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Small fiber neuropathy

Discussion in 'Support Subforum' started by cly09, Feb 21, 2026 at 11:45 AM.

  1. cly09

    cly09 Newcomer

    Hi,

    I am looking for any advice on whether or not this could be TMS. I’ve been reading all the posts on small fiber neuropathy symptoms. People keep mentioning that if your biopsy comes back negative then it is TMS. But what if it’s positive with a lot of nerve fibers loss? I’m confused because elsewhere on this website it says biopsy results can be positive even in normal people. My neuropathy started in my feet only, so typical stocking glove fashion, but now is body wide many years later as a result of inflammation from MCAS…but I also see replies saying MCAS is TMS. So now I am very confused as I have real damage from a condition some consider TMS….any help is greatly appreciated.
     
  2. JanAtheCPA

    JanAtheCPA Beloved Grand Eagle

    Many of us in the last half decade or so have come to believe that there is no hard and fast line between TMS and Not-TMS.

    The first thing you have to understand is that we all have TMS, which is an evolutionary brain mechanism designed to help us survive and multiply. It worked, obviously. But having evolved over millenia in a primitive wilderness environment, it hasn't had any time at all to adapt to the minuscule sliver of time representing the modern world - and it has NO idea what to do with the avalanche of complex modern stressors we live with 24/7, especially in this century.

    The second thing to understand is how the immune system works.

    Inflammation is a basic response of our immune systems. Our immune systems are triggered by stress - whether it's the stress of being stalked by a sabre-tooth tiger or of living with PTSD from childhood adversity, or of being subjected to job or relationship stress, or, these days, suffering from the unconscious stress of having no control in an increasingly dysfunctional world.

    The bottom line is that inflammation is being recognized more and more as a key source of physically pathological conditions. Just look up "stress and inflammation" for a tutorial.

    I'm a case study for this. I was a TMS success story for over eight years when the pandemic upended my hard-won equanimity in April 2020. A complicated series of stressors that were pandemic-adjacent brought me to a diagnosis of full-blown Rheumatoid Arthritis. A well known TMS doctor (David Schecter MD) confirmed that I had to take the recommended medication to reduce my inflammatory response, or risk serious consequences.

    I don't consider myself a TMS failure by any means. In fact, I'm convinced that my TMS education and commitment have resulted in being virtually symptom free (confirmed by regular blood tests) while maintaining a low dose of the most basic (and cheap) RA medication that has been in use for decades. Many people with RA who are ignorant of the stress component keep ramping up or changing medications while enduring multiple other mindbody symptoms such as fibro and chronic fatigue. My first rheumatologist did not disagree when I told him I blamed extreme stress, but he retired and my new young female rheumatologist totally agrees with my self-assessment.

    We can't tell you whether or not to keep getting checked out. We CAN tell you that making a commitment to your mental and emotional health by taking on TMS knowledge and skills can not hurt, and might help. You literally have nothing to lose, as our Structured Educational Program is free of cost, ads, or even registration. It's a labor of love provided and maintained by people who have done the work and reaped the benefits.
     
    Joulegirl, Ellen and Mani like this.
  3. cly09

    cly09 Newcomer

    Thank you so much for taking the time to reply. Your experience is super interesting and one I have not read anything similar to. I completely agree about inflammation and I am encouraged to hear that it is not always so black and white when it comes to TMS or not. I am happy you were able to achieve so much, multiple times, regardless of RA. When it comes to issues like this it seems most people take a hard line-at least where MCAS is concerned. I’ve seen people say programs like DNRS put them in “remission,” while others get mad that it’s even mentioned on the Facebook page.

    I’ve been doing a lot of book reading of different mind-body approaches but I am going to dive into the structured educational program. Thanks again for the help!
     

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