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Alcoholic Neuropathy: How Heavy Drinking Affects the Brain

Last Updated: November 3, 2023

Editorial Policy | Research Policy

Although experts aren't entirely sure how it happens, drinking too much alcohol can harm your nerves, causing a condition called neuropathy.

Neuropathy is a group of nerve disorders affecting a person's motor skills, senses and automatic nerve responses. Heavy drinking is associated with neuropathy, with up to 50% of people who use alcohol long-term. 


What Is Neuropathy? 

Neuropathy can be a type of nerve damage that affects the peripheral nervous system or the pathways between the brain and spinal cord that send messages to the rest of the body. The brain and spinal cord make up the central nervous system. When the connection between the two systems is damaged, it can lead to symptoms such as: 

  • Numbness
  • Tingling
  • Muscle weakness
  • Cramps
  • Loss of bodily functions   

Because it involves the peripheral nervous system, this type of neuropathy is called peripheral neuropathy. Over 100 types of neuropathy exist, each with specific symptoms and prognosis. Certain types of neuropathy also have shared symptoms. Because of the different variations of the condition, neuropathy can be broken down into four categories:  

  • Automatic nerve neuropathy: This type of neuropathy affects the unconscious nervous system or automatic nerves that control breathing and heartbeat. 
  • Motor neuropathy: Motor neuropathy damages the part of the nervous system responsible for muscle movement. Affected areas of the body include the arms and hands. 
  • Sensory neuropathy: Neuropathy conditions in this category affect a person's sensations such as touch, feel and pain levels.  
  • Combination neuropathy: This form of neuropathy combines several categories. For example, a person with combination neuropathy may be diagnosed with sensory and motor neuropathy.  

How Alcoholism Can Lead To Neuropathy 

Excess alcohol consumption and alcoholism are linked to neuropathy in several ways. The specific mechanisms that tie neuropathy and alcohol use together aren't exactly understood. However, medical experts suggest there may be a connection between poor nutrition that sometimes accompanies alcoholism and possible alcoholic poisoning of the nerves. 

Symptoms of Alcoholic Neuropathy 

Some symptoms of alcoholic neuropathy are similar to those of other types of neuropathy, while others are more specific to vitamin deficiencies associated with excessive alcohol use. Symptoms of alcoholic neuropathy can vary in severity and include:  

  • Numbness or tingling in the arms or legs 
  • Muscle weakness and muscle cramps 
  • Difficult urination 
  • Constipation, diarrhea and other digestive issues 
  • Unsteady walking 
  • Heat intolerance 
  • Gradual change in muscle strength on both sides of the body 

The Science Behind Alcoholic Neuropathy 

When someone uses alcohol chronically or excessively, the body may be unable to store important vitamins and minerals essential to healthy nerve function. Depleted vitamin levels combined with heavy drinking may lead to: 

  • Pain
  • Tingling and other unusual body sensations
  • Poor muscle control 
  • Overall discomfort 

Vitamins that may be difficult for the body to store in a person with alcoholic neuropathy include: 

  • Vitamin B12
  • Folic acid
  • Thiamine (vitamin B1)
  • Niacin (vitamin B3)
  • Vitamin A

Vitamin deficiencies and consuming large quantities of alcohol over an extended period can also lead to severe malnutrition. Excessive alcohol use is linked to inadequate nutrient absorption, and many people who drink heavily do not consume the recommended daily amount of calories. Some studies have also shown that excess alcohol consumption can have a direct toxic effect on the metabolites of the nervous system. 

How Alcoholic Neuropathy Is Diagnosed 

Alcoholic neuropathy is diagnosed by assessing a person’s medical history, physical examinations and diagnostic tests. Healthcare providers may also order these tests when they suspect alcoholic neuropathy but want to rule out other types of neuropathy. Tests that help diagnose alcoholic neuropathy include:  

  • Nerve biopsy tests to examine damaged nerves
  • Upper GI and small bowel tests
  • Electromyography tests that analyze nerve and muscle health

Other Alcohol-Related Neurological Conditions 

In addition to alcoholic neuropathy, heavy drinking and excessive alcohol use are associated with several other conditions. Some of these conditions include: 

  • Myopathy: This condition causes muscle weakness, swelling and tenderness. Episodes of myopathy often occur after periods of binge drinking. 
  • Wernicke-Korsakoff syndrome: Also referred to as "wet brain," this condition is a central nervous system complication linked to chronic alcohol use. Those with Wernicke-Korsakoff syndrome are often deficient in vitamin B1 (thiamine). 
  • Stroke: While stroke can occur for many reasons, long-term alcohol use can sometimes lead to cardiac conditions such as atrial fibrillation and cardiomyopathy. These conditions are known to contribute to stroke. 

Treatment and Management of Alcoholic Neuropathy 

The overall objective of a care provider when treating alcoholic neuropathy is to help the person prevent injury, control symptoms and improve their ability to live and function independently. Specific treatment plans can vary depending on the extent of the condition but often include: 

  • Low-dose pain medications to help relieve pain and other physical sensations 
  • Vitamin therapy to replenish deficiencies 

In addition to standard medical treatments, it's extremely important for those diagnosed with alcoholic neuropathy to abstain from alcohol. Alcoholism is a lifelong condition, and recovery takes time, patience and determination. Substance use treatment centers offer programs such as medical detox and residential rehabilitation options where patients live on-site in a safe space during recovery.  

Long-Term Prognosis and Possible Complications 

Nerve damage from alcoholic neuropathy is often permanent but manageable. If left untreated or if someone continues to binge drink or neglects their nutritional deficiencies, symptoms of alcoholic neuropathy can worsen as time goes on. Important factors in managing alcoholic neuropathy include: 

  • Abstaining from alcohol
  • Sticking to a healthy diet
  • Regular exercise 
  • Replenishing lost vitamins and nutrients.  

How To Prevent Alcoholic Neuropathy 

Heavy drinking over extended periods is the primary cause of alcoholic neuropathy. In binge drinkers or chronic alcohol users who are yet to be diagnosed, the only way to prevent the condition is to stop drinking excessively.  

Get Help for Alcohol Addiction Before Neuropathy Develops  

While it can be hard for those who drink heavily to quit drinking cold turkey, help is available. The Recovery Village Kansas City specializes in addiction treatment and offers care at all levels and stages of a person's recovery. 

We believe anyone can recover from addiction, and our physician-led programs are tailored to meet your needs and goals. Programs include: 

  • Residential rehab
  • Partial hospitalization treatment
  • Intensive outpatient programs
  • Medical detox
  • Medication-assisted treatment
  • Aftercare

The Recovery Village Kansas City accepts private pay and most insurance plans, and outside referrals are available through our admissions team. We look forward to assisting you on your path to recovery. Contact us today to get started.


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John Hopkins Medicine. “Peripheral Neuropathy?” Accessed July 13, 2023.

Mount Sinai. “Alcoholic neuropathy.” Accessed July 13, 2023.

Sadowski, Adam., Houck, Richard C. “Alcoholic Neuropathy.” National Library of Medicine, December 30, 2022. Accessed July 13, 2023.

Simon, Liz, Jolley, Sarah E., Molina, Patricia E. “Alcoholic Myopathy: Pathophysiologic Mechanisms and Clinical Implications.” National Library of Medicine. Accessed July 13, 2023.

Mosel, Stacy. “Wernicke-Korsakoff Syndrome- Causes, Symptoms, Effects, Treatment.”, May 15, 2023. Accessed July 13, 2023.

MUSC Health. “Drinking & Stroke Risk.” Accessed July 13, 2023.