Causes of Diabetic Neuropathy
Neuropathy is nerve damage caused by diabetes. Symptoms include numbness, tingling and/or pain in the arms, hands, feet and legs. According to the National Diabetes Information Clearinghouse (NDIC), neuropathy can affect every organ system including the digestive tract, heart and sex organs. Causes vary, depending on the type of diabetic neuropathy.
High Blood Glucose
Over time, high blood glucose levels can cause nerve damage that results in diabetic neuropathy. The Mayo Clinic says increased glucose levels weaken the walls of capillaries that provide nerves with oxygen and nutrients. It also impedes the transmission of signals between nerves.
An autoimmune response can cause nerve inflammation that leads to diabetic neuropathy. An autoimmune response is when the body reacts unfavorably against tissues and organs of the body. In neuropathy, the body views nerves as a foreign invader and attacks them. This causes inflammation, which weakens the nerves and eventually results in nerve damage.
Some genetic traits, if inherited, can make a person more susceptible to nerve damage. Certain genetic mutations result in neuropathies that may manifest themselves in childhood or early adulthood. The onset of diabetes can enhance the effects of existing neuropathy.
Alcohol and Smoking
Smoking and alcohol consumption can result in diabetic neuropathy. Tobacco smoke narrows the blood vessels that provide nutrients to nerves. This results in weakened nerves, and symptoms of neuropathy may arise. Quitting smoking can alleviate symptoms. Excessive alcohol consumption can cause neuropathy, although the exact reason is unknown. According to Medline Plus, it likely stems from poisoning of the nerve by alcohol and poor nutrition associated with alcoholism.
5 Things You Need to Know About Preventing Diabetic Neuropathy
1. Checking Glucose is Important for Preventing Diabetic Neuropathy
Although doctors are not certain what causes diabetic peripheral neuropathy, they believe that keeping your blood sugar levels in check is one of the best preventions. Check your glucose regularly and keep it in a safe range. Preventing diabetic neuropathy will also help prevent other diabetes complications. For example, if you have neuropathy in your feet that is causing loss of sensation, you could injure yourself and not be aware of it.
2. Neuropathy in Feet: A Common Problem
People with diabetes often develop feet neuropathy, so it is important to pay special attention to them. Choose white socks and check them daily for fluid or blood. Also check your feet for redness or sores, and make sure your doctor looks at your feet for signs of neuropathy. Shoes should fit loosely, allowing for swelling, so try them on later in the day. If you develop any soreness while breaking them in, stop wearing them until it clears. You can also consider having a custom-made shoe. Keep your feet clean and dry. Applying lotion can help keep your heels from cracking. If your feet sweat, use powder to keep them dry. Manicure your feet properly to avoid ingrown toenails.
3. Eat Well to Prevent Diabetic Neuropathy
A healthy diet addresses two possible causes of diabetic neuropathy. First, a deficiency in vitamin B may cause peripheral neuropathy. Good sources of vitamin B-12 are fortified cereals, eggs, fish, meat and low-fat dairy. Eating a diet with lots of fruits, vegetables, lean proteins and whole grains will ensure you get enough nutrients. Talk to your doctor if you think you may not be getting enough vitamin B. The same diet that is rich in vitamin B-12 will also help you maintain a healthy weight, which may be a contributing factor to neuropathy.
Exercise improves circulation, which can help in preventing diabetic neuropathy. Regular exercise is also an excellent way to keep your weight in check. However, you should always talk to your doctor about a proper exercise program if you have diabetes.
5. More Healthy Ideas to Prevent Neuropathy
Because doctors don’t know why some people develop diabetic neuropathy, you should do everything you can to stay healthy. Check your blood pressure regularly and take all medications your doctor has prescribed you. Don’t smoke and limit the use of alcohol as these add to circulation problems, which in turn can cause damage to your nerves. See your doctor regularly and report anything that concerns you.
5 Things You Need to Know About the Causes of Peripheral Neuropathy
1. Causes of Peripheral Neuropathy Elude Researchers
All the nerves in the human body that are not part of the central nervous system the brain or spinal cord belong to the peripheral nervous system. The causes of peripheral neuropathy are due to damage or impingement to one or more of those three nerves. The autonomic nerves regulate organs and involuntary body functions, such as blood pressure and digestion. Sensory nerves, as the name suggests, allow humans to feel sensations like heat or pain. And motor nerves control muscle movement. Many causes exist for peripheral neuropathy, but doctors often do not find the cause.
2. Diabetic Neuropathy Common
About 50 percent of people who have diabetes will also end up with some type of peripheral neuropathy. It’s common for diabetics to develop neuropathy in several nerves, and this is a clue for doctors that the source of their symptoms is diabetic neuropathy. People who have had diabetes for 25 years or longer are more likely to develop peripheral neuropathy, as are those who struggle with their glucose levels. The exact reason that diabetes causes neuropathies is unclear, but it is possible that damage to blood vessels, as well as the metabolic disorder itself, play a role.
3. Trauma a Likely Culprit
Experts believe that trauma to a nerve is one of the causes of peripheral neuropathy. Repetitive strain to a nerve, such as that which occurs with carpal tunnel syndrome, may be a cause. The use of crutches or some other unnatural position for a long duration is also a suspect. Other possibilities include tumors or abnormal bone growths. Doctors suspect trauma or nerve pressure if a person presents with peripheral neuropathy in just one nerve.
4. Look Deep Inside Yourself
B vitamins are essential for the nerves. As such, it’s possible that a deficiency in the B vitamins cause peripheral neuropathy. Because alcoholism leads to poor nutrition, it may also cause some neuropathies. Poisons are a definite possibility, especially those heavy in metals. Some medications may be responsible for peripheral neuropathy, especially cancer-treating drugs.
5. Diseases and Disorders are also Suspects
Certain inherited disorders such as Charcot-Marie-Tooth disease may cause neuropathy. Other diseases of the kidneys, liver or thyroid are possible causes of peripheral neuropathy. Also, people with HIV/AIDS appear to be at higher risk for developing it. Autoimmune disorders, such as lupus or rheumatoid arthritis, are also on the list of possible suspects.
Diabetic Neuropathy Supplements
Evening Primrose Oil
Evening primrose oil is extracted from the Oenothera biennis plant and is used to treat PMS, inflammatory disorders and diabetic neuropathy. The supplement, generally administered in capsule form, is rich in gamma-linolenic acid, which is an essential fatty acid. According to Memorial Sloan-Kettering Cancer Center, research and clinical trials administered on animals have shown that evening primrose oil can be effective in treating diabetic neuropathy and in reversing it. Further research is needed; however, evening primrose oil supplements are considered relatively safe for use for most people. If you are considering the use of evening primrose oil for diabetic neuropathy, consult your physician first.
Capsaicin is a naturally occurring spicy substance commonly extracted from chili peppers and used in capsule, extract and topical cream forms to treat a variety of conditions. Capsaicin is used as an antibacterial, digestive aid and anti-cancer supplement. Additionally, the burning sensation caused by capsaicin stimulates your nerve endings to release chemical messengers that elicit pain, including the kind caused by diabetic neuropathy. Pain is often experienced with diabetic neuropathy as a result of damage to the nerves, but capsaicin appears to impair the body’s ability to send pain signals to the brain. Topical application of capsaicin cream, therefore, can help reduce or even relieve the pain of diabetic neuropathy.
Alpha-lipoic acid is an antioxidant that is frequently used in Europe to treat diabetic neuropathy. Antioxidants are substances in your body that take byproducts of metabolism, known as free radicals, from your body and excrete them as waste. When free radicals linger in the body, they can cause cellular and neurological damage and can decrease your body’s ability to ward off viruses and bacteria. Alpha-lipoic acid may be able to reduce high blood sugar levels as well, which decreases pain and damage caused by diabetic neuropathy. Alpha-lipoic acid is available in tablet form at your local health food store but check with your physician before using a dietary supplement.
Carnitine, also known a L-carnitine, is a substance manufactured by your body that can help lower high blood sugar levels and reduce oxidative stress that can lead to nerve damage. According to the University of Maryland Medical Center, carnitine is showing promise in being able to help damaged nerves regenerate, although more research is needed to confirm this. Carnitine supplements are available in several different forms under different names and each is indicated for a specific area of illness. Check with your doctor for the appropriate kind of carnitine for your condition and the recommended dosage.
- National Kidney and Urologic Diseases Information Clearinghouse: Diabetic Neuropathies: The Nerve Damage of Diabetes
- Memorial Sloan-Kettering Cancer Center: Evening Primrose Oil
- Florida State University: Capsaicin
- University of Maryland Medical Center; Alpha-Lipolic Acid; Steven D. Ehrlich, NMD
- University of Maryland Medical Center; Carnitine (L-Carnitine); Steven D. Ehrlich, NMD
Neuropathy Background Information
Peripheral neuropathy, states the University of Maryland Medical Center, may be caused by hereditary disorders, metabolic disorders, infections, drugs, poisonous substances and prolonged nerve compression. Some of the most common signs and symptoms associated with peripheral neuropathy include shock-like pain, burning pain, heightened sensitivity to touch, the sensation that you are wearing a glove or sock, decreased muscle strength, excessive sweating, reduced coordination, balance problems, and blood pressure abnormalities.
Although dietary supplements are a time-honored approach to treating peripheral neuropathy, further testing using contemporary scientific research methods may be necessary to validate the use of these natural substances for this condition. According to the University of Maryland Medical Center, several herbal and non-herbal dietary supplements may possess some degree of efficacy in treating your peripheral neuropathy, including vitamin E, biotin, cayenne, omega-6 fatty acids, gamma-linolenic acid and evening primrose.
Evening primrose is a dietary supplement that has historically been used in treating neuropathy, especially diabetic neuropathy — a nerve condition associated with diabetes. Evening primrose may be helpful in reducing the symptoms associated with diabetic neuropathy, such as decreased sensation in your lower extremities as well as burning, tingling or pain in your affected area. Primrose seed oil contains numerous phytochemicals and nutrients that are used in treating a wide range of ailments.
- University of Chicago: Peripheral Neuropathy
- University of Maryland Medical Center: Peripheral Neuropathy Overview
- University of Maryland Medical Center: Herbs and Supplements for Peripheral Neuropathy
- University of Maryland Medical Center: Evening Primrose Oil
Herbal Neuropathy Cures
Capsaicin is one of the few herbal products that is regulated by the Food and Drug Administration as an over-the-counter analgesic. Capsaicin is the substance that gives chili peppers their distinctive sensation of heat. Halat and Dennehy wrote that capsaicin directly affects the sensory fibers involved in neuropathy. They describe several clinical trials in which topical capsaicin was used in patients with neuropathy. Patients reported significantly less pain after 8 weeks of treatment. Additionally, capsaicin relieved neuropathy pain as effectively as a tricyclic antidepressant. Consult a qualified health care practitioner before adding capsaicin to your regimen.
Medical herbalist Katolen Yardley writes that skullcap, a traditional nerve tonic, may help relieve the muscle weakness, nerve damage and numbness of neuropathy. Found in the moist thickets, woods and fields of North America, skullcap was used by the Cherokee and Iroquois people to normalize menstruation, aid the kidneys and prevent smallpox. Skullcap later gained a reputation among Europeans for use in psychological disorders, insomnia and neuropathic pain. According to an article in the “Journal of the American Herbalist Guild,” researchers believe that the active ingredients in skullcap are bioflavonoids, potent antioxidants that prevent cells from being damaged by harmful free radicals. Do not substitute the use of skullcap or any other herb for treatment by a qualified health care professional.
- Katolen Yardley: Herbal Remedies for Peripheral Neuropathy
- Journal of the American Board of Family Practice: Botanicals and Dietary Supplements in Diabetic Peripheral Neuropathy
- “Journal of the American Herbalist Guild”; Monograph of Scutellaria Laterflora; HL Metzman; 2006
- National Institute of Neurological Disorders and Stroke: Peripheral Neuropathy Information Page
Herbal Remedies for Peripheral Neuropathy
Helpful Herbal Remedies
Helpful herbal remedies may reduce the signs and symptoms of your peripheral neuropathy. Naturopathic physician and master herbalist Sharol Tilgner, author of “Herbal Medicine From the Heart of the Earth,” states that several herbs may be helpful in reducing nerve damage-related pain, including kava kava, valerian and meadowsweet, while other herbs–passionflower, oat and skullcap–may help support the health and function of your nervous system. St. John’s wort, wild yam and California poppy are also known for their ability to treat pain. Many of these herbs may not have been subjected to rigorous scientific research studies.
Featured Botanical: Passionflower
Passionflower is a botanical remedy that may be a helpful adjunct therapy in treating your peripheral neuropathy. Ed Smith, an expert herbalist and author of “Therapeutic Herb Manual,” states that passionflower possesses anodyne action, which is the ability to relieve pain, including the pain associated with peripheral neuropathy. Passionflower has historically been used to treat nerve pain, muscle twitching, insomnia and elevated heart rates. The leaves, flowers and young stem of the passionflower plant are used in herbal supplements.
- National Institute of Neurological Disorders and Stroke: Peripheral Neuropathy Fact Sheet
- University of Chicago: About Peripheral Neuropathy
- “Herbal Medicine From the Heart of the Earth”; Sharol Tilgner, ND; 1999
- “Therapeutic Herb Manual”; Ed Smith; 2007
Vitamin Therapy for Peripheral Neuropathy
Thiamine deficiency is also prevalent in many diabetics due to depletion of the vitamin as a result of the disease. More studies are needed, but the Serbian medical journal “Srpski Arhiv Za Celokupno Lekarstvo” reports that a combination of benfotiamine, a fat-soluble form of thiamine, and vitamin B-6 were successfully used to treat symptoms of peripheral neuropathy in diabetics.
Vitamin B-12 is extremely important to overall nerve health. Diabetics and alcoholics are often deficient in this vitamin, which causes the classic numbness and tingling of peripheral neuropathy in the feet and hands. Deficiencies are typically treated with injections of vitamin B-12. Vitamin B-12, a water soluble vitamin, is also necessary for red blood cell formation and DNA synthesis. It is present in some foods, including liver, clams, salmon and beef. Because of its importance in the diet, many commercially processed foods, such as breakfast cereals and yogurt, are fortified with vitamin B-12.
Vitamin E is a fat-soluble vitamin that is a powerful antioxidant, important in protecting cells from damage by free radicals. Vitamin E is also important in maintaining healthy nerve function. Cancer patients receiving certain types of chemotherapy, including cisplastin and paclitaxel, often develop symptoms of peripheral neuropathy. The medical journal “Neurology” reports patients receiving 600 mg of vitamin E supplementation daily during chemotherapy treatment and three months thereafter showed improvement in their symptoms. However, you should only take vitamin E supplements for peripheral neuroapthy if advised to do so by your doctor.
Vitamin B-6 is necessary for proper conduction of nerve impulses. Vitamin B-6, or pyroxidine, deficiency may be another cause of peripheral neuropathy in diabetics, alcoholics and some cancer patients. The University of Virginia Health System states that 50 to 300 mg of vitamin B-6 is sometimes used to treat peripheral neuropathy. However, care must be taken because UVHS also reports taking too much vitamin B-6, over 200 mg daily, has been linked to the development of peripheral neuropathy. You should only take vitamin B-6 supplements under the supervision of your health care provider.
- MayoClinic.com: Peripheral Neuropathy
- National Institute of Neurological Disorders and Stroke: Peripheral Neuropathy
- “Srpski Arhiv Za Celokupno Lekarstvo”; The Effect of Benfothiamine in the Therapy of Diabetic Polyneuropathy; A. Nikolic et al.; November-December 2009
- Office of Dietary Supplements: Vitamin B12
- “Neurology”; Vitamin E for Prophylaxis Against Chemotherapy-Induced Neuropathy; AA Argyriou et al.; February 2011
- University of Virginia Health System: Peripheral Neuropathy and Vitamin B6
Vitamin D Deficiency & Peripheral Neuropathy
Vitamin D plays a role in preventing peripheral neuropathy because of its immune boosting benefits and ability to help ward off chronic diseases that lead to nerve damage.
The main source of vitamin D is sunlight. Few dietary sources exist; though egg yolks, cod liver oil and salmon are effective food sources of vitamin D. Many food products are fortified with additional D, including fortified cereals and milk. To prevent rickets, a vitamin-D-deficiency-related disease that causes weak and soft bones, milk producers began adding vitamin D to milk in the 1930s. Vitamin D supplements are another source of the nutrient and usually are included with calcium supplements.
While a well-rounded diet is important for overall health and disease prevention, nerve problems usually are associated with vitamin B12 deficiencies, according to the Mayo Clinic. Fortified cereals and milk that also contain vitamin D are effective sources of B12 as well. Fruits, vegetables, meat and whole grains also provide you with sufficient vitamin B12 to help prevent peripheral neuropathy.
Vitamin D enhances the uptake of important minerals in your body, including calcium and magnesium. It is an antioxidant that protects you against nerve damage and reduces lipid, or fat, production that can interfere with healthy nerve transmission. Vitamin D increases the synthesis of insulin in your body, according to the Worldwide Health Center. Adequate vitamin D levels can protect you from developing Type 2 diabetes, a major contributor to peripheral nerve damage. A vitamin D deficiency may be mistakenly diagnosed as peripheral nerve disease and chronic fatigue syndrome.
When your body is deficient in vitamin D, you are at risk for developing a host of problems that can lead to peripheral neuropathy. Nerve tissues are highly susceptible to damage from conditions that interfere with your body’s ability to turn nutrients into energy, manage cell regeneration and remove waste products. Trauma to bones weakened from a lack of vitamin D increases the risk of trapping a nerve and causing damage. According to the National Institute of Neurological Disorders and Stroke, broken bones cause pressure on surrounding nerves and compress the nerve fibers that cause the pain and discomfort of neuropathies. While 60 to 70 percent of people with diabetes have some level of nerve damage, other conditions that put you at risk for developing peripheral neuropathy include alcoholism, cancer, kidney failure, repetitive stress and autoimmune disorders.
Are Vitamins D and C the Best for Neuropathy?
Neuropathy is a description of conditions that affect the nerves. “Neuro” means nerves and “pathy” means abnormal. Vitamins C and D may be helpful for neuropathy, but they are not necessarily the best. Vitamin B-12 is particularly useful for preventing and treating neuropathy. There are other vitamins that might assist neuropathy.
Vitamin C may reduce neuropathy symptoms. A study published in “Nature Medicine” in March 2004 saw less severe neuropathy in mice with Charcot-Marie-Tooth disease that were treated with vitamin C. Charcot-Marie-Tooth disease affects 1 in 2,500 people. It is the most common hereditary peripheral neuropathy. However, a human trial performed on 81 children with CMT found no significant difference between children treated with vitamin C and those who took a placebo. The study was published in “The Lancet Neurology” in June 2009.
Vitamin D may be effective for relieving pain associated with diabetic neuropathy. A study published in the “Archives of Internal Medicine” in April 2008 found that participants receiving vitamin D supplements saw a decrease in pain of approximately 40 to 50 percent. Participants all suffered from Type 2 diabetes and had a vitamin D deficiency. Researchers did not know how vitamin D could help diabetic neuropathy but hypotheized that a deficiency of vitamin D may potentiate diabetic nerve damage.
A vitamin B-12 deficiency can cause neuropathy. Vitamin B-12 supplements can treat diabetic neuropathy, according to Michael Lam, a specialist in nutritional and anti-aging medicine. Dr. Lam says that 500 to 2,000 mcg of vitamin B-12 daily is usually an effective treatment. Inadequate vitamin B-12 levels can result in damage to the myelin sheath that protects nerves. This lack of protection results in nerves being unable to function correctly, leading to conditions such as peripheral neuropathy.
In addition to vitamin B-12, vitamin B-1, B-6 and E may help decrease pain and neuropathy symptoms. Vitamin B-1 may be effective for treating diabetic and alcoholic neuropathies. A vitamin B-6 deficiency may cause neuropathy with symptoms similar to those of diabetic neuropathy. Supplements can be beneficial, although too much B-6 is toxic and can cause neuropathy. Vitamin E can improve nerve conduction, which may suggest that it could reduce neuropathy symptoms.
- “Nature Medicine”; Ascorbic Acid Treatment Corrects the Phenotype of a Mouse Model of Charcot-Marie-Tooth Disease; Edith Passage et al.; March 2004
- “The Lancet Neurology”; Ascorbic Acid for Charcot-Marie-Tooth Disease Type 1A in Children: A Randomised, Double-blind, Placebo-controlled, Safety and Efficacy Trial; Joshua Burns et al.; June 2009
- Linus Pauling Institute Oregon State University; Vitamin C for the Treatment of Charcot-Marie-Tooth Disease; Davide Pareyson, MD; 2006
- Care Cure Community; Vitamin D Reverses Diabetic Neuropathy; April 2008
- 6 Minutes; Vitamin D Reverses Diabetic Neuropathy; Dr. Linda Calabresi; April 2008
- LamMD.com; Diabetes; Michael Lam, MD
- LifeExtension: Neuropathy (Diabetic)
- The University of Chicago Center for Peripheral Neuropathy: Nutritional/Vitamin Deficiency