Food & Supplements For Neuropathy

Transcript:

KARA: Welcome to Dishing Up Nutrition. Our podcast today is brought to you by Nutritional Weight & Wellness. We're a company in Minnesota that specializes in nutrition education and counseling. I'm Kara Carper, a licensed nutritionist and a Certified Nutrition Specialist.

Melanie Beasley is my cohost today. She's a Licensed and Registered Dietitian. Melanie meets with clients in person at our Eagan office, and she'll often meet with clients via Zoom or even the phone.

MELANIE: Well, thanks for the introduction, Kara. Our topic today is food and supplements for neuropathy, and we'll start by explaining what neuropathy is and common symptoms associated with the condition.

What is neuropathy?

KARA: So, we want to start today by explaining what neuropathy is, especially if you have not heard that term before. Neuropathy, it's a form of nerve damage and it's estimated to affect more than 20 million Americans. People with neuropathy usually say they notice a burning sensation, shooting pain, partial or even complete numbness. Muscle weakness is another symptom and there's often a tingling, a prickly sensation. It's described as feeling like pins and needles.

MELANIE: Yeah, it can get really painful. And some of my clients tell me their symptoms of neuropathy may just be an annoyance. They might notice a slight tingling or occasional tingling or numbness in their hands or feet. Those are two of the most common parts of the body where neuropathy is most likely to occur. But neuropathy can also be very serious and debilitating, definitely more than an annoyance, especially in the advanced stages of nerve damage.

I frequently hear that chronic pain in the feet is one of the most disruptive types of neuropathy. I have a very good friend who's on disability because neuropathy is just progressed so far and is so painful.

KARA: Yeah, I hear that too. I have a few family members who struggle with neuropathy and we'll be talking about, you know, sometimes it's related to diabetes. Sometimes it's something else.

MELANIE: Yeah.

KARA: But in this particular situation, there's a couple that have higher blood sugars and really suffer with the tingly numbness and pain in the feet. So if someone has nerve damage that has led to the loss of use of a limb, you know, obviously that's extremely disruptive to their quality of life. My father-in-law, here's an example. He had neuropathy. Unfortunately, he did pass away. He had a severe stroke five years ago, but I remember the last few years of his life, the neuropathy in his hands got so bad he had to stop cooking.

Now cooking was his love. He had been in the kitchen his entire life and at some point he wasn't able to hold the handle of a pan or a spatula or utensil anymore. Because his neuropathy resulted in complete numbness of his hands. He also didn't know when something was hot or cold, and of course, if something is very hot, he often would burn himself, maybe on a hot pan, or maybe the stove was still hot, and he didn't realize it. I remember one time I got a little scolded a little bit from the daughter in law. I left the curling iron, heated curling iron in the bathroom and unfortunately he got a pretty bad burn on his hand.

MELANIE: Oh my goodness.

KARA: Cause he, you know…

MELANIE: He couldn't feel it.

KARA: Couldn't feel it.

MELANIE: So when we break down the word neuropathy, there are two parts to the word. Neuro is the Greek meaning for nerve.

Common cases of neuropathy + common root causes

KARA: And apathy comes from the Greek word pathos. Now pathos just means disease of a specific organ or part of the body. So the whole term neuropathy is a disease of the nerves. Neuropathy is somewhat of a general term. And because there are many different types and causes of neuropathy, Melanie and I are going to focus on the most common cases of neuropathy and the most common root causes as well.

MELANIE: Yep. Kara, you mentioned that people often complain about either pain, tingling, numbness or weakness in the hands or feet. Our listeners may have heard of the term peripheral neuropathy, and that's when the hands and the feet are affected.

KARA: And we have two parts to our nervous system. Maybe think back to when you were in school and you were learning about the central nervous system, the CNS. That's made of the brain and the spinal cord. Then, there's the one Melanie just mentioned, the peripheral nervous system, the PNS. And that contains all of the other nerves that are branching off to various parts of the body, like the hands and the feet.

MELANIE: And the reason that nerve damage usually shows up in the extremities first, like the hands and the feet, is because those nerves are the longest and therefore the most vulnerable in the body. So it makes sense that the longest nerves in the body would have issues before, thank goodness, before the organs that are closer, like your heart or your vital organs. With longer nerves, the hands and the feet don't get as much oxygen or other nutrients compared to the vital organs like the heart and the lungs.

KARA: It's really important to address these issues. We can't emphasize this enough. If you're noticing some numbness or tingling or pain, really need to speak with your medical provider about that because if it goes left unaddressed, neuropathy can progress and get worse. And then, it can start to affect some of the other nerves in the body, almost like it's kind of spreading up towards the vital organs you mentioned.

MELANIE: Yes. Did your, now did your father in law have any of the vital organ involvement? It seemed his was pretty severe.

KARA: It was pretty severe but it was in the later stages of life. So It didn't have an opportunity to progress into the heart or the lungs or the stomach or anything like that.

MELANIE: Oh my goodness. An example would be that your nerve pain or your numbness used to be in your hands or your feet, but as the disease progresses, it can start creeping up and affecting the legs or the arms. It could even be more serious if the nerve damage started to affect organs, such as heart, lungs, bladder, or intestines.

And that's much less common. But it's important to talk to a medical professional in the early stages of nerve damage because often the damage can be stopped.

KARA: Yeah, absolutely. So we will be getting into nutritional tips, and how to stop the progression of neuropathy. And in some less common cases, such as a B12 deficiency, you know, it may be reversible. We'll get to that in a couple moments. But we want to just talk about probably the three most common causes that people do acquire nerve damage. Research shows that approximately half of the people diagnosed with diabetes acquire neuropathy and that can be from type one and type two diabetes. And it's a direct relationship between those high blood sugar levels that can damage the nerves throughout the body.

There are other less common causes of neuropathy and that's from having chemotherapy treatment from cancer. Also it could be a vitamin or nutrient deficiency. I had mentioned B12. And another cause of neuropathy can be from alcohol use disorder. You know, so many folks these days are just, especially since the pandemic, having the nightly cocktail or beer or glass of wine and

MELANIE: Seems so harmless.

KARA: It does. Unfortunately, having too much alcohol in the system can lead to nerve damage. And so because the prevalence of prediabetes and type 2 diabetes, it's higher than ever. We're going to look at just a couple numbers. According to the Centers for Disease Control, this was last year, 2023, nearly half the population in the U.S. had prediabetes or type two diabetes. And that breaks down into 11% had type two diabetes, 38% had prediabetes. I learned that most cases of prediabetes are actually undiagnosed.

MELANIE: Yeah, I was thinking that when you said that. So it's really frightening because there are often not a lot of obvious symptoms when it comes to prediabetes, but higher than normal blood sugar levels start to damage tissues even before developing into type 2 diabetes.

KARA: And one of our licensed and registered dietitians hosted a really informative, it was a podcast, a mini podcast. It was an “Ask a Nutritionist” titled Diet and Lifestyle in Type 2 Diabetes. And if you just go to the search engine on our website, weightandwellness.com, and you just type that in, Diet and Lifestyle in Type 2 Diabetes, you'll get a lot more information on what some of those numbers look like when we're looking at fasting blood sugars and A1C and things like that.

MELANIE: Yeah, it's a good show. And it's very common for people to not even know they have high glucose or blood sugar levels. I had a client come in and tell me they bring their labs and we're looking through the labs and I said, well, you're prediabetic. She said, well, my doctor said, we're just going to watch and see what her blood sugar does, and I am not a fan of the watch and see, so she and I turned things around pretty quick, but a healthy fasting blood sugar is between 70 and 90.

And when I'm working with a client, I explain having a fasting glucose that is closer to 70 is even best. But technically prediabetes isn't diagnosed until glucose reaches 100 or more, but even a glucose level that is hanging out in the nineties for too long can start to create insulin resistance, weight gain, and other health problems like the beginning stages of nerve damage.

KARA: So if that's something that you have not received before, definitely get your fasting glucose, get your fasting blood sugar number. And A1C is also important. That determines kind of your average blood sugar levels, an average three month reading of your glucose. So it's a little bit of a bigger snapshot.

MELANIE: With the increasing rate of prediabetes and type 2 diabetes, it's even better to get a fasting insulin test. Because by the time your fasting glucose shows that it's too high, that means damage has been going on inside your body and your blood vessels for possibly years or even decades, and a fasting insulin test is more accurate. You might show an elevated fasting insulin well before your fasting glucose would show up as abnormal, but you have to ask for it. It's not something that it, that goes with your regular physical, right?

KARA: Right, the fasting insulin test is definitely less common than the fasting glucose or even the A1C.

MELANIE: Yes.

KARA: So, it's just a good way to stay ahead of the game. Keep on top of your blood sugar numbers before that invisible damage starts to occur.

Foods & beverages that can cause high blood sugar levels

MELANIE: So, are you wondering what foods or beverages will perpetrate a high blood sugar level, and maybe some neuropathy symptoms? Well, you probably guess by now that sugary treats such as brownies, cookies, and birthday cake, those are obvious culprits, right?

KARA: Yeah.

MELANIE: But did you know that four chips contain a teaspoon of sugar? And we're not talking about added sugar. We're talking about the carbohydrates that convert to blood glucose and that sugar impact. So that gives you an idea.

KARA: Yeah.

MELANIE: We've talked about this before.

KARA: And we have talked about it before, but if maybe someone's tuning in for the first time or the second time we'll also just give you the calculation. So if you're looking at a label or if you're looking online at how many carbohydrates a certain serving of food has, what you want to do is take the total carbohydrates divided by the number four.

MELANIE: And that shows how many teaspoons of impact sugar in your bloodstream.

KARA: Just like the chips. The level of damage done to nerves after years of eating too many carbohydrates or too much sugar, it can vary. In fact, sometimes people talk about that they have some numbness, pain, or tingling even just from eating sugar a little bit, you know, having glucose going, streaming through their blood and having it too high, even that can trigger some of those symptoms a little bit more instantaneously.

And I spoke with a colleague at Nutritional Weight & Wellness. She shared a powerful story about a client who was struggling with some of these neuropathy symptoms in her feet. And she was able to reverse the symptoms when she got her blood sugars back under control.

MELANIE: Yeah, that was a great testimonial that our colleague shared. Her client was diagnosed with type 2 diabetes. Her blood sugar levels had been bordering in the prediabetic range, but her fasting glucose exceeded 125 mg per deciliter. And she was diagnosed with Type 2 diabetes. Health and weight issues seemed to start popping up almost overnight after her diagnosis.

KARA: Right. And that's just because, insulin resistance is something that precedes type 2 diabetes. And if somebody starts becoming more insulin resistant, they start having a slower metabolism. They hold on to fat. It's a little bit more difficult to get that metabolism going and other health issues pop up as well.

And this client had bad pain on the bottoms of both of her feet. It was almost a stabbing type pain especially during the night and it made it really hard for her to sleep.

MELANIE: The chronic and relentless pain from neuropathy is really debilitating, especially when it flares up at night when trying to sleep at night. This is when I hear my clients say that's when they feel it because the busyness of the day distracts them.

This client had the goal to reduce fasting glucose levels because she wanted to avoid taking diabetes medication. And the hardest thing for her was giving up bread because she liked her toast for breakfast, sandwiches for lunch, and she loved sourdough but it really wasn't serving her well.

KARA: No, and that, bread, it happened to be the main source of starchy carbohydrates she was consuming every day. So, to take her glucose numbers and her type 2 diabetes seriously, she really needed to start incorporating more protein, focusing more on vegetable carbohydrates, and include healthy natural fats at every meal, which we know stabilizes that glucose.

So we're going to talk more about this when we come back from break. You're listening to Dishing Up Nutrition. Our topic today is food and supplements for neuropathy. Some of the most common causes of neuropathy are from having diabetes or chronically elevated blood sugar levels, could also be from chemotherapy treatment. or even from a vitamin B12 deficiency. We will continue our discussion right after break.

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MELANE: Welcome back. You're listening to our Dishing Up Nutrition weekly podcast, and we're discussing how nutrition and a few key supplements can improve symptoms of neuropathy. From what I heard, she was a rock star. Within two months of giving up bread and simply adding in more protein and vegetables and healthy fats, she reported back that her fasting blood sugar levels were back in the prediabetic range, definitely under 125.

KARA: And she was thrilled. Her doctor was thrilled. And regarding the symptoms that she was having, the pain and the tingling, kind of that burning sensation on the bottoms of her feet, you know, it didn't completely go away but it was drastically reduced from a level let's just say it was a seven is how she was quoted saying it from a level seven pain on a scale of one to ten down to about a two.

MELANIE: Well, that's winning.

KARA: That's a win. Yeah. She was finally able to get out and do some of her walks and get back to playing pickleball with her neighbor.

MELANIE: Yeah. And you know, Kara, when someone's eating treats or desserts on a regular basis or drinking sweetened beverages or even eating processed carbohydrates regularly, this can lead to chronically high blood sugar levels.

KARA: And when your blood sugar spikes, did you know that the immune system also spikes kind of jumps into action? So every time that blood sugar goes up too high, there are certain inflammatory molecules, blood cells and cytokines, they jump into action and they try to lower the glucose levels.

High blood glucose = inflammation

MELANIE: Yeah. And as a result, anyone who has high blood glucose level will experience inflammation throughout their entire body.

KARA: That's powerful. So I'm going to repeat that. Anyone who has high blood glucose is experiencing inflammation. Inflammation can mean a lot of things. We know that if you sprain your elbow, there's going to be inflammation. And that's part of the healing process. The type of inflammation we're talking about today is internal in the blood vessels, in the nerves.

MELANIE: And when it comes to neuropathy, that inflammation of the nerves and nerve roots can cause swelling that destroys their protective covering around the nerves called the myelin.

KARA: And once that protective cover called myelin is damaged, it can lead to damaged nerve fibers.

MELANIE: Yeah. And the damaged nerve fibers can't send signals anymore. And the symptoms people talk about like weakness, pain, fatigue, and numbness is because those nerves are damaged and can't send proper signals. So inflammation can cause neuropathy in a number of ways, including thickening blood vessels.

Inflammation can cause blood vessel walls to thicken and scar, which can impede blood flow and damage nerves. Or you could have swollen nerves where the inflammation of the nerves and the nerve roots can cause swelling that destroys the protective covering around the nerves known as the myelin. And this can damage nerve fibers and slow their ability to send signals, which can lead to weakness, pain, fatigue, and numbness.

And then you have an autoimmune diseases, and those autoimmune diseases, which, such as rheumatoid arthritis, they can cause inflammation and swelling that can also lead to nerve damage. We just have to be really protective of our nerves.

KARA: We do. And again, the earlier the symptoms of neuropathy are noticed and addressed, and you talk to a medical provider about it, the more likely that that progression can be stopped. And in the case of the colleague who had the client and her blood sugar levels improved, sometimes the pain or tingling or numbness can be reversed or greatly lessened.

MELANIE: Yeah. Yeah. It's a really great story. So you were talking about the myelin sheath, which is a membrane that surrounds all of the neurons or the nerve cells. And the myelin sheath is made up of fatty acid. And the reason this is relevant is because a damaged myelin sheath can benefit from certain fatty acids in order to heal, which that gives us some control.

Omega-3 fatty acids strengthen myelin sheath

KARA: It does. And that's a really important job is protecting the nerve cells. So that myelin sheath, it's very delicate. One nutrient that we know that can strengthen the myelin sheath, it's the omega-3 fatty acid. You've probably heard us or others talk about omega-3 fatty acids, and we can get that from diet if we're eating cold water fish like salmon, herring, mackerel eggs, specifically egg yolks do also have omega-3 fatty acids.

MELANIE: Especially if they are free range or pasture-raised.

KARA: Yep. Out, they’re eating the insects, they're getting some sunlight. They're more likely to have that natural, nice yellow, not the dye, but the natural, nice, rich nutrient dense yolk.

MELANIE: Yeah.

KARA: But when it comes to something so serious as neuropathy and nerve damage, the research supports taking high doses of omega-3 fatty acids via supplement, high quality supplement.

MELANIE: A good supplement. So when there is a chronic inflammation in the body, the nerves are more sensitive, which means that they will send pain signals more frequently to the brain. Omega-3 supplements can reduce pain and promote healing. They bring that inflammation down.

KARA: And we do have one that I really like that it's called the Nutrikey Extra Strength Omega-3. And instead of needing to take three to six soft gels per day, personally, I like to take a good robust amount of essential fatty acids every day, and I take two or three of the high strength. So it's just a way to avoid taking a huge handful of omega-3 supplements.

MELANIE: When it's an extra strength, you get a little less pills.

KARA: Yeah.

You can’t out supplement your way out of a poor diet

MELANIE: Yeah. And I want to mention that you can't supplement your way out of a poor diet. So, start with diet. And when we recommend certain supplements to correct a health issue, just know that if you're continuing to eat takeout or fast food or frozen dinners or processed foods, it's really not likely that the supplements will be able to help your condition at all. We have to start with food first.

KARA: We do. And we always say food definitely trumps everything. Without that foundation, just throwing a bunch of supplements at a condition is really not going to be beneficial. You're probably just wasting your dollars.

MELANIE: Yeah. Spend your money on good quality, organic grass fed food. That is the best starting place.

KARA: Yep. Organic pasture raised meats and protein, get that protein in and lots of organic vegetables. We had talked about the healthy fats: butter, coconut oil. I know you really like avocado oil.

Nerve Eze: supplement beneficial for neuropathy

I do want to talk about a supplement called Nerve Eze that can be beneficial for folks struggling with neuropathy.

It contains alpha lipoic acid and something called PEA. And the combination's really powerful and beneficial for those symptoms of neuropathy. Britni, a registered and licensed dietitian at Nutritional Weight & Wellness, recently did a mini podcast on how PEA reduces inflammation. So you can go to our website, weightandwellness.com. And if you just look at all of the recent “Ask a Nutritionist” mini podcasts from 2024, you will find one done by Britni on PEA.

MELANIE: Ever since we started carrying Nerve Eze by NutriDyn a couple of years ago, I've been recommending it for my clients who have high blood sugar levels, type 2 diabetes, and any condition related to nerve pain, numbness, tingling or pain in general and it is, I just feel like it's magic.

KARA: I've heard you talk about that at some of the nutritionist meetings. And so I started recommending it to some family members after I knew that you were having success with certain clients. That's great.

MELANIE: Kara and I found some interesting research from the journal called Nutrients from 2023. And it was a meta-analysis, which means the researchers are analyzed results from multiple studies. The researchers wanted to investigate whether or not alpha lipoic acid taken orally would benefit participants who had diabetic peripheral neuropathy.

KARA: The participants who took the alpha lipoic acid compared to the placebo group who did not take alpha lipoic acid, they had significant improvements in their neuropathy symptoms. And so the researchers also noted the results were really based on the dosing of the alpha lipoic acid. So that is also important. It was the participants who took the higher doses had greater improvements. So that's relevant if someone has been struggling with neuropathy, especially for a while and you were looking at taking the supplement, you'd want to shoot for a higher dose.

MELANIE: Yeah. And I usually start clients at a higher dose, and then we play with it later. But other studies have also found that alpha lipoic acid is most beneficial for neuropathy when taken at least 600 milligrams per day. So that's why we start with a little higher dose out the gate.

Chemotherapy treatment can also cause neuropathy

KARA: So we're going to circle back to a couple of other root causes of neuropathy. And we've gone over the fact that type two diabetes and having chronic high blood sugars, that's the most common cause of neuropathy, but having chemotherapy treatment for cancer can also cause neuropathy.

MELANIE: Yep. And it's called chemotherapy induced peripheral neuropathy. That's a mouthful and it affects most cancer patients. The oncology nursing society states that in the first month of chemotherapy, 68 percent of cancer patients experience this neuropathy. So that's pretty daunting. You're already facing the challenge of cancer and then you have this on the tail end for the treatment.

KARA: It really is. I think it's good to at least give that information though if someone has a loved one or needs to go through chemotherapy or has in the past and was wondering what's that numbing, numbness and tingling and pain from? It is very common. The research found that after three months of chemotherapy, the number dropped down to 60 percent of the cancer patients were experienced neuropathy.

And after six months of chemo, 30 percent of the patients experienced neuropathy. So the number, that is good. The number did go down over time. So, to summarize, most patients going through chemotherapy will have some neuropathy symptoms, especially in the beginning stages.

MELANIE: Mm hmm. And when chemotherapy treatment is finished, most patients have their neuropathy symptoms go away. But sometimes the symptoms last for a while, and in some cases it can be permanent. And it's something that you'd want to talk with your oncologist about.

Lessen likelihood of permanent chemo induced neuropathy through nutrition

And I know when I have clients walk through their cancer journey with me because they want to do it as healthy as possible, I really focus on balancing their blood sugar, real foods, reducing processed carbohydrates and sugar to even lessen the likelihood that they'll be having some permanent chemotherapy induced neuropathy.

KARA: Because from a nutrition standpoint, if you are someone or know someone that has chemotherapy related neuropathy, it does make sense to still really focus on that food and avoid the excess sugars, avoid the processed carbohydrates because having elevated blood sugar levels on top of going through chemotherapy could, like you said, exacerbate some of those symptoms.

MELANIE: Yeah. All the way around, it's just not good for the cancer journey. And although our topic today is now focused on nutrition for cancer, I want to mention that sugar and processed carbohydrates are fuel for cancer cells. And there is quite a bit of research showing that a low sugar, lower carbohydrate eating plan is recommended for cancer patients. And the outcome I've seen in clinic is just better.

Nutrient deficiencies can cause neuropathy

KARA: Yeah. Thank you for sharing that at a clinical perspective. So there are also certain nutrient deficiencies that can cause neuropathy and we want to talk about one of the more common deficiencies that can cause the symptoms. It's vitamin B12. Vitamin B12 is found in certain foods, mostly in meat.

It's very high in shellfish, liver, and other organ meats. It's interesting to note though that there are really no adequate diet sources of B12 in a vegan or vegetarian diet. And because of that, vitamin B12 deficiency is higher, for vegans and vegetarians, if they're not taking, you know, if they’re not proactively taking vitamin B12

MELANIE: Or getting the shots. And I have seen people who came and they were vegans and that was one of their symptoms was tingling in their hands and feet. So when we get them on a good quality methylated B12, it did turn it around. So if you have neuropathy symptoms, the first thing to do is of course talk with your doctor and determine what the root cause is.

In the case of a B12 deficiency, this can be determined by a blood test, but you can't know what to ask for when you go to the doctor and a lot of times the doctors don't make the connection between a B12 deficiency and neuropathy. So, I encourage clients always look at nutrition first. What have you been eating? What have you not been eating?

Recap

KARA: So just to summarize some of the key points that we talked about today on nutrition and supplements for neuropathy; and again, neuropathy is a very common condition that can lead to tingling, numbness, pain, usually in the hands and feet, but often other parts of the body as well. So it's really important to get that addressed if you've been experiencing those symptoms.

The three most common causes of neuropathy or nerve damage is high blood sugar levels or having prediabetes or diabetes. Also, it can also be caused from having chemotherapy for cancer treatment. And sometimes a vitamin B12 deficiency can cause symptoms of neuropathy. So nutritionally, it's really important to be eating adequate protein, vegetable carbohydrates, and healthy fats in balance several times per day, avoiding sugars and processed carbohydrates to keep those glucose numbers in balance.

A couple of supplements that can be very helpful are the omega-3 fatty acids, as well as alpha lipoic acid, which you can find on its own or in a product called Nerve Eze. So we want to thank you so much for listening today.

MELANIE: Our goal at Nutritional Weight & Wellness is to help each person experience better health through eating real food. It's a simple yet powerful message. Eating real food is life changing. Thank you for listening and have a wonderful day.