Diabetes and Your Nerves (Part 2)

Nerve damage is called “neuropathy” (pronounced new-ROP-a-thee). It is one of the most common complications of diabetes. This week we’ll look at effective ways to soothe nerves and manage pain, numbness, and other symptoms.

As I wrote last week, lowering blood sugar levels is the best treatment. Without good glucose control, other remedies eventually fail. But there are some good things to do while you get your sugars down:

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Nutritional
Fish oil improved nerve function in a group of diabetic mice. Of course, mice are not people, but fish oil in food or supplements is safe and has shown other health benefits, including reducing inflammation. Anecdotally, many people report pain relief, too.

Magnesium is a must. Many people with diabetes have low magnesium levels. Magnesium relaxes nerves and is vital for hundreds of body functions. Good sources of magnesium are leafy greens, nuts, seeds, and beans. I eat a lot of those foods and take a supplement as well. A normal dose is 250–500 milligrams per day.

Nerves need potassium to work, and some people with diabetes have low potassium. Good sources are beans, yogurt, fish, avocados, and mushrooms.

According to the Mayo Clinic, vitamins B1, B6, B12, E, and niacin are all needed for nerve health. That doesn’t mean you are low in them, but you can try supplements to see if they help.

Alpha-lipoic acid, a natural antioxidant, is a prescribed therapy for neuropathy in Europe. It helps the body use carbohydrates. About 600 milligrams once a day is the common dose.

Two large studies described in the journal Diabetes Care showed that the amino acid acetyl-l-carnitine improved peripheral neuropathy in people with diabetes. Pain was reduced, numbness improved, and the number of nerve fibers increased. A usual dose is 500–1,000 milligrams a day.

Be aware that all these nutritional approaches take weeks to work. If you decide to use one, commit to giving it at least a two-month try.

Alternatives
Creams with capsaicin (derived from hot peppers) are known to help. Some people swear by homeopathic creams, often made with the herb arnica. Another widely used herb is evening primrose oil. You can often get these creams, teas, or pills at vitamin stores and some pharmacies.

Acupuncture is widely used for nerve pain in much of the world. Some studies suggest it works.

Aromatherapy, or breathing in scents from oils, is used for pain relief in many countries. There are too many choices to list here, but you can explore them at this neuropathy treatment site.

Of course, there are many prescription medications available, as described here and here.

Physical therapies
Heat brings more blood to painful areas. That means more oxygen and better disposal of waste products. Heat also relaxes muscles and reduces pain sensations. Try a warm foot soak. If you have numbness, be careful not to overdo the heat — not too hot or too long. Always check the temperature of the water with your arm before putting in your foot.

Some people say cooling works better for them than heat. They may soak their feet in cool water and get days of relief. I would be careful with this, however, because the long-term effects of cooling might be bad for circulation.

Exercise is vital to improve leg circulation and lower blood sugars. But exercising can be tough when you’re in pain. Water exercise, yoga, and tai chi might be less painful and more helpful. Balancing exercises might be useful. Stretching exercises for the calves and thighs relieve pain and improve walking for some people.

See if you can get a physical therapist consult to help plan an exercise program for you. This site has a slide show with good exercise ideas for neuropathy.

Biofeedback is shown in studies to be good for pain control and for improving circulation. A version of biofeedback called WarmFeet has been developed especially for diabetic foot symptoms.

Massage helps many people with neuropathy. Massaging your own feet and legs is affordable and convenient. You can do it while doing your daily foot inspection. Use some lotion to keep feet soft and moist (except between the toes).

In cases of severe leg pain, a TENS unit (transcutaneous electrical nerve stimulation) can block the pain signals and provide good relief.

Read here and here or here for more valuable foot care ideas.

Other kinds of neuropathy
Autonomic neuropathy is nerve damage to internal organs: stomach, intestines, bladder, sex organs, and blood vessels. These nerves are harder to treat and heal, since you can’t reach them. They can sometimes heal with time if you get your sugars down, but the symptoms can be hard to manage and even dangerous.

Focal neuropathy occurs suddenly in a specific nerve, usually in the head, torso, or legs. Symptoms include double vision, eye pain, one-sided facial paralysis, or severe pain in a limited area. Symptoms can be distressing but often go away by themselves over some weeks or months.

Nerve compression syndromes like carpal tunnel or frozen shoulder are more common in diabetes.

I’ll write about managing these neuropathies next week.

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Please check out my new story on how we look at our lives. Is it all about us, or are we part of something larger? You can see it at davidsperorn.com/blog.