By Dan Gleason, DC

Peripheral neuropathy (PN) is characterized by painful, stinging, itching, burning and/or numbing sensations in the extremities, particularly the feet. Peripheral nerves are defined as those outside the central nervous system, in other words, not of the brain or spinal cord. Neuropathy is a disease or condition affecting the nerves. PN is often accompanied by circulatory problems in the extremities as vascular damage has many of the same causes.

PN is of most concern when it starts to affect balance, which it can because the proprioceptive nerves (those that affect balance) send signals to the brain from the feet. They are the fastest nerves in the body, sending signals faster than 300 meters per second. If proprioception is compromised, falls often result, and falls are a leading cause of injuries in older populations.
The diagnosis of PN is made by considering the symptoms and neurological assessment. A typical exam includes testing for heat and cold, pinprick sensation, fine and deep touch and balance testing. It can be confirmed by EMG electrodiagnostic testing. These measures are good at determining what it is and giving it a label. They are not good at determining the cause(s), which can include the following:

• Toxic exposure to heavy metals or mold
• Physical trauma, sudden or repetitive
• Nutritional deficiency
• Diabetes or pre-diabetes with associated insulin resistance

Heavy metal accumulation can be detected by testing. Some people live and work in toxic environments. Couple this with a condition that some people have that does not allow them to normally excrete lead, mercury, cadmium and other heavy metals, they can end up with too much even with minimal exposure. Testing the urine for the presence of mold and chemical toxins may yield insight into contributing causes of PN. Correction of the underlying reasons for exposure and accumulation may result in stopping or even reversing the progression of this serious condition. Those who tend to accumulate toxins often have genetic polymorphisms that make them unable to detox normally. Diagnosis and treatment of these underlying predispositions can be of significant value.

Nutritional deficiencies are common and can be diagnosed by testing. Common deficiencies that contribute to peripheral neuropathy include B12, B6, magnesium, SAMe, methionine and B-complex. Testing and subsequent replenishment of any deficiency can be of significant value in addressing the underlying cause of PN. Doctors and clinics that specialize in Functional Medicine are skilled at this type of detective work.
By far the most common cause of PN is diabetes, pre-diabetes and insulin resistance. Many, if not most, Americans are somewhere on the “Diabetic Spectrum” thanks to a diet high in carbs in the form of excess sugar and starch, which are addictive, too cheap and readily available. The most obvious sign of this problem is overweight and obesity. Clinical findings include elevated blood glucose and Hemoglobin A1c. Other indicators include high triglycerides, fasting insulin and low HDL. If not dealt with by the appropriate diet changes, these conditions likely will cause kidney, retinal and cardiovascular problems, as well. While some medications may give some relief from PN, addressing the most common underlying problem of insulin resistance is key to success in mitigating peripheral neuropathy.

Therapies that improve circulation can be of help. Exercise, walking and yoga all improve blood flow to the periphery as well as help improve insulin sensitivity. Cold laser treatments are an exciting approach to PN. Cold lasers can restore dormant nerve function by adding infrared energy, an FDA cleared for the treatment. When paired with the above-mentioned approaches, including a low carbohydrate diet and intermittent fasting, cold laser has shown significant positive results.

Early treatment is best, but even advanced, long-standing cases of PN have responded when the underlying causes are addressed.
Dr. Dan Gleason is the owner of The Gleason Center located at 19084 North Fruitport Road in Spring Lake. For more info: go to TheGleasonCenter.com or call 616-846-5410.