Neuropathy Gets on My Nerves

Hello and welcome. So I wanted to do the show today on neuropathy and talk about exactly what it is, what you can do. There's a lot of people that actually uh suffer from it, and I wanted to actually go through neuropathy and um see if it'll make a difference for in folks for their lives because this is a a really uh can be a very, very debilitating uh symptoms. So if you're listening and you want me to cover or ask or you want to ask a question about this particular topic or really any other, while I'm live on the show, I'm also looking at my email. Um and so you can send me an email at info at asdrv.us, info at asdrv.us. So let's talk about what exactly is neuropathy, right? So, first of all, there are several different types of neuropathy. Um, you can have a peripheral neuropathy, which is what most people actually suffer from. You can have an autonomic neuropathy, and that sort of that sort of affects your uh involuntary functions like your heart rate, your digestion, your blood pressure, and then you can have a focal or a localized neuropathy, which involves like one nerve or maybe a group of nerves that are sort of near each other. But for today's conversation, we're gonna primarily talk about peripheral neuropathy because that is what most people suffer from. And peripheral just means it's at the periphery or the uh ends of your body. So peripheral neuropathy impacts your uh your toes, your feet. Um sometimes people say they have a lot of problems with the sole of their feet. Um, it may also impact your fingertips and your hands. Um, and that's that's kind of the areas that we're talking about that are are sort of impacted. Oh, I see. So basically, what happens is um there is damage to the conduction of your peripheral nerves that carry information from your brain to from your brain and your spinal cord down to your hands and to your feet, and it's actually what allows you to actually feel your feet when you're actually walking, uh, move your hands, um, not have any pain, etc. So this disruption in the signaling um occurs for a lot of different reasons. There's a lot of different causes of it. I'm gonna talk about that a little bit. But about 35 million people are in the US are impacted by peripheral neuropathy. And what you'll find with it is that more you get it more as you age, right? So if you look at folks that are kind of like 40 to 69 years old, about 10% of them will have neuropathy. Um folks that are 70 and older, about a quarter of them will have neuropathy. Um and it can kind of um go up from there. Um you'll also see that we we see we see neuropathy neuropathy more frequently in people with diabetes. Um we also see it, and we don't know exactly why, uh more in men. Um, and we also see it more in African Americans. So, what exactly is neuropathy? So, for some folks, they actually get sort of like a tingling or a numbness or a burning sensation. Like I said, it can usually start in their hands or feet. It can actually get as bad to the point where it's sort of sharp shooting or stabbing pain. Um, there can also be a hypersensitivity to touch. Um, some folks kind of get a weak. They actually find that their feet or their ankles get weak or their hands feel weak. They can't grip things the way they normally actually could grip things, and it's sort of a slow progressing thing. If you have a problem with your grip that's sort of immediate, you want to make sure that you go get checked out for a stroke. Um, this is and you go immediately to the emergency department. This is something that kind of like occurs really slowly over time. Um, for some people, they lose coordination and balance again, slowly over time. Um, again, if you suddenly lose coordination or balance, you should go to your nearest emergency department. Um, and then in the in the severe cases, what happens is they can completely lose sensation. So if you can imagine, it can be hard to walk if you don't actually feel your feet on the ground, right? In some situations, if you completely lose sensation, um you also um might have your shoes on too tight or develop wounds on your sh on your feet, um, or you may injure your hands or or or arms. So those are all the things that are kind of associated with um a typical neuropathy. It can be quite debilitating. So let's talk about the causes and a little bit about um what you can do for uh neuropathy. So the first and most common cause of neuropathy is diabetes. If you have diabetes and you start to complain of these symptoms, your physician will not do a workup and will tell you you have peripheral neuropathy related to diabetes. It's very, very common in diabetics, um, and it's often what leads to them having uh ulcers or or wounds on their uh feet or leg. So it's very, very common in diabetes. Um, you also see it um if people have um received chemotherapy. So a lot of chemotherapy agents are what we call neurotoxic, and that is that they are toxic to they can be toxic to the central nervous system, they can also be toxic to the peripheral nervous system. And even though the chemo is over, these agents can kind of linger for a little while. We also see neuropathy in autoimmune diseases, things like uh lupus or rheumatoid arthritis. Um, you can see them in certain infections, um, shingles, uh, Lyme disease, HIV, certain vitamin deficiencies, particularly B12. We also see them in uh in uh alcohol abuse, uh some uh hereditary diseases like uh charcomerie tooth disease, and various um injuries. So that's kind of like what some of the some of the causes are. Um what I'm gonna do is after we after I after news you you can use, we're gonna go into a little bit more about what can you actually do. So I really want to hear about you and I wanna wanna uh you wanna give us a call um and ask some questions about this. Our um phone number is 1-800-450-7876, 1-800-450-7876, and we'll start answering some questions right after news you can use. All right, what the health is happening? That's the real question. It's also the name of my new podcast. If you have not checked out my new podcast, that is where you go to actually any episode of the Ask Dr. V show is on the podcast. In addition, there's also episodes on the podcast that have not been a part of the radio show. So if there's things that you want to see, what other topics are there, you want to go to the podcast, which is what the hell is happening. You can get all the life-changing information that you want and all the inside scoop about all sorts of health matters. Um, it is your dose of reality with me and my friends. Um, sometimes it's me talking, sometimes I interview folks. It is on all streaming platforms. So you can find it on uh you can find it on Audible, uh, you can find it on Apple Podcasts, uh any sort of podcast platform that you actually listen to, you will actually find it there. So download and subscribe, comment. Um, if there's things that you want to hear more about, uh let me know. All right, news you can use. I really want to talk about this government shutdown and what is going on with food stamps. I know there's a lot of people in our community that are impacted by this because food stamps, the money did not load up on Saturday. So I wanted to talk a little bit about what you can do. There's a lot of area food banks around in the area. Um, and you know, go there and get whatever you need. And we need to kind of be able to, as a community, ride this out. So I wanted to just give a couple of names. Um, there is a Capital Area Food Bank, there's World Central Kitchen, which is uh WCK.org, there's Bread for the City, um, and there's the ARC, uh, Food and Farm Fridays. Um, every Friday they give out organic vegetables and food every Friday. So um, you know, if you are one of the people that are impacted by either government shutdown, rift, doge, uh the uh the the food stamps uh not being loaded up, any of those things, it doesn't really matter. Just go and get what you need. Um, and so all right, and the next uh story I wanted to actually news you can use, and this is really important because we're in a time now where we are actually selecting our health insurance. I know uh for myself at my job I have until the 12th to select my uh health insurance. There's a lot of people, if you're on the Obamacare marketplace, um, I think you have until uh the end of the year or maybe the first or second week of January. So I wanted to actually really talk about a really important health insurance scam that we are beginning to see out here that you want to make sure that you protect yourself and family from. And basically, what this is is these are folks that actually sell you what you think is health insurance. And actually, what it is is a fixed indemnity plan. Now, let me tell you what a fixed indemnity plan is. A fixed indemnity plan is they pay a particular amount, a fixed amount, that's why they use the word fixed, and they pay that amount no matter what the bill is. So if the bill is$1,000 and the fixed amount that they pay for that particular service is$200, then you are responsible for the$800. And they are making this seem like to people that it's actually health insurance, and it is a fixed indemnity plan. Now, here is how you protect yourself from this. If you are buying insurance today in this marketplace, what you want to ask someone is is this ACA compliant, which is affordable health care, uh, or is this a compliant with Obamacare? Fixed indemnity plans are not compliant with Obamacare. So that is a question to ask to make sure that you are not uh subject to these particular scams. You want to make sure to protect yourself and your family out there. If you buy insurance, you want to make sure that you actually really, really have health care insurance so that when you go into the doctors, you can actually get the treatment that you need to get. Alrighty, let's get back to some questions here today on uh neuropathy. Um if you have any questions, you can give us a call at 1-800-450-7876. 1-800-450-7876. I have some folks that have emailed me some questions at info at askdrv.us. And if you're shy and you want to in it, you wanna um you want to email me questions, you can do that as well. All right, so Francetta asked, what medications are used and are available to actually treat uh neuropathy symptoms? So you'll see several medications that are actually used. These are all prescription medications. These are medications that have to be prescribed by your physician, they've got to be dosed based upon what your medical history and all the things that you have going on. Um, the most common one that you'll probably see is a medication called gabapentin. Um, and what gabapentin does is it increases the release of neurotransmitters and it decreases the release of excitatory neurotransmitters. And basically, what that does and the goal of gabapentin is to actually decrease the pain. There's other medications like lyrica that kind of work similarly. You will see some people may also uh use medications like uh Symbolta or uh or effects are so these are sort of the types of medications that you'll actually see, um prescription medications that are actually used for uh neuropathy. Um, again, these are prescribed by a physician and dosed by a physician. Um I had another question, uh, and this question was from Alicia. Um, and this she is on gabapentin. So she says, Dr. V, I take 300 milligrams of gabapentin three times a day, so 900 milligrams a day for my neuropathy. Sometimes it makes me a little dizzy and it makes me a little sleepy. I was wondering what vitamins and supplements might help with nerve health, and are there any natural solutions that can help? So, great question. So, yes, there are natural solutions that can help. Um, and they're primarily uh uh vitamin related, um, and some of them are um are are not vitamin related. So let me just kind of go over um some of these uh medications. And and I think it's really important, all of these vitamins can be actually obtained through your diet, through your normal diet. You don't necessarily have to go out and buy uh supplements. And I don't, and I'm not a big believer in people spending a whole bunch of money on supplements. Um a multivitamin is fine, but you know, all these various supplements, you can overdose on vitamins. And so I'm very, very careful. But just so you guys know what happens, B12 is the most, all your B vitamins are very, very important for nerve health. Um and and B12 actually helps with the myelin sheath that actually um protects uh the nerve. Uh B1, which is thymine, actually helps with uh nerve conduction. Uh B6, also known as pyridoxine, um, it kind of supports uh nerve transmitter uh communication. Uh B9, which is folate, um, works with B12 to help repair the nerve. Um and then there's other uh other vitamins like vitamin D, uh, which is um low vitamin, low vitamin D is really linked to a higher pain sensitivity and poor nerve recovery. Um after uh when when COVID occurred, we actually got we we began to understand in medicine the importance of vitamin D and measuring vitamin D. So your physician can measure your vitamin D level before taking any or taking any supplements and then prescribe, he can prescribe vitamin D based upon what that lab result shows. Vitamin E is an antioxidant and it protects the nerve membranes. And then you have other things like acetyl-L-cartine, which really supports energy metabolism in the cells of the nerve and helps the nerve to actually really be able to regenerate. Um, and you have alpha lipoic acid, which is also an antioxidant that improves nerve blood flow and also helps with glucose metabolism. So, in general, I tell people the best thing to do is really look at having a healthy diet. Um, and you know, certainly, you know, if you want to get a broad spectrum multivitamin and take a broad spectrum multivitamin or a broad spectrum B complex vitamin, a multivitamin would be better because then you can get vitamin D and vitamin E. But I want, I think it's really, really important that whatever you do around this, make sure that you speak with your physician because some of these vitamins, you can overdose on these vitamins. So, you know, a multivitamin a day uh doesn't hurt uh anybody, but if you're gonna do anything more than that, you really want to do it in consultation with your uh with your primary care doctor. All right. So Belinda asks, how does diabetes cause neuropathy and how can I prevent it from uh worsening? Oh, but let me let me actually take uh let me actually take the call before I answer this online question. Let me actually take this caller on line one. Hi, Kashiba, how are you?

I'm fine. I'm fine.

Um can you speak up just a bit? Because I can't quite hear you.

Okay, can you hear me now?

Better, much better.

Okay. Um I have a couple of questions. Um you went through the nutritional supplement um quickly. Because I took I took one which helped and full of poor yes, as well as um, yes.

So so you took a supplement that was was it a multivitamin or what sort of supplement was it?

Well, it was a it's a dietary supplement. Okay.

Okay.

And it it did have all those things you mentioned, in addition to calcium and alpha lipoic acid.

You can call back in, but let me actually go over uh gabapentin and the side effects of gabapentin. So the most common things, because gabapentin is probably the first-line medication, prescription medication that your physician is going to prescribe to you. Um and gabapentin actually is associated at higher doses with uh fatigue or sedation or sort of lightheadedness or um feeling a little dizzy. Um some people also get um swelling in their uh lower legs. Um less common side effects, um there are some people that experience increase in their appetite and a uh a weight gain. Um, and there are some people that kind of experience uh mood swings, anxiety, or depression. Um, if someone actually has really, really severe side effects to GABA pentin, then they it will sort of deteriorate their mental wellness and also um they can actually have an allergic reaction. Kashiba, you're back with us.

Yes.

Great, okay.

I didn't hear the um the side effects of gabapentin.

Yes. So um the most common ones are fatigue, sedation, lightheadedness. Some people get a little bit of uh uh problems with their coordination, difficulty walking, swelling around their legs. Um some people fewer side effects are things like um increased appetite, weight gain, um, mood swings, um, memory difficulties, um, and then very severe reactions, or if someone has like an allergic reaction or a significant deterioration in their mental health.

Is this a symptom of an actual vitamin deficiency? Is peripheral neuropathy?

So you can, so peripheral neuropathy can be related to an actual vitamin deficiency. So there are people that have uh a B12 deficiency and get a peripheral neuropathy or a folate or thymine deficiency and they'll get a peripheral neuropathy. We particularly see that in people that are really severe alcoholics because they're not eating, they're drinking, right? And they'll have really severe B vitamin deficiencies.

But you don't uh you don't advertise any particular nutritional supplement uh that has all of the above needed deficiencies in it.

Yeah, so so no, I don't actually uh I have I'm I've kind of sh shied away from getting in the business of selling supplements. Um so I more tell people, this is what I tell people I would look for. I would look for a multivitamin um that has all of those things in it. Um and if you could find that multivitamin in a liquid format, I tell people um Costco has probably the highest uh number of liquid supplements that I've actually seen. Um and the liquid supplements are better than the pills because you get better absorption.

Okay.

Yeah, so if you can find, but it needs it sounds like you're taking something that had the things that I listed off. Are is it helping you?

Uh yes. Yes, yes, yes, it has, because I had a lot of tingling and oh pain in the feet.

Right.

Um but uh you know, as I said, it had a a couple of other extra um ingredients like calcium. Alpha lycoric acid.

Right.

Yes.

Now were you able because of this supplement to get off of gabapentin? Um that's a success. Yeah, congratulations.

I'm trying to tell my neighbor to get off of it because he still has problems and I want to, you know, address those side effects.

Right. Right. I I tell people all the time, you know, sometimes people come to us as physicians for the prescription first. And I think, you know, part of part of what I want to do with this show is to look at well, what can you do first? Because as soon as we write a prescription, one, it's expensive, two, um, you know, it has side effects, right? There there's there's pros and cons to anything that we actually do, whether or not it's a prescription or a procedure. Yeah. Yeah. All right. Thank you for calling in. All right. I got Another question from Belinda. She wanted to know how does neuropathy, how does diabetes cause neuropathy? So this is important because diabetes causes a clogging of your small vessels, your very, very, very tiny peripheral vessels. In addition to clogging the vessels like in your coronaries, it also clogs and stops blood flow. That's how come diabetics also get wounds and sores and need amputations because their blood flow gets very, very bad to their peripheral body, which is primarily their legs and their feet. So when you get that uh when you get that stoppage of blood flow peripherally, um then what happens is um the nerves are affect are infected, uh affected. Just just like you would get a um you can get a heart attack, you start to actually get decreased blood flow to your nerves, then they don't work and conduct as well, and that is how diabetic neuropath that is how diabetic neuropathy actually occurs. So I got another question from Trey who wanted to know um what other sort of therapy or exercises or things that can help with uh uh with peripheral neuropathy. So there's a couple of things that are um I think that are important that have really helped. Um there are several people that have gotten some significant improvement using acupuncture. Um, and so that is something to actually try if you're suffering from neuropathy. Um, the other thing that you'll see on the marketplace are these uh vibrating platforms, um, and you put your feet on them and they kind of they jiggle, and it helps to actually increase your blood flow to your toes and your feet. Um, I tell people it's really important to make sure that it's okay from your primary care physician to use these sort of vibrating platforms, but assuming that that your primary care doctor is okay with that, given whatever other medical issues you have going on, there are some people that have actually had some significant improvement uh with these uh with these vibrating uh vibrating platforms. And so they've actually really uh really made a difference uh with uh with um uh with neuropathy. All right, Mark asked, are there any new and emerging treatments for neuropathy? And yes, there are. Um so there's a lot of clinical trials. If you are frustrated, you can also join a clinical trial. Um if you go to clinicaltrials.gov, uh there are clinical trials related to neuropathy. But let me actually go over what some of them are. So we're seeing cryoneurolysis, which is actually using cryo, which is cold therapy, to actually reactivate the nerves. Um we're also seeing something called TENS and spinal cord stimulation. This is transcutaneous electrical stimulation of the nerves. Um, some people are using the TENS or the spinal cord stimulators to actually make a difference. And the other thing that we're seeing is we're seeing a lot of advancements in stem cell therapy, which is actually allowing for the regeneration of nerve tissue. Um, and I think ultimately um that is going these some of these sorts of things are going to be um a real um a real a real cure. And so um these are very, very exciting. As I said, you can go to clinicaltrials.gov, um you can Google clinical trials, you can ask your doctor for clinical trials, and you could see whether or not any of those things would actually help. All right, I think I got time for one last question from Stephanie. Stephanie says, I had foot surgery, oh, I had foot surgery for plant plantar fasciitis, and I also had varicose vein treatment with needles shortly afterwards. I was diagnosed with neuropathy. Any sort of surgery on your foot is trauma. So, as I said, trauma will actually cause neuropathy. Um, so you do need to, as a part of your physical therapy, look at how you can actually get that feeling again, right? And and sometimes with surgery, some of those tens and some of the nerve stimulations are really some of the best uh treatment. All right, so the Ask Dr. V show is produced by the nonprofit Channel of Health. The mission of Channel of Health is to inform, educate, and empower communities about pressing health care issues. We also provide scholarships for MCAT Prep for a promising scholars majoring in science and medical-related careers. You can support our efforts and educate in educating our and empowering our community and go to askdrv.us to donate today. That is a wrap. I want to thank you for joining us today. And if you want to hear a topic that is important to you, make sure to reach out and email me. I do respond. Talk to you next week.