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November is Diabetes Awareness Month and the opportunity to delve into a health issue that affects millions of Americans. Imagine being haunted by the possibility that some day you may lose the feeling in your feet, ankles, and lower legs and that this lost sensation could ultimately lead to infection, ulceration, and even the amputation of limbs that become unsalvageable. This grim yet very real condition is known as diabetic peripheral neuropathy (DPN). According to the National Institute of Diabetes and Digestive and Kidney Disease, up to 70% of diabetics suffer some kind of nerve damage.
This means we are facing a growing population of DPN sufferers as the number of type 2 diabetics continues to spiral out of control. What’s even more tragic is that many of the people who are suffering from DPN are not even aware that these conditions are preventable and largely reversible.
There are many natural things you can do to prevent and even reverse diabetic peripheral neuropathy, despite conventional medicine’s contention that such nerve damage is permanent and cannot be reversed. This is no more true than the belief by many doctors that a whole host of chronic diseases cannot be reversed, when there is plenty of “living proof” to the contrary.
As is most often the case, when allopathic medicine says something cannot be cured or reversed they should add the qualifying phrase… “with mainstream medicine.”
Diabetic Peripheral Neuropathy Explained
Each time a diabetic consumes carbohydrates and other foods which have high glycemic index values, their sugar levels rise above normal. When this happens the elevated blood glucose can harm microscopic blood vessels and hyperactive nerve cells which become damaged and worn out. This leads to the degeneration of nerves which results in both numbness as well as higher sensitivity to pain and external stimuli (such as touch, heat, and cold).
Neuropathy is generally associated with three sensations:
- Paraesthesia – numbness and/or tingling.
- Causalgia – a burning sensation.
- Dyesthesia – an unpleasant burning, itchy, crawling sensation in an area that is numbed or dulled.
The longer a person is diabetic, the more the damage can mount until ultimately it becomes severe. This damage includes loss of most or all feeling in the feet and lower legs and ultimately to ulceration, infection, and even amputation of unsalvageable limbs and premature death.
Diabetic Peripheral Neuropathy by the Numbers
The statistics for diabetes and DPN are grim and sadly the predictions are worse. In 2010, the CDC predicted that the number of diabetics would double or triple by 2050 and that as many as 1 in 3 Americans would develop diabetes. Only four years later, the CDC predicted that 2 in every 5 members of the adult population would develop diabetes.
A study published in the Journal of the American Medical Association (JAMA) in September 2015 found that 50% of the adult U.S. population either had diabetes or pre-diabetes, a condition where a person’s blood sugar is already elevated and they are at risk to develop diabetes.
With a current U.S. population of over 326 million (75% of whom are adults) – that works out to over 122 million people who are either diabetic or pre-diabetic and almost 98 million who will become diabetic in their lifetime. About 60-70 million will suffer nerve damage which may lead to diabetic peripheral neuropathy.
Preventing Diabetic Peripheral Neuropathy Through Diet
Obviously, the best way to prevent diabetic peripheral neuropathy is to not get diabetes in the first place (though for many it may be too late for that). If you do NOT already have diabetes, take steps to prevent it by avoiding the standard American diet (SAD) of processed, junk, and fast food. Limit your intake of food items with lots of sugar or ingredients which turn to sugar, such as wheat flour (especially bleached white flour) and starchy vegetables.
In addition to such obvious items as candies, pies, cakes, cookies, ice cream, and soft drinks, you should also limit your intake of most fruit juices (especially the ones found on your grocers’ shelves), processed foods, potatoes (especially in the form of chips & French fries), baked goods with wheat flour, and other processed grains.
If you are pre-diabetic, which is defined as having an HbAIC blood level of 5.7 to 6.0, then avoiding these items entirely can bring your A1C levels back into the normal non-diabetic range. (Note: The A1C test has multiple names including hemoglobin A1c, HbA1c, or glycohemoglobin test.)
Eat a diet that has as much organic whole-food ingredients as possible including plenty of vegetables. Consume foods that are rich in omega-3 fatty acids such as wild-caught salmon, avocados, extra-virgin olive oil, flaxseeds, coconut oil, and healthy nuts, seeds, roots, and mushrooms.
Organic grass-fed, free range, cage-free type beef and chicken are fine, as are organic pastured eggs. If possible, limit your dairy to butter or ghee and modest amounts of organic milk. Raw milk is better and raw goat’s milk is best of all.
Do not live a sedentary couch-potato lifestyle. Make sure that you get regular physical activity and be aware that belly fat is closely linked to diabetes.
Reversing Diabetes is Key to Reversing Diabetic Peripheral Neuropathy
In order to reverse diabetic peripheral neuropathy, you must reverse diabetes itself. It can be done – but only with natural approaches. One of mainstream medicine’s biggest misconceptions is the assumption that diabetes can be controlled by medication alone. We have somehow developed a fantasy that we can eat whatever we want, avoid exercise and other physical activity, and address any health complications from diabetes with pills or injections. Nothing could be further from the truth!
Conventional medicine’s treatment of diabetes consists of treating the symptoms of diabetes (high blood glucose and high blood AIC levels) with ever-increasing and ever more potent (i.e. dangerous) medications and a diet that calls for simply eating smaller portions of the foods you should avoid entirely.
Such an approach virtually guarantees that diabetes will only worsen as time goes by and the risks of diabetes complications will become ever greater – including doubling or quadrupling the risk of heart attack or stroke and the often horrific complication of diabetic peripheral neuropathy.
There are two very successful approaches to reversing diabetes. One calls for changing to a ketogenic diet, at least until the diabetes is reversed. A ketogenic diet (also referred to as keto or LCHF) advocates plenty of fats and little to no carbohydrates. The other approach is to avoid all the “no-no” foods, including those listed above and more, and allows for plenty of healthy carbohydrates from vegetables and a few fruits (such as berries).
Both diets call for ample, but not excessive, healthy protein and avoidance of almost all sugar. Two notable exceptions are high cacao dark chocolate and a couple of ounces of pure pomegranate juice daily.
Since this article is about diabetic peripheral neuropathy, I encourage readers to do their own research about the two main dietary approaches to reversing diabetes. There are some good articles about the ketogenic diet on TTAC and I highly recommended Joel Fuhrman’s book The End of Diabetes.
Reversing Diabetic Peripheral Neuropathy (DPN)
Reversing diabetic peripheral neuropathy involves regenerating damaged or lost nerves. As noted above, that may take time and the longer a person has had diabetic peripheral nerve damage, the longer it may take. While it may well take years, if you are a sufferer of DPN take heart that it CAN be done.
Assuming that you have reversed diabetes or are in the process of doing so, and that you are following the healthy diet and lifestyle recommendations for reversing diabetes, read on for an overview of some protocols for reversing diabetic peripheral neuropathy.
The Diabetic Peripheral Neuropathy Reversal Protocol of Dr. Ken O’Neal
Dr. Ken O’Neal is a Naturopathic PhD and MD who 30 years ago turned to using nature to heal, because as he said, “I became a doctor to heal people and I wasn’t healing anyone with mainstream medicine – I was just managing their symptoms with side effect-laden mainstream medications which led to further health conditions.”
Here, in brief, is Dr. O’Neal’s suggested protocol for reversing diabetic peripheral neuropathy:
- Eat a ketogenic diet with the only carbs coming from 2-3 servings or meals of low carb veggies daily.
- Use Ketostix Test Strips to assure you are in mild ketosis & learn what you have to do to stay there.
- Take 2-3 tablespoons of extra virgin coconut oil daily. Coconut oil is an extremely healthy fat.
- Consume ½ cup of nuts and/or seeds daily for healthy fats and protein.
- Take 2-3 tablespoons of organic unrefined red palm oil daily. Palm oil contains vitamin E (tocopherols and tocotrienols), which is important for reversing diabetes and diabetic peripheral neuropathy (Dr. Ken recommends 400 IUs of vitamin E daily. Palm oil also contains carotenoids (alpha-,beta-,and gamma-carotenes), sterols (sitosterol, stigmasterol and campesterol), and water-soluble powerful antioxidants, phenolic acids, and flavonoids.
- NO ethanol consumption, which means no alcoholic beverages.
- Take 100mg daily of vitamin B6 in the form pyridoxal phosphate.
- Take 500mg of niacinamide twice daily. Niacinimide is an important B vitamin and it helps keep blood vessels free of plaque.
- Take two capsules of the Hans Neiper supplement known as Membrane Complex twice daily. Each serving of two capsules contains 400mg of magnesium, 400mg of calcium, and 200mg of potassium.
- Apply 1 teaspoon of magnesium oil topically to the affected area of the feet three times daily, such as Dr. Ken’s own Miracle Magnesium Oil.
- Be sure to get 30mg per day of zinc, which is found in nuts and seeds as well as supplemental forms. Note: Do not overdo daily zinc consumption, but be sure to get the recommended amount of zinc daily.
- Take 1,000mg per day of high quality fresh fish oil. (Author’s note: a rodent study published in 2015 in the Journal of Neurophysiology found that fish oil can reverse diabetic peripheral neuropathy.)
- 120 to 240mg of ginkgo biloba daily. Ginkgo biloba is the best flavonoid for people older than 50 years of age and it is important in increasing and maintaining blood flow to the lower extremities as well as protecting vascular linings.
- To relieve existing pain, apply a topical cream containing cayenne pepper (capsicum). Capsicum blocks small nerve pain fibers and Dr. Ken reports that 80% of people respond positively to 0.075%.
Dr. O’Neal says that the target for the above protocol, along with a healthy diet and exercise program is a Hgb A1c level of 5.4 in 3 months.
Dr. Robert A. Kornfeld’s Protocol for Reversing Diabetic Peripheral Neuropathy
Dr. Robert A. Kornfeld is a holistic foot doctor (podiatrist) who has had success in reversing diabetic peripheral neuropathy. His dietary recommendations for DPN include:
- Making about 40% of your diet lean, healthy protein such as fish (especially small and wild-caught fish) and lean, grass-fed beef, chicken, lamb, or pork. He notes that vegetarian sources of protein such as traditionally processed fermented non-GMO soy and tempeh are also good choices.
- Having 30% of your diet consist of healthy fat, such as extra-virgin olive oil, sesame oil, safflower oil, or grapeseed oil to cook with and adding nuts and seeds to your diet as your primary snacks. Like many natural health figures, Dr. Kornfeld recommends only small quantities of dairy products.
- Carbohydrate intake should be no more than 30% of your diet and you should focus on low glycemic index vegetables, fruits, whole grains, and sprouted grains. Avoid processed carbs, starchy vegetables, starchy fruits, fruit juices, sweetened beverages, alcohol, and baked goods.
- Consuming organic foods to lessen the toxic load in your body and help promote a stronger and more efficient immune system.
Dr. Kornfeld’s Recommended Supplements
- Alpha lipoic acid, a fat and water soluble antioxidant which can protect nerve cells from further damage and assist in the repair of damaged nerve cells. He suggests starting with 300mg with each meal, unless otherwise determined by a healthcare professional.
- L-arginine in the amount of 250mg three times daily. L-arginine is an amino acid which helps improve blood flow, an important step in repairing nerve damage. Dr. Kornfeld notes that patients with a history of herpes should not take this amino acid because it has been implicated in an increase in outbreaks.
- Dr. Kornfeld reports that supplementing with omega-3s and omega-6s can greatly improve diabetic peripheral neuropathy because nerve cells depend on these fats for repair and healthy function. He notes that a blood test is often used to examine red blood count (RBC) levels of these fats to determine specific needs and that omega-3s and omega-6s need to be in ideal balance.
- A balanced B vitamin complex may help with symptoms of peripheral neuropathy. Make sure the B complex has synergistic levels of B vitamins and not just every B vitamin in the same dose and that the complex has adequate levels of folate in it (400 mcg). Dr. Kornfeld notes that high levels of B6 may worsen symptoms over time and thus he advises to be careful not to take too much.
- Benfotiamine, an important B-vitamin derivative, has proven helpful in many cases of diabetic peripheral neuropathy.
- Vitamin B12 can also be given by injection weekly, and this will increase your levels more rapidly if they are not improving orally.
Dr. Kornfeld agrees with Dr. O’Neal’s recommendation to stay away from drinking alcohol because it can block the body’s proper use of thiamine, folate, and vitamin B12 – and it can only worsen symptoms of neuropathy.
Doctor Jack Kruse’s Recommendations for Diabetic Peripheral Neuropathy
Dr. Jack Kruse is a neurosurgeon and self-described “Optimal Health Educator.” He makes some important scientific observations about diabetic peripheral neuropathy in his excellent essay “What to Do About Neuropathy.”
In this essay, Dr. Kruse talks about the role of blue light and extreme low frequency (ELF) magnetic fields. He also discusses the critical role sufficient dietary iodine plays for proper ketogenesis in our nerves, which he explains is critical for myelination of all nerves in humans. (Note: myelination is the creation of a protective insulating layer around nerves.)
Dr. Kruse advises his patients to avoid non-native EMF from cell phones and from any blue light emitting diode in their environment. He also recommends avoiding sugar alcohols found in many low carb foods, as well as the sweetener sorbitol like the plague.
Other recommendations for DPN by Dr. Kruse include:
- A strict low carb, paleo type ketogenic diet, especially like the one in Dr. Kruse’s book “Epi-paleo Rx: The Prescription for Disease Reversal and Optimal Health.”
- Be very careful of frying any carbohydrates. Carbohydrates subjected to frying in PUFA oils form the chemical acrylamide, a compound which is strongly linked to the development of peripheral neuropathy.
- Use of iodine and iodide supplements, R-alpha lipoic acid, resveratrol, PQQ, magnesium, and CoEnzyme Q10 to decrease cellular stress. (Note: R-alpha lipoic acid is a “carnitine like” analog which is thought to balance carnitine depletion and is often used as a treatment of diabetic peripheral neuropathy.)
- Fatty acid balance to reduce peroxide generation. The goal, Dr. Kruse says, is to decrease omega-6 fats and increase omega-3 fats, as well as increase gamma linolenic acid (GLA). Borage oil has copious amounts of GLA, as does black currant oil and evening primrose oil. These oils can help increase blood flow to decrease cellular stress.
- Very liberal replacement of B complex vitamins, especially B1 and B12.
- Optimization of vitamin D3 and vitamin E levels because of their immune modulating and antioxidant effects in nerves. Use of inositol is also a treatment option.
- Zinc, magnesium, and vitamin K2 replacement/supplementation. Zinc and magnesium are two of the most common mineral deficiencies in neuropathic pain. Zinc aids tremendously in wound healing.
- Supplementation with N-Acetyl Cysteine (NAC) and Acetyl-L-Carnitine. NAC is a precursor for the essential compound glutathione, which helps rid the nerve of the free radicals produced by the polyol pathway. Carnitine is replaced because polyol pathway depletes it.
- Optimization of thyroid hormone function is critical.
Two other supplements to strongly consider are Myo-Inositol and D-Chiro-Inositol, which are two substances that belong to the B-vitamin complex and which are produced in the body. Studies, as well as anecdotal evidence, have shown that a good combination is 2,000mg of Myo-Inositol and 50mg D-Chiro-Inositol.
Other supplements worth consideration are: cinnamon/cinnamon extract, soluble fibers, ashwagandha and other Ayurvedic herbs, and GTF chromium.
DPN Protocols Take Time and Consistency
As you can see from the protocols and supplement recommendations outlined above, different approaches and different supplements have been used successfully to combat and reverse diabetic peripheral neuropathy, so take heart!
Realize, however, that it will likely take a considerable amount of time and persistent, consistent dedication. According to Dr. O’Neal and Dr. Kruse, while diabetes may be reversed in only a few months, peripheral diabetic neuropathy may take as long as 18 months to 3 years or longer. Considering that the alternative is a lifetime of pain and perhaps worse, it is time well spent.
As Dr. Kruse observed:
Pain is temporary. It may last a minute, or an hour, or a day, or a year, but eventually it will subside and something else will take its place. If I quit, however, it lasts forever. That surrender, even the smallest act of giving up, stays with me. So when I feel like quitting, I ask myself, which would I rather live with?
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70% of diabetics suffer some kind of nerve damage.
Diabetic peripheral neuropathy (DPN) is the degeneration of nerves, which results in both numbness and higher sensitivity to pain and external stimuli.
The longer a person is diabetic, the more nerve damage can mount until it becomes severe.
The best way to prevent diabetic peripheral neuropathy is to not get diabetes in the first place, which can be prevented through diet and exercise.
In order to reverse diabetic peripheral neuropathy, one must reverse diabetes itself.
Recommendations for reversing DPN include:
- Healthy diet low in carbs and sugars
- Healthy lifestyle that includes ample exercise
- Use of vitamins and supplements to help protect and repair nerve cells