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Neuropathy is a condition that causes nerves to malfunction and make you feel pain and discomfort that can make your life miserable.
The sensory symptoms linked to neuropathies can include numbness, tingling, pricking/burning pain called paresthesia and an increased sensitivity to touch. These conditions can lead to motor symptoms like muscle wasting, weakness, paralysis or organ/gland dysfunction, as well as autonomic symptoms such as problems with digestion, blood pressure, sweating, sexual function or breathing.
To give you an example, I encountered the case of a 30-year-old woman who has been suffering debilitating symptoms from autonomic neuropathy for years. She asked me for suggestions to help her reverse her symptoms.
Just to give you an idea of what she is going through, here are the symptoms of autonomic neuropathy:
- Dizziness and fainting: When you stand up, blood vessels don’t constrict as needed.
- Exercise intolerance: Heart rate does not increase as needed.
- Urinary problems: Difficult starting urination, incontinence; incomplete emptying.
- Sexual difficulties: Erectile dysfunction (men); orgasm difficulties in women
- Digestion difficulties: Loss of appetite, diarrhea, constipation, abdominal bloating, difficulty swallowing, heartburn or gastroparesis (nausea, food empties from the stomach very slowly).
- Sweating abnormalities: Can cause excessive or insufficient perspiration; body temperature dysregulation.
- Sluggish pupil reaction: Trouble adjusting to changes in brightness; difficult in night driving.
Neuropathy affects at least 20 million (1 in 15) people in the United States and is largely underreported. The most common kind is caused by diabetes. Fifty percent to 70 percent of all diabetic patients suffer from neuropathy  after years of uncontrolled blood sugar.  Even though there are more than 100 types of neuropathy, the most common kinds I see are diabetic neuropathy, carpal tunnel syndrome and lumbar spine radiculopathy.
What causes neuropathy? In diabetic neuropathy it is clear that high blood sugar levels are to blame for numbness, poor circulation and poor healing in the feet and toes. With lumbar spine disc disease, compression on the peripheral nerves directly causes the symptoms of pain, numbness or muscle weakness. And in many other neuropathies a metabolic component of inflammation greatly contributes to the disease state.
Let’s consider the median nerve compression neuropathy called carpal tunnel syndrome. There is more causing it than just compression of your median nerve as it passes through the wrist, which causes numbness, pain grip weakness of the hand. There is also an underlying metabolic problem (i.e., low thyroid hormone, kidney or liver disease, amyloidosis, or high stress levels) along with overuse of the wrist flexor tendons (gripping tightly) that make symptoms manifest.
Other known causes for neuropathy:
- Autoimmune and nerve-related diseases: Sjogren’s, lupus, Guillain-Barre; Parkinson’s disease.
- Poisons: Exposure to toxic chemicals or heavy metals (e.g., mercury).
- Chemotherapy: Drugs like cisplatin are poisons that kill cancer cell but are also dangerous for other cells.
- Infections: Epstein-Barr virus, shingles (varicella-zoster), Lyme disease, hepatitis C, leprosy and HIV.
- Vitamin deficiencies: B vitamins and vitamin E are crucial to nerve health, and deficiency can contribute to neuropathy. In alcoholism, poor nutrition leads to thiamine (vitamin B1) deficiency which directly causes peripheral neuropathy.
Prescription medications for neuropathy
When pain is the predominant symptom, your first impulse may be to reach for a pain reliever. These range from NSAIDs (i.e., Advil) to tramadol (Ultram®) to narcotics (Vicodin®) to even cannabis (medical marijuana in California, for example). There are also topical pain relievers such as capsaicin cream or lidocaine patches that can help.
More commonly prescribed for the long term are the anti-seizure medications, which can block nerve pain even better but may cause drowsiness. Common drugs in this category include Neurontin®, Topamax®, Lyrica®, Tegretol® and Dilantin®. You can even use antidepressants to lower your sensitivity to nerve pain.
What about for motor or autoimmune neuropathy? Immunosuppressant medications are used because they improve function, but have terrible long-term side effects. These include prednisone, cyclosporine or azathioprine. Alternatively, plasma exchange and intravenous immune globulin can help suppress immune system activity.
Therapies for neuropathy
What can you do if you really want to stay away from using prescription drugs? Consider these therapies:
- Cold Laser Therapy  stimulates increased blood flow to heal nerve fibers.
- Neural prolotherapy  injections dramatically reduces nerve pain.
- Magnetic therapy. 
- Older, more traditional therapies include TENS (transcutaneous electrical nerve stimulation), physical therapy, acupuncture or biofeedback.
Nutrient supplements to help heal neuropathy
These are involved in the reversal of the disease and can take many months to have their full effect:
- Acetyl-L-carnitine: is an amino acid that clearly improves diabetic neuropathy at 500 mg or 1,000 mg three times daily. 
- Geranium oil: Approximately two-thirds of study participants had highly significant results using 100 percent or 50 percent strength geranium essential oil topically.  Other useful essential oils are lavender, bergamot, tea tree and eucalyptus. St. John’s wort is a useful botanical antidepressant.
- Vinpocetine: opens up peripheral blood flow around the end of the nerves that are damaged. Begin with 20 mg twice daily with meals and increase as needed.
- α-Lipoic acid: is used in Germany given intravenously (IV). Oral doses of 300 mg twice daily or more can be effective, but less effective than when given IV.
- Inositol: at 500 mg to 1,000 mg daily was effective in certain studies. 
- Omega-3 oil: (krill oil, fish oil, flaxseed oil) are building blocks of nerve tissue and are useful at high doses (6 grams daily) to reduce nerve inflammation.
- Gamma-linolenic acid (GLA): is an omega-6 oil that has been studied and found to protect nerves from diabetes-induced injury,   high in evening primrose, borage and black currant oils.
- Tumeric (curcumin): is an Ayurvedic herb used to calm nerve pain.
- Vitamin E: at 1,600 IU daily along with vitaminB12 and the B complex are advised to assist in healing damaged nerves.
To feeling good in life,
Michael Cutler, M.D.
-  Martyn CN, Hughes RA. Epidemiology of peripheral neuropathy. J Neurol Neurosurg Psychiatry. 1997 Apr;62(4):310-8.
-  Narayan KM, et al. Impact of recent increase in incidence on future diabetes burden: U.S., 2005-2050. Diabetes Care. 2006;29(9):2114-2116.
-  Kerry Zang, DPM, Janna Kroleski, DPM, Shahram Askari, DPM, and Sanford Kaner, DPM. Can Low-Level Laser Therapy Have An Impact For Small Fiber Neuropathy? Podiatry Today. June 2011; 24(6). Online at: http://www.podiatrytoday.com/can-low-level-laser-therapy-treat-diabetic-peripheral-neuropathy
-  http://drleewolfer.com/regenerative-injection-therapy-rit/neural-prolotherapy-npt/
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-  http://restorativemedicine.org/books/fundamentals-of-naturopathic-endocrinology/professionals/blood-sugar-metabolism-disorders/diabetic-neuropathy/
-  Salway JG, Finnegan JA, Barnett D, et al. Effect of myo-inositol on peripheral-nerve function in diabetes. Lancet. 1978;2:1282-1284. Also: Gregersen G, Bertelsen B, Harbo H, et al. Oral supplementation of myoinositol: effects on peripheral nerve function in human diabetics and on the concentration in plasma, erythrocytes, urine and muscle tissue in human diabetics and normals. Acta Neurol Scand. 1983;67:164-172.
-  Jamal GA, Carmichael H. The effect of gamma-linolenic acid on human diabetic peripheral neuropathy: a double-blind placebo-controlled trial. Diabet Med. 1990;7:319-323.
-  Keen H, Payan J, Allawi J, et al. Treatment of diabetic neuropathy with gamma-linolenic acid. The gamma-Linolenic Acid Multicenter Trial Group. Diabetes Care. 1993;16:8-15.