Peripheral neuropathy diagnosed for numbness in toes. blood work and emg clean. thoughts on next step md seems unclear on direction to go.?

Peripheral Nerve: Peripheral neuropathy is often idiopathic (not sure of the cause) this doesn't stop us from looking. http://www.ninds.nih.gov/disorders/peripheralneuropathy/detail_peripheralneuropathy.htm.

One needs to : Understand there is a difference between large nerve and small nerve fiber disease. If there is a negative emg/ncv which is testing large nerve fibers perhaps you have small nerve fiber disease, which can be tested by epidermal nerve fiber density testing. This is done via a small 3mm skin biopsy. Various treatments would include metanx if positive result.