Key points:

• Peripheral neuropathy never starts on its own, there is always an underlying cause.

• Diabetes is the number one cause, but 70% of the time neuropathy is caused by something other than diabetes.

• It is believed to be over two hundred causes for neuropathy.

• There is no cure for neuropathy currently.

• 97% of the causes of neuropathy decrease the amount of oxygen it gets to nerve cells.

• There are effective treatments that can reverse neuropathy without medication, surgery, or injections for 90% of neuropathy cases.

• Continuation of these treatments can provide long-lasting relief from neuropathy.

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First and foremost, peripheral neuropathy never starts on its own there is always an underlying cause it might be easier to think of it as a symptom of something else that is occurring in the body. It is believed there are over two hundred causes for peripheral neuropathy currently. Peripheral neuropathy normally starts with damage to the sensory nerves, most commonly in the feet, sometimes in the hands. This leads to changes in sensation development of symptoms such as numbness, burning, sharp shooting pains, tingling, pins and needles, cold sensation, hot sensations, and balance issues. A substantial percentage of neuropathy sufferers state the first sensation that they felt was that their socks are rolled up underneath their toes.

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Peripheral neuropathy is known by various names including neuropathy diabetic neuropathy idiopathic neuropathy Induced peripheral neuropathy (CIPN). These names refer to the reason the neuropathy started resulting in the same type of damage to the nerve tissue.

Physiologically what happens the cells at the end of the nerve skin level die off and recede deeper into the tissue and then begin to fire on their own. This phenomenon is similar to the phantom sensations experienced by amputees and limbs that are no longer present. Balance issues develop as the nerve endings recede deeper into the tissue and are no longer down to the sole of the foot, they are deeper in, so people may feel like they are walking on a sponge for a piece of cardboard. This causes the loss of awareness of where the feet are in relation to the body and neuropathy sufferers become more dependent on their depth perception to maintain their balance. This may be most evident when washing their hair in the shower they find they need to reach out and stabilize themselves when they close their eyes.

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Diabetes is the number one cause of neuropathy, 30% of all cases of neuropathy are related to diabetes. It is believed between 50 to 70% of all diabetics will develop neuropathy at some point in time in their life. Other common causes are chemotherapy cancer, metabolic issues (B-12 deficiency, excessive B-6 are common examples) alcoholism, certain antibiotics, blood pressure medications, statin drugs for cholesterol and toxins. 30 to 40% of neuropathy sufferers will be diagnosed with idiopathic neuropathy, because the cause of the neuropathy is not known. Although neuropathy may be from different causes, the damage to the nerve endings is similar.

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Symptoms of neuropathy can vary from individual to individual depending on which of the nerve endings have become damaged. Some neuropathy sufferers will experience pain for others just numbness and tingling. Many individuals report heightened symptoms at night this occurs because of the fact that during the day you still have normal nerve endings that are being stimulated by your socks shoes being on your feet but at night we remove those socks and shoes there was nothing stimulating the normal nerve endings to override the abnormal sensations and the abnormal nerves become more dominant.

 

Oxygen loss is the primary reason that the nerve endings become damaged. The reason that 50 to 70% of diabetics will suffer from neuropathy is due to the loss of oxygen related to high blood sugar. When we talk about high blood sugar, the sugar is not floating freely through the bloodstream, it attaches to the red blood cell on the receptor site for oxygen. The oxygen receptor site actually has a higher affinity for sugar than oxygen. A common blood test for diabetes is called a hemoglobin A1C, what this test shows is how much sugar has been attached to the red blood cell over the last 90 days, the number you get from this test is actually the percentage of receptor sites take it up with sugar where oxygen should be. In normal A1C is 5.5 or less, prediabetic is 5.6 to 6.5 and diabetes is defined as having an A1C of 6.6 or higher. It controlled diabetic is defined as having an A1C of 7.0 or less, this means that a controlled diabetic is running on 1.5% less oxygen on each and every red blood cell in their body. This is like having a high-performance engine in your car that requires high octane fuel, but you keep putting regular gas in it, it runs but after a while it will eventually develop problems. The loss of oxygen affects the nerve endings causing the cells ends of the nerve to die off, overtime this loss of oxygen will actually start to compromise the capillaries where we actually have the exchange of oxygen and nutrients from the bloodstream to the tissues causing further damage to the nerve endings. This is one of the reasons that a diabetic may develop neuropathy one or two years after they have gotten their diabetes under control.

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B12 deficiencies can lead to anemia where there is an inability to produce a sufficient amount of red blood cells, thus limiting the amount of oxygen that gets to the tissues. It is thought that all B vitamins are soluble in water, that any excess will be eliminated through the urine, which is not always the case. Excessive B6 can cause neuropathy as it will interfere with the normal metabolic pathway that forms red blood cells, thus causing anemia.

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Chemotherapy and radiation therapy for cancer can also cause neuropathy, though the mechanisms are different in chemotherapy, the mitochondrial which is the energy portion of any cell becomes damaged limiting its ability to create new cells. This damage to the mitochondria is designed kill cancer cells but unfortunately nerve cells can become damaged also from the same process. Radiation therapy for cancer causes specific mitochondrial gene expression changes that are related to cell survival. Mitochondria is the primary target for radiation induced apoptosis, A type of cell death in which series of molecular steps affecting the mitochondria's ability to function lead to a cell's death, again this affects both the cancer cells and nerve cells. This is also the reason that chemo-induced neuropathy may start immediately and neuropathy from radiation may not start for four to five years after the fact.

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These changes to the nerve cell and to the mitochondria can be reversed. Pre and post skin biopsies (this is where two or three plugs of skin from the lower leg and feet are taken and then stained to count the number of nerve endings) on patients we have treated have demonstrated an increase of nerve density by over 400% in severe cases, no matter the cause. More information on this is available on the lifetime relief page.