4 Essential Things to Know About Neuropathy

1. Symptoms of neuropathy

In most cases, neuropathy causes nerve pain. Other symptoms typically depend on the underlying cause and the person, but they can include:

- Temporary or permanent numbness

- Tingling, prickling, or burning sensation

- Increased sensitivity to touch

- Muscle weakness or wasting

- Paralysis

- Dysfunction in organs or glands

- Impairment to urination and sexual function

To understand how neuropathy acts in the body, it’s important to know that the nervous system is divided into two parts: the central nervous system and the peripheral nervous system. The peripheral nervous system transmits messages between the central nervous system and the rest of the body. Damage or disruption to peripheral nerves is considered neuropathy.

2. Causes and risk factors for neuropathy

Neuropathy can be provoked by a host of factors. The most common ones are health conditions, such as:

- Poorly Managed Diabetes. Diabetic peripheral neuropathy is the most common type of neuropathy that affects people with poorly managed blood glucose and accounts for about 60 percent of the total people with neuropathy.

- Idiopathic Neuropathy. This term is usually used to describe neuropathy that occurs for unknown reasons.

- Cancer treatments. Chemotherapy-related peripheral neuropathy afflicts 10 percent of Americans with neuropathy.

- HIV/AIDS. Nearly 2 percent of total neuropathy cases are attributed to HIV/AIDs, which can be caused by the effects of the human immunodeficiency virus or the drugs used to treat it.

- Other health conditions, such as autoimmune diseases, and health events, like physical trauma.

Other common reasons for neuropathy are deficiencies, such as:

- Vitamin B12 Deficiency. This problem is prevalent in 10 to 15 percent of people over age 60 and has been connected with neuropathy. Vitamin B12 deficiency causes damage to the myelin sheath that surrounds and protects nerves. The nerves won’t function well without this protection.

- Copper Deficiency. Copper deficiency is another reason for neuropathy. This deficiency is typically the result of an individual’s metabolism or malabsorption, rather than an unbalanced diet.

Other less common causes of neuropathy include:

- Excess Nutrient Consumption. Surprisingly, consuming too much of a nutrient can provoke neuropathy as well. For example, too high levels of vitamin B6 in the blood can be toxic to the nerves. The normal requirement is less than 2 milligrams a day, while many B6 supplements are 100 milligrams or more. If you take B6 supplements, you should have your blood levels checked to make sure they’re not in excess.

- Exposure to Toxins. Toxins that are found in various foods like seafood, can also contribute to neuropathy. Fish can have mercury, which is especially dangerous for people of all ages.

- Arsenic, another heavy metal, can also provoke neuropathy if ingested in high amounts. Typically, this stems from exposure via drinking water that has been exposed to industrial waste. Arsenic can be contained in brown and white rice in trace amounts, but not at levels high enough to cause nerve damage.

3. Types of neuropathy

The type of neuropathy is usually determined by the location of damaged nerves. The Foundation for Peripheral Neuropathy describes:

- Mononeuropathy. Mononeuropathy is when neuropathy involves damage to only one nerve.

- Polyneuropathy. It involves damage to multiple nerves. The symptoms can vary depending on whether autonomic, sensory or motor nerves — or a combination of them — are involved. Autonomic nerve damage can impact bodily functions or blood pressure, and even create gastrointestinal symptoms. Damage to sensory nerves can affect sensations and sense of balance, while damage to motor nerves can affect movement and reflexes.

- Distal symmetric polyneuropathy. It’s a common kind of neuropathy and the one most prevalent among people with diabetes. In this type of polyneuropathy, the first nerve fibers to malfunction are those most distant from the central nervous system, with symptoms such as pain and numbness felt symmetrically in the feet, and then traveling up the legs as the condition progresses. The upper extremities might also be involved eventually.

4. Treatment for neuropathy

There are lots of treatment options for neuropathy. The choice of the treatment will depend on the type of nerve damage and the severity of your symptoms.

Medications

Common over-the-counter medications that people take with mild to moderate neuropathic pain include:

- Tylenol (acetaminophen)

- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil (ibuprofen) and Aleve (naproxen)

- Topical treatments such as capsaicin and lidocaine creams

- COX-2 inhibitors like Celebrex (celecoxib)

- Opioids

- Ultram (tramadol)

Other possible options may include antidepressants, antiseizure, and antiepileptic medications. Antidepressants have an effect on some of the neurotransmitters such as norepinephrine and serotonin, which can have some effect on pain. Antidepressants that are used to treat neuropathy include:

- Selective serotonin reuptake inhibitors (SSRIs), like Prozac (fluoxetine) and Zoloft (sertraline). These medications restore the chemical balance in the nerve cells of the brain

- Serotonin and norepinephrine reuptake inhibitors (SNRIs), like Cymbalta (duloxetine)and Effexor (venlafaxine), which inhibit the production and release of specific neurotransmitters, including serotonin and norepinephrine

- Norepinephrine reuptake inhibitors (NRIs), which inhibit the reuse of the neurotransmitters dopamine, serotonin, and norepinephrine

- Serotonin receptor modulators, such as Oleptro (trazodone), which increase the levels of serotonin and norepinephrine in the brain available to transmit signals to other nerves

Surgery

Surgery is used to release pressure on a nerve which can help treat carpal tunnel syndrome and diabetic neuropathy.

Nerve Stimulation

Nerve stimulation can involve placing an electrode along a peripheral nerve. They are helpful by essentially turning off pain signals.

Alternative and Complementary Therapies

Some alternative therapies include:

- Cannabidiol (CBD) has been used to treat chronic, noncancer neuropathic pain. According to a small, randomized, controlled clinical trial that was published in December 2019 in Current Pharmaceutical Biotechnology, there is a statistically significant reduction in intense pain, sharp pain, cold and itchy sensations in the CBD group when compared to the placebo group.

- Alpha Lipoic Acid. Alpha-lipoic acid is an antioxidant that has been used to treat diabetic neuropathy at Houston Methodist Hospital in Houston. This is a naturally occurring fatty acid that’s contained in foods, like spinach, broccoli, yams, potatoes, Brussels sprouts, yeast, and organ meats such as kidneys and liver.

- Carnitine. This is another fatty acid that can help treat deficiency that leads to an insufficient blood supply to nerves. The body makes all of the carnitine that it needs in healthy children and adults, so it is not necessary to get more from supplements or nutritional sources such as meat, poultry, and dairy.

Diet

A nutritious diet is extremely important for preventing or treating any health conditions that may be at the root of neuropathy.

Those who have diabetes should eat a diet that will help them manage their blood glucose levels. In fact, uncontrolled blood glucose can cause damage to the peripheral nerves, especially in the feet.

While there is no one-size-fits-all diet for diabetes, limiting sweets and sugar-sweetened beverages, as well as large portions of foods that are high in starches or carbohydrates, is essential.

Celiac disease can increase a person's risk for developing nerve damage, so if you have been diagnosed with this condition, stick to the gluten-free diet prescribed for you. Gluten is contained in many types of breads, pasta, cereal, and processed foods that contain wheat, rye, barley, and sometimes oats.

If you have alcoholism-related neuropathy, it’s time to get rid of the bad habit. Heavy alcohol consumption can lead to malabsorption of the nutrients such as vitamin B12, as well as direct poisoning of nerves.