young and even now it seems that my adrenal glands are working overtime. Is there any other test for adrenal malfunction. Also how many IU of Vitamin D3 should I be taking. I have already taken vitamin D3 2000 IU per day. If they test for a Vitamin D deficiency wouldn't that ruin the test if I am taking Vitamin D. Would the only way to find if I have Myopathy at this point be to perform a muscle biopsy in the hip region as you said before since I am taking Vitamin D3? I am having difficulty in my hips and thighs getting up out of chairs and walking up the steps. It is the type of burn you get in your muscles after you have run. It does appear to be coming and going at this point. Should I also watch my salt intake. I do very much appreciate your insight in this matter. It is a pleasure speaking with you.
Kind regards,
XXXXX
doctor
Answered by Dr. Neeraj Kumar 20 hours later
Brief Answer:
Continue vitamin supplements and visit a neurologist

Detailed Answer:
Hello,
You can get free levels of T3 and T4. Thyroid scan studies can also be performed.
For muscle disease if all metabolic studies are normal then biopsy is an option.
Vitamin D levels will not be accurate if you already are taking supplementation.
You are taking adequate doses of vitamin ..
Adrenal test should be done if advised by an endocrinologist.
If you have symptoms only on walking and prolonged standing with no symptoms at rest then possibility of lumbar canal stenosis should be considered too.
Get examined by a neurologist for accurate diagnosis and investigation plan.
Hope you found the answer helpful.
Wishing you good health and early recovery.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Sonia Raina
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