Hi suedonym, I have a lot to say on the neuropathy! Please read the bit I wrote on respiratory alkalosis especially. Aside from the classic SSRI withdrawal/low serotonin zaps and such, I think a great many things can contribute to pins and needles. Your nerves are very oxygen thirsty, they actually consume about 20% of your bodies oxygen supply even though they are less than 2% of your mass. The arteries that run through the nerves themselves are called the vasa nervorum. When your nerves aren't getting adequate oxygen the symptoms kick up, this includes twitching (
fasciculations/myoclonus) and the pins and needles. Now what contributes to your nerves not getting enough oxygen? Vasoconstriction is an important factor. When your arteries constrict your nerves are in big trouble, not permanent damage just to be clear (it takes a long time consecutively without oxygen for the nerves to actually get damaged) but the CNS symptoms will kick up. Many things contribute to too much vasoconstriction/not enough vasodilation but adrenaline is a big one.
Another one to keep in mind that you have conscious control of is hyperventilating, when it gets severe it is known as
respiratory alkalosis and what typically happens is the extremities go from pins/needles to numb, then they start to spasm and eventually you will go full on tetanus mode if the hyperventilating is bad enough. Though this can result in a feeling of heavy tingling (almost massage-like) falling asleep throughout the body, hard to describe but it is a head to toe feeling caused by hyperventilating, this can kick up when you do cardio and breathe like crazy. Reduced blood flow to the brain can put you in a horrible brain fog and this can kick in at lower levels of respiratory alkalosis too. When you have too much oxygen in your bloodstream (saturation) your cells actually can't get oxygen, you need some CO2 for your cells to get oxygen. This can become very strange because you will be short of breath because you actually have too much oxygen and not enough cO2. Very counter intuitive.
Essentially, hyperventilating will not only be contributing not only to adrenaline/vasoconstriction but if your oxygen level is saturated your nerves will actually have a harder time getting oxygen. This will first be felt in the extremities (usually hands first, they will burn typically when used as more oxygen is being used up by the nerves, but if you let them rest a while typically they will get better, point being is that its transient) but all nerves/tissues throughout the body suffer when it comes to oxygen saturation
If you combine some nerve compression (laying down a certain way) with the vasoconstriction from adrenaline and lack of tissue oxygen perfusion from respiratory alkalosis, you can get some nasty neuropathy. But it will get better, key point is that this is not permanent damage. And if your nerves are getting compressed in a physical location somewhere (much more likely than a demyelinating polyneuropathy) this can be fixed as well, its not permanent
But the compression neuropathy (if you have it somewhere) is very likely the exact same as it was before, its just that now that your nerves have even less oxygen for whatever reason, the same exact physical nerve compression that didn't give you problems before is now enough to bring the symptoms to the surface. A common one with anxiety/chest breathing (and one that will develop quickly if a chest breathing pattern builds in the muscles over the years) is thoracic outlet syndrome, the nerve is compressed near the ribcage with all the chest breathing (common breathing pattern when hunched in a chair, not a whole lot of space to breath through the stomach and not move the ribcage), symptoms are worst with the hands out in front or over your head (which even in normal people cuts blood flow anyways). Combine a little bit of each one of these contributors to neuropathy and you will have a bag of fun, but don't be convinced that it is MS or necessarily thoracic outlet syndrome, I am knowledgeable regarding MS and I don't believe you have it
One thing particularly useful you will find as far as nutritional deficiencies go for neuropathy (and maybe something that was on your lab work already) is probably b12. You could take a good multi and B vitamin multi to be sure your nerves are getting what they need.
The vasoconstriction/sympathetic activity could very well be contributing to the not getting it up btw.
I highly recommend cardio, deep stomach breathing (to stimulate the vagus nerve and parasympathetic nervous system to calm you down) and mindfulness meditation, the goal is to focus on the sensation of breathing slow and clear your thoughts/shut off the voice in your head, every time your mind wanders return your attention to the breath. This will probably be very hard at first but give it some time and you will notice it start to benefit your sleep, and very likely your hands.
There are also sympatholytic medications to help shut off your adrenaline and dilate your arteries, such as Clonidine. I would ask your doctor about Clonidine probably, though there are meds that just work in the periphery to dilate the arteries too. Beware some of these meds in particular beta-blockers can hinder the production of melatonin so you should definitely take some extended release melatonin with it if you can get your doctor to prescribe, though melatonin will be good for you to take regardless. Clonidine etc. is not particularly addicting (Not at ALL like Xanax and such) but you will get sympathetic nervous system rebound if you are on them for a long time and don't taper off. But they could help you sleep too and this is essentially for your recovery. If you have any questions down the road feel free to PM me, I have been there my friend
