Neuropathy

Neuropathy is dysfunction or damage of one or more nerves that usually causes tingling, numbness, muscle weakness, muscle shrinking, and pain. Neuropathy typically starts in the hands and feet, but other areas of your body may be affected as well.

Neuropathy may develop because of metabolic dysfunctions, diabetes, infections, chemotherapy, traumatic injuries, some medications, and other reasons. The symptoms can be mild to debilitating. Fortunately, there are natural support options to help improve your overall health and well-being.

Let’s look at the symptoms, types of neuropathies, risk factors, and root causes of neuropathy. After an overview of the diagnosis and traditional treatments, you will learn about natural support strategies to help deal with neuropathy.

What is neuropathy?

Neuropathy is a condition resulting from nerve damage from metabolic issues, diabetes, infections, chemotherapy, traumatic injuries, and other conditions. The most common form of neuropathy is peripheral neuropathy, which is frequently caused by diabetes and results in damage to the peripheral nerves.

Peripheral neuropathy affects approximately 20 million people in the United States. The peripheral nervous system sends messages from the brain and spinal cord to other parts of the body. In addition, it delivers sensory information to your nervous system. Damage to the peripheral nerves disrupts their functioning causing weakness, numbness, pain, and other symptoms.

Symptoms of neuropathy

Symptoms of neuropathy may include:

• Muscle weakness
• Cramps
• Muscle shrinking
• Pain
• Temporary or permanent numbness
• Tingling or prickling sensation
• Increased sensitivity
• Impairment of urination or sexual function
• Dysfunction of certain glands or nerves
• Sweating or heat intolerance
• Gastrointestinal issues

Types of neuropathies

There are two primary types of neuropathies: mononeuropathy and polyneuropathy. Mononeuropathy involves damage to a single nerve. Polyneuropathy involves damage to multiple nerves.

There are different types of polyneuropathies:

Autonomic neuropathy: Autonomic neuropathy is a type of neuropathy that affects the nerves that control your involuntary bodily functions, including your digestion, heart rate, and urination.

Peripheral symmetric neuropathy: Peripheral symmetric neuropathy is the most common type of neuropathy. It is also the most common form of diabetic neuropathy. Peripheral symmetric neuropathy tends to affect the feet and hands.

Thoracic and lumbar root proximal neuropathy: Thoracic and lumbar root proximal neuropathy is a type of neuropathy that leads to damage to the nerves along with certain specific areas of your body, including your legs or chest wall.

Risk factors for neuropathy

Risk factors for neuropathy may include:

• Poorly managed diabetes
• Chemotherapy
• Alcohol
• Kidney failure
• Cancer
• HIV/AIDS
• Autoimmune conditions
• Carpal tunnel syndrome
• Nutrient deficiencies, including vitamin B12 and copper
• Excess nutrient consumption, especially excess of vitamin B6
• Toxins in food
• Inflammation
• Trauma
• Poor Posture & Ergonomics

Root causes of neuropathy

Neuropathy has a range of root causes including diabetes, insulin resistance, brain and spinal cord injury, infections, autoimmunity, nerve pressure, nutrient deficiencies, and some medications.

Diabetes and insulin resistance

Insulin resistance happens when your body does not respond well to insulin and cannot regulate blood glucose levels. Insulin resistance raises your risk of developing prediabetes and diabetes. It may also occur in the absence of diabetes.

According to a 2017 study, diabetes accounts for approximately 50% of all peripheral neuropathy cases. The study found that glycemic control, balancing blood sugar levels, and lifestyle changes are effective methods of lowering the risk of diabetic peripheral neuropathy and some of its risk factors, including prediabetes, diabetes, obesity, and metabolic syndrome.

Of the nearly 20 million people with peripheral neuropathy, approximately 68% have diabetes. About 8% of Americans have diabetes, and up to 70% of them have some level of peripheral neuropathy.

While diabetic neuropathy is more likely to develop in those with type 2 diabetes, individuals with type 1 diabetes may also experience neuropathy. Both men and women may experience nerve pain from peripheral neuropathy, but women are more likely to experience pain.

Brain or spinal cord injury

Brain and spinal cord injuries may also result in neuropathy. Traumatic brain injury, spinal cord injury, encephalitis, stroke, and transverse myelitis may contribute to or worsen neuropathy.

Traumatic brain injury may occur due to a severe sports injury, car accident, serious fall, violent blow to the head, or other outside force. It may lead to confusion, concentration troubles, blurry vision, headaches, and other symptoms. According to a 2017 study, traumatic brain injury in those with diabetes and diabetic neuropathy can increase psychiatric health issues, such as anxiety and depression, sustained brain trauma, and other associated issues

Spinal cord injury means that there is damage to your spinal cord or nerves located at the end of your spinal canal. A sudden blow or cut to your spine from a fall or accident can cause a traumatic spinal cord injury. Spinal cord injury can result in permanent loss of function, strength, or sensation below the location of the injury. Central neuropathic pain is common in spinal cord injury patients. Researchers also found that psychological treatment, acupuncture, or exercise may help alleviate symptoms.

Encephalitis is a brain inflammation that is usually caused by a viral infection. Symptoms can include flu-like symptoms, seizures, fatigue, weakness, movement issues, and problems with sight or hearing. Encephalitis may cause acute neuropathy.

Strokes occur when there is an interruption to the blood supply to your brain causing your brain cells to start dying within minutes. Neuropathy may affect up to 20% of stroke survivors.

Transverse myelitis is a neurological disorder and an inflammation that affects both sides of one section of your spinal cord and your nerve cell fibers. This can disrupt messages across your spinal cord nerves and your entire body. Transverse myelitis can cause polyneuropathy.

Infections & autoimmunity

Infections and certain autoimmune conditions may increase your risk of neuropathy. Inflammatory neuropathy is specifically caused by an infection or autoimmunity. The infection or an autoimmune reaction attacks your nerves, which leads to symptoms of neuropathy. Sensory symptoms, such as numbness, tingling, muscle weakness, muscle pain, or burning, are very common.

Some infections that may cause neuropathy include herpes simplex, cytomegalovirus, hepatitis B, hepatitis C, Lyme Disease, HIV/AIDS, West Nile virus, varicella, herpes zoster, and leprosy. Approximately 30% of people with HIV develop peripheral neuropathy, and around 20% develop distal neuropathic pain.

People with Lyme disease may develop neuropathic symptoms within a few weeks of the infection from a tick bite. However, neuropathic pain may develop weeks, months, or even years after the initial infection. While peripheral neuropathy from viral, bacterial, and parasitic infections is common, they are treatable.

Neuropathy may also develop because of an autoimmune disease. Systemic autoimmune diseases, such as lupus, rheumatoid arthritis, and Sjögren’s syndrome affect multiple areas of your body. As your immune system attacks its own tissues, it may affect your nerves in these diseases leading to neuropathic pain. In some autoimmune diseases, infections trigger your immune system to attack its nerve that can lead to chronic autoimmune neuropathy, visible muscle shrinking, and weakness.

B12 deficiency

Nutrient deficiencies are one of the common root causes of neuropathy. Vitamin B12 deficiency is one nutrient deficiency that can lead to peripheral neuropathy.

Vitamin B12 is found in animal-based foods like fish, red meat, poultry, eggs, and dairy, and fortified foods. Certain medical conditions, including autoimmune diseases, pancreatic disease, gastritis, malabsorption syndrome, and pernicious or unexplained anemia, taking histamine 2 receptor antagonists or proton pump inhibitors, may also cause a deficiency.

Vitamin B12 deficiency may damage the myelin sheath that protects your nerve causing peripheral neuropathy. Even mild deficiencies can result in problems, but long-term and serious deficiencies can result in permanently debilitating problems.

Vitamin D deficiency

Vitamin D is a fat-soluble vitamin that is important for your bone, muscle, teeth, brain, immune system, and other areas of your health. Due to our indoor lifestyles and lack of supplementation, vitamin D deficiencies are very common among both people with type 2 diabetes and the general public. Neuropathy is a common complication of diabetes, and increasing research suggests that vitamin D deficiency may increase the development and symptoms of neuropathy.

A 2016 cross-sectional study looked at 861 patients with diabetes and found that having a vitamin D deficiency can increase the risk of peripheral neuropathy in adults with type 2 diabetes.

A 2018 study found that vitamin D deficiency may increase the risk of painful diabetic peripheral neuropathy. The participants receive seasonal (summer) sunlight exposure. Their 25-hydroxyvitamin D levels were measured, and they underwent a lower limb skin biopsy. Researchers observed a significant difference in vitamin D levels between participants with painful diabetic peripheral neuropathy and other participants. Results suggest that vitamin D deficiency plays a role in the symptoms of peripheral neuropathy related to diabetes.

Nerve pressure

Nerve pressure is one of the most common causes of neuropathy. An injury from playing sports falls, car accidents, whiplash, or other incidents can cause damage to or around your nerves, such as stretching, compressing, or crushing your nerves.

Repetitive activities or poor posture can also cause your ligaments or tendons to swell or your discs to move, narrowing your nerve pathways and compressing your nerve fibers. Sciatica, scoliosis, and spinal subluxation can put pressure on and compress your nerve fibers increasing the risk of neuropathic pain. Arthritis puts ongoing pressure on your nerves. Carpal tunnel syndrome and ulnar neuropathy cause compressed nerves in your elbow or wrist, leading to pain and discomfort.

Certain medications

Neuropathy may occur as a side effect of using certain medications. For instance, chemotherapy and medication for HIV/AIDS commonly cause symptoms of neuropathy. In many cases, medication-induced peripheral neuropathy goes away once the medication is discontinued or reduced. In some rare instances, medication may cause long-term or permanent neuropathy.

Medications that may result in peripheral neuropathy include INH, nitrofurantoin, vincristine, perhexiline, hydralazine, cancer medications, anticonvulsants, anti-alcohol drugs, heart and blood pressure medications, infection-fighting drugs, thalidomide, and skin treatments.

In some cases, peripheral neuropathy symptoms may continue after chemotherapy treatment. Radiation therapy may also lead to nerve damage and neuropathy that can affect you for months or even years after your treatment

Diagnosis and traditional treatments

To diagnose neuropathy, your doctor will take your medical history, your symptoms, and results from a physical examination. Your physician may order certain tests to diagnose neuropathy, neurological exams to look at nerve damage, tests for vitamin deficiencies, tests for infections, immune systems issues, diabetes, and more. To look at nerve function, they may order a nerve conduction velocity test (NCV) to check the signal strength and speed of your large motor and sensory nerves and electromyography (EMG) to check the electrical activity of your muscles during rest and contraction.

Your doctor may order neuropathology tests for nerve appearance, including a nerve biopsy to check a sample of nerve tissue for pathologies and a neurodiagnostic skin biopsy to look at your nerve fiber endings. Your doctor may order autonomic testing to evaluate peripheral neuropathies and radiology imaging tests, such as an MRI or a CT to look for nerve root compression, tumors, bone, and vascular irregularities, herniated disks, and other issues.

Traditional treatment for neuropathy typically includes over-the-counter pain medication like nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen. Along with OCTs, treatment usually involves one or several of a variety of prescription medications, including antidepressants, cyclooxygenase-2 inhibitors, tramadol, seizure medications, narcotics, lidocaine patches, and corticosteroid injections.

Other treatments may include plasmapheresis, a blood transfusion removing irritating antibodies, transcutaneous electronic nerve stimulation (TENS), and ergonomic casts or splints. In certain situations, surgery may also be part of the treatment for pinched nerves.

Natural support strategies

You have numerous options to support your health, reduce your risks, and improve your symptoms. These include the following:

Chiropractic care and physical therapy

Nerve pressure for spinal subluxation, scoliosis, sciatica, poor posture and injuries can cause neuropathy. Chiropractic care and physical therapy can help to relieve nerve pressure and possibly correct underlying structural issues.

Chiropractic care can help to correct spinal subluxations, scoliosis, and poor posture, and help to improve sciatica, injuries, disc issues, and other structural problems. A 2020 study found that physical therapy and exercise therapy may help to improve diabetic neuropathy.

Decompression therapy uses traction to stretch your spine, release tension between your vertebrates, increase the flow of oxygen, and reduce pain. It is often used for neuropathy and disc injuries and may be paired with Active Release Technique or cold laser therapy. A 2018 study found that decompression therapy may help diabetic neuropathy.

Transcutaneous electrical nerve stimulation (TENS) is a battery-operated device using electrical stimulation that’s used to relieve pain related to back pain, neck pain, joint pain, injuries, painful diabetic neuropathy, and other pain issues. A 2017 study found that the TENS unit may help to relieve pain related to diabetic neuropathy.

Anti-inflammatory diet

Addressing inflammation may help neuropathic pain. Following an anti-inflammatory diet helps reduce inflammation in your body. Eating a nutrient-dense diet rich in vegetables, fruits, and lean protein can help to improve peripheral neuropathy. In addition, reduce alcohol and remove foods that may trigger neuropathic pain, including all wheat flours, refined grains, added sugar, and saturated fats that can increase symptoms of neuropathy.

Remove the following from your diet: refined sugar, refined oils, conventional dairy, conventionally raised and processed animal products, gluten, artificial ingredients, highly processed foods, deep-fried foods, junk food, food allergens, food sensitivities, and anything that’s triggering your symptoms.

Follow an anti-inflammatory nutrition plan rich in greens, vegetables, herbs, spices, fermented foods, low glycemic index fruits, healthy fats, organic grass-fed butter or ghee, avocadoes, nuts, and seeds, and clean animal protein, such as grass-fed beef, pasture-raised poultry and eggs, wild-caught fish, and wild game.

Resveratrol-rich foods, such grapes, berries, and pistachio, and quercetin-rich foods, such as berries, cherries, black plums, black currants, cruciferous vegetables, raw kale, romaine lettuce, red leaf lettuce, snap peas, cabbage, sprouts, raw red onion, peppers, and raw asparagus may also help to lower inflammation in your body.

Foods rich in omega-3 fatty acids, such as algae, wild-caught fish and seafood, chia seeds, hemp seeds, and flax seeds, and anti-inflammatory herbs, such as turmeric and ginger may help to lower inflammation.

Consider a ketogenic diet

Insulin resistance and diabetes are common causes of peripheral neuropathy. Balancing your blood sugar levels and increasing insulin sensitivity is critical for reducing your risks and symptoms of neuropathy. Following a ketogenic diet can help do this. A 2010 study found that a ketogenic diet can improve insulin sensitivity and glucose tolerance.

Your body burns glucose for energy. When your body doesn’t have enough dietary glucose to burn for energy, it will burn fat for energy instead and make ketones in the process. Ketosis has many health benefits, from reduced inflammation, increased insulin sensitivity, improved cellular renewal to a decreased risk of disease.

Beyond improving insulin sensitivity and reducing the risk of diabetes, getting into ketosis may help neuropathy in other ways and help other forms of neuropathy besides diabetic peripheral neuropathy. A 2017 review found that a ketogenic diet may help to manage Leber’s hereditary optic neuropathy.

A 2021 study found that a ketogenic diet can help to reduce inflammation and improve inflammation-related conditions, including diabetic neuropathy and chemotherapeutic neuropathy. It may also improve rheumatoid arthritis.

A ketogenic diet is very low in carbohydrates, around 5% to 10% of calories. Protein levels should be around 30% to 35%, and fats should be around 55% to 60%. Continue to eat an anti-inflammatory real food keto diet with nutrient-dense whole foods and eliminate fat-laden junk foods.

A keto diet should rely on healthy fats, including avocados, coconut oil, coconut butter, coconuts, avocado oil, extra-virgin olive oil, pasture-raised butter and ghee, lard, flax seeds, hemp seeds, chia seeds, pumpkin seeds, other seeds, olives, nuts, and any fats from clean animal foods, such as grass-fed beef, pasture-raised poultry and eggs, wild-caught fish, and wild game.

Optimize B vitamin levels

Research suggests that a deficiency in vitamin B1 and B12, and a deficiency or excess in vitamin B6 can result in neuropathy. Optimizing your B vitamin levels is crucial. If you follow a vegetarian or vegan diet, you will need supplements.

Eating a diet that includes high-quality animal-based foods is a foundation. You will need to be aware of your intake of vitamin B rich foods like grass-fed meat, pasture-raised eggs, grass-fed or fermented raw dairy if you can tolerate it, dark leafy greens, sunflower seeds, almonds, avocados, and citrus.

You may want to add a supplement with vitamin B12 and a high-quality B complex vitamin daily. A methylated form of B vitamin supplement to ensure proper absorption.

Optimize copper/zinc ratio

Research suggests that copper and zinc deficiencies may increase the risk of neuropathy. A 2014 study found that zinc supplementation may help diabetic peripheral neuropathy.

Zinc and copper compete against each other as antagonists to regulate physiological pathways. A healthy balance between these two minerals is critical for your health. Your dietary choices can improve your copper/zinc ratio. Zinc-rich foods include grass-fed lean meat, pasture-raised poultry, nuts, seeds, oysters, peas, and chickpeas. Foods that are good sources of copper include oysters, leafy green, shiitake mushrooms, liver, lobsters, nuts, and seeds. You may also consider a high-quality zinc supplement and a chelated copper supplement or a zinc supplement with copper to support a healthy copper/zinc ratio.

Optimize vitamin D levels

Research has shown that vitamin D deficiency can result in neuropathy. Optimizing your vitamin D levels may help. A 2019 study found that vitamin D supplementation can improve diabetic peripheral neuropathy. A 2020 systematic review has also found the same.

Most people are not getting enough sunshine or consuming enough vitamin D from food. Therefore, most people need supplements to optimize their vitamin D levels. Pairing vitamin D3 with vitamin K2 helps improve calcium absorption and inflammation control.

Typically, taking 1,000 IU per 25 lbs. of body weight will help you get your levels into a healthy range. You want to test your vitamin D levels at least 1-2 times each year and get your levels between 50-100 ng/ml. It has been hypothesized that a therapeutic level for major health conditions is going to be between 70-100 ng/ml.

Consider acupuncture

Acupuncture is a form of alternative medicine and an important part of traditional Chinese medicine. It uses thin needles placed strategically at certain points of your body to help improve blood flow, recreate balance, reduce symptoms, and improve health.

Several studies found that acupuncture helps with neuropathy. A 2019 systematic review found that acupuncture may help with diabetic peripheral neuropathy. If you have symptoms of neuropathy or are experiencing any of its risk factors, you may want to consider acupuncture.

Consider alpha-lipoic acid

Alpha-lipoic acid is a vitamin-like antioxidant that can offer several health benefits, including alleviating neuropathy. A 2009 study published found that alpha-lipoic acid may support the treatment of diabetic neuropathy.

A 2004 clinical trial has also found that alpha-lipoic acid may help the treatment of autonomic diabetic neuropathy (36). If you have neuropathy, I recommend supplementing with alpha-lipoic acid.

Consider benfotiamine

Benfotiamine is a dietary supplement. It is derived from vitamin B1 and is also found in certain foods, including nuts, seeds, legumes, rice, and certain meat and fish. It is often used for nerve pain related to diabetes.

A 2005 study found that benfotiamine helped to improve diabetic polyneuropathy after 3 weeks only. A 2006 study also found that it can help to reduce inflammation and neuropathic pain.

Consider omega-3 fatty acids

Omega-3 fatty acids are fatty acids with anti-inflammatory benefits that may benefit those with neuropathic pain and symptoms. A 2019 study found that omega-3 supplementation may help to reduce symptoms of neuropathy in participants with type 2 diabetes.

Consume foods rich in omega-3 fatty acids, such as algae, wild-caught fish and seafood, chia seeds, hemp seeds, and flax seeds. You may also take a high-quality omega-3 fish oil supplement daily.

Consider using turmeric – curcumin

Curcumin is the active compound in turmeric. Due to its anti-inflammatory and pain-relieving benefits, curcumin may be a great option for neuropathy.

A 2014 study found that curcumin may help to reduce neuropathic pain. A 2020 study also found that curcumin may be a potential and effective therapeutic option for peripheral neuropathy. You can add turmeric to curries, soups, vegetable dishes, dressings, sauces, juices, and smoothies. Or you may wish to consider a supplement.

Final thoughts

Neuropathy is a condition caused by nerve damage and resulting in several symptoms, including numbness, tingling, prickling, muscle weakness, pain, muscle shrinking, and other issues. If you are experiencing neuropathic pain, natural support strategies can offer significant relief.