Peripheral Neuropathy and Food

The nerve damage called peripheral neuropathy (per-RIFF-er-el noo-ROP-uh-thee), or PN, is a major diabetes complication. People may describe peripheral neuropathy as “like I’m walking barefoot on cut glass,” or “walking in hot coals up to my ankles.” It can also affect the arms, legs, and hands.

Other possible symptoms are numbness, itching, weakness, and loss of balance. Medications may or may not help, but diet might. What foods make peripheral neuropathy better, and which ones make it worse?


Nutritionist Amy Campbell wrote here that “Roughly 60% to 70% of people with diabetes have some form of neuropathy.”

“In people with diabetes,” she writes, “it’s the constant exposure to high blood glucose levels that [likely causes neuropathy]. Nerve fibers are very delicate. High glucose levels can interfere with nerve signal transmission, damage the nerves themselves, and also weaken the blood vessels that supply nerves with nutrients and oxygen.”

Besides high glucose, peripheral neuropathy is worsened by inflammation, which is heating up and swelling of tissues. The body uses inflammation to heal damage or fight infection, but too much inflammation causes pain and damage. Certain foods increase inflammation, while others reduce it.

So there are two ways that diet changes can heal neuropathy: lowering blood sugar and cooling off inflammation.

Lowering sugars
High glucose does much of the damage in peripheral neuropathy. Most people’s highest glucose levels come after meals, so reducing these after-meal spikes is step one for healing the condition. A study in the journal Gerontology found that high after-meal glucose levels were strongly associated with peripheral neuropathy.

How to reduce after-meal levels? According to The Foundation for Peripheral Neuropathy, eating lots of fiber and “foods that are more slowly absorbed into the bloodstream [have a low “glycemic index” or GI] such as fruits, vegetables, nuts, and beans” often helps.

Refined starches and sugars will raise your glucose level rapidly and burn your nerves. So avoid those. Amy Campbell says eat smaller portions and reduce carbohydrates to keep sugars down.

Diabetes educator Gary Scheiner wrote here that exercise, particularly after meals, will keep sugars down. He also suggested working with a doctor or educator to adjust your medicines. Fast-acting insulin, meglitinides, and starch blockers such as acarbose (brand name Precose) lower after-meal sugars.

Over-the-counter supplements that can help reduce postprandial sugars include vinegar, tea made from mulberry or guava leaves, and bitter melon tea or capsules.

Avoiding inflammatory foods
Foods can trigger inflammation. The trouble is that different foods inflame different people. The website Everyday Health lists these foods as inflammatory:

Trans fats and saturated fats
• Omega-6 oils such as corn, soybean, and safflower oils
• Sugar
• Alcohol

Most oils are classified as “omega-6” or “omega-3.” Omega-3 oils tend to cool down inflammation. Omega-6 oils tend to make it worse.

Dr. Neal Barnard’s book Foods That Fight Pain lists the following foods as potential pain triggers:

• Dairy
• Wheat
• Citrus fruits
• Corn
• Caffeine
• Meat of all kinds
• Nuts
• Eggs

Based on a series of studies, the site Natural Health Reports listed the “worst foods for arthritis and joint pain,” which may or may not be similar to those that cause nerve pain:

• Blackened or barbecued food
• Gluten — present in wheat, rye, and barley (and, although they are naturally gluten-free, oats often contain gluten from being grown and shipped with other grains)
• Nightshade vegetables including potatoes, tomatoes, eggplant, peppers, and tobacco
• Processed foods
• Sugar

Dr. Peter Osborne at the Gluten Free Society believes nearly all grains, including rice and soy, can cause inflammation.

Finding what’s wrong for you
Obviously, you can’t stop all those foods, and you don’t have to. Everyone is different; you need to find out what is inflaming your own nerves.

One way is to notice when your pain is worse. What did you eat that day? Stop eating that food for a week and see if your pain is reduced.

A more difficult but effective way is with an elimination diet. Web MD tells how to do an elimination diet. First, stop eating all the foods you suspect of hurting you. This will probably include many of the foods on the lists above. Stop all processed foods because you don’t really know what’s in them.

After a week or two, you should have much less pain. Then add back the suspicious foods one by one. If the pain doesn’t return, that food wasn’t the problem. Keep it and go on to the next one. If symptoms recur after restarting a food, put that food on your never-eat list.

Things to eat
A number of studies such as this study from 1994 have found that low-fat vegetarian or vegan diets greatly improve neuropathy pain. This article reports research that fruits, vegetables, lean proteins, and foods rich in B vitamins reduce pain.

The Foundation for Peripheral Neuropathy recommends increasing omega-3 fatty acids. Their suggestions include: Take 1–2 tablespoons of flaxseed oil a day; eat fatty fish such as halibut, salmon, or mackerel several times a week; and eat 3 ounces of walnuts a day.

Other nutritionists recommend taking alpha-lipoic acid (ALA), which is also thought to help control blood sugars. B vitamins, especially B-12, as well as magnesium and vitamin D are also recommended by many doctors for neuropathy.

Various studies have shown ginger, turmeric (present in curry powder), olive oil, coffee, salmon, thyme, and resveratrol (found in red grapes) each reduced pain in many subjects.

Remember that controlling glucose levels may be more important than fighting inflammation.

Not forever
One encouraging final note: Studies, including this one from Diabetes Care, show that peripheral neuropathy can be cured. Better glucose control leads to nerve regrowth and a great reduction of pain.

You can read more about food and pain in the October/November issue of Pain-Free Living, due out in October 2016.

Rebellion may take different forms for children living with diabetes. Bookmark and tune in tomorrow to read about Scott Coulter’s experience as a youth at camp.