Peripheral neuropathy (PN) is a type of damage that occurs in the peripheral nervous system, the network of nerves that sends information from the brain and spinal cord (central nervous system) to the rest of the body.
Peripheral neuropathy affects from 7% to10% of the world population, the most common cause being diabetes, which is known as diabetic neuropathy (DN). This is caused by high blood sugar levels and results in nerve damage in the feet and legs. About 20-50% of those with diabetes suffer from diabetic neuropathy, while about 25% show no signs of it, even though they may have pain symptoms.
The most common symptoms of this form of neuropathy are numbness or tingling in a certain body part, followed by more serious symptoms including burning pain or even paralysis.
There are also other causes of PN including genetic, injury, kidney disease, or hormonal imbalance. Neuropathic pain can also be caused by the use of drugs, particularly taxanes, which can trigger chemotherapy-induced neuropathic pain.
In fact, according to the medical profession, there are more than 100 types of peripheral neuropathy, each with its own type of symptoms and prognosis. These many different types of PN have been broken down into four categories, in order to help doctors to classify them.
Peripheral Neuropathy Types
Motor neuropathy: Damage to the nerves that control muscles and movement (moving our limbs and even talking).
Sensory neuropathy: Damage to the sensory nerves which control what we feel, including pain, temperature and touch.
Autonomic nerve neuropathy: Damage to autonomic nerves control functions are especially serious since the autonomic nervous system controls breathing and heartbeat.
Combination neuropathies: One may have a combination of two or three of the other types of neuropathies (e.g. “sensory-motor neuropathy”). This is most dangerous indicating widespread nerve damage throughout the body.
Peripheral Neuropathy Symptoms
Aside from the aforementioned symptoms accompanying diabetic neuropathy, tingling, numbness, burning and paralysis, there are many other symptoms that can be indicative of this disorder.
These include: cramps; changes in hair, nails, or skin; diarrhea, constipation related to nerve damage in the intestines; difficulty breathing; dizziness, lightheadedness, or fainting because of loss of control over blood pressure (autonomic nervous system); emotional disturbances; irregular heartbeat; loss of sensation or feeling in body parts; loss of balance or other functions due to loss of feeling in the limbs or other body parts; loss of muscle and bone; loss of bladder control which can lead to incontinence or infection; inability to sweat properly, leading to heat intolerance; muscle weakness or twitching; loss of pain sensations, which could put one at risk of not feeling an oncoming heart attack; problems eating or swallowing; sleep disruptions.
Unfortunately, many of these symptoms also accompany other medical conditions, so oftentimes it may take a while before neuropathy is properly diagnosed by medical professionals.
Peripheral Neuropathy Treatment
The medical approach to PN is that (of course) it can’t be cured, but things can be done to prevent it from worsening.
Obviously, if the condition is due to diabetes the first approach would be to treat that issue, preventing further nerve damage by regulating insulin. The first line of treatment for diabetes is to be prescribed Metformin, if the situation is not too advanced requiring treatment with insulin. For those of us with a more natural bent, berberine can be used as a viable alternative to Metformin. Those on Metformin should be aware that it depletes the body of vitamin B12, something necessary in the body for repairing nerve damage. Berberine will not deplete this vital nutrient.
For treating the pain that accompanies PN the medical profession recommends over-the-counter pain relievers for mild cases and prescription drugs for more severe symptoms.
Medications used include “mexiletine, a medicine developed to correct irregular heart rhythms; antiseizure drugs, such as gabapentin, phenytoin, and carbamazepine; and some classes of antidepressants, including tricyclics such as amitriptyline”. However, use of such drugs can lead to side effects.
Local anesthetics like Lidocaine, are often used (either by injection or patches), and for extreme cases surgery is used to destroy nerves (so they can no longer send a pain signal), or to repair injuries that may be causing the neuropathic pain.
Lifestyle recommendations usually include avoiding alcohol and tobacco, eliminating vitamin deficiencies, heating a healthy diet, losing excess weight, exercising regularly and avoiding toxins (or actively detoxifying the body with infrared saunas and glutathione).
Furthermore, do not “let injuries go untreated, and be meticulous about caring for your feet and treating wounds to avoid complications, such as the loss of a limb”.
Using relaxation modalities, like yoga or Tai Chi, can help ease both emotional (constant pain is associated with anxiety and depression) and physical symptoms, and some find benefit from using hand or foot braces, to compensate for muscle weakness.(Source for above material.)
The Natural Approach
Since the approach of treating PN symptoms with serious drugs has obvious drawbacks, we will now examine a massive clinical review that examined all the nutraceuticals and dietary supplements that have proven helpful for relieving neuropathic pain and related symptoms.
Even when strong drugs are used to treat PN “the pharmacological approach is unable to fully counteract the neuropathic pain condition”. Therefore, this clinical review of all the science on the subject was initiated to provide medical professionals with new and different approaches to treat PN, approaches which can be used in tandem with some drugs or offered as an alternative for those unable (due to side effects), or unwilling (due to having researched side effects), to use such drugs.
From a mechanical perspective, new therapies include “nerve stimulation techniques—such as transcutaneous electrical nerve stimulation and spinal cord or deep brain stimulation, acupuncture, surgical nerve decompression—as well as behavioral, cognitive and animal therapies, exercise and diaphragmatic breathing”.
But what we shall examine here are the nutritional supplements and nutraceuticals that made this list of “new” therapies because there was enough research on them to confidently recommend that doctors incorporate these compounds into their recommendations to patients suffering from neuropathic pain. And since such substances are generally safe, we can choose to use them on our own without waiting for a doctor to prescribe them. (And in this country we wait a long time to even see a doctor.)
Here, briefly, are the chief mechanisms by which our nervous system structures are damaged, leading to neuropathic pain. I bring this technical material in at this point so that when these mechanisms are referred to in the material that follows, we will all understand that they pertain to PN, and to addressing the underlying causes of the ensuing nerve pain.
“The mechanism behind the damage of nervous system structures involves mainly oxidative stress and altered ion channel activity, but also mitochondrial damage, microtubule disruption, myelin sheath damage, DNA damage, neuroinflammation and other immunological processes.”
Our clinical review begins with the premise that recent studies have shown a diet high in fruits and vegetables, which are rich in antioxidants, improve immune system function and fight free radical damage. Oxidative damage is one of the main mechanisms influencing neuropathic pain, so it stands to reason that if diet alone can reduce free radical damage, supplements which serve an antioxidant function can further benefit this painful condition.
Many of these studies examined are based on animal trials in which (unfortunately) nerve damage is artificially induced in mice. While this approach is not exactly the same as human studies, where humans experience PN due to health issues, the beneficial effects of supplements on nerve pain and regeneration experienced by the lab animals can be reliably extrapolated to humans. All such studies tend to end with a call to follow up animal studies with human studies to confirm the findings.
Some other of these studies were carried out on humans, but in either case all the information to follow shows exciting promise for those suffering from neuropathic pain.
In Part 2 we will examine the vitamins and minerals with a track record of reducing symptoms of PN, and preventing further nerve damage from occuring.