Sunday, 21 January 2018

Should You Supplement With Vitamin D To Help Your Nervous System?

Today's short post from (see link below) looks at the benefits of Vitamin D for your nervous system. Vitamin D is a bit of a buzz vitamin at the moment and is often promoted as a bone protector because of its ability to help the body absorb calcium, or an immune system booster, especially in cold and flu seasons but it is also vital for your nervous system as explained below. You'd be wise to heed the dosage warnings because too much vitamin D can be toxic for your system but if you have a D deficiency, it may be wise to supplement daily.

Neuropathy Nutrition: Vitamin D
by john | Nov 16, 2017 

Your Neuropathy Nutrition and Diet Should include Vitamin D

Yes, and this essential vitamin has a role in many other disorders too. Vitamin D is a key nutrient, responsible for many essential functions in human body.

What’s the Connection?

Perhaps the most significant functions are maintenance of bone mass and a powerful immune system. The more recent research suggests many additional roles for this key nutrient. We now know that when Vitamin D levels are low, widespread aches and pains plus more illnesses like flus and colds are common.

Yes, and maybe even neuropathy, both directly and indirectly.

Regarding infections, some researchers suggest we should be heading out vitamin D tablets as opposed to flu shots as they probably would be so much more effective, with minimal side effects.

But that’s another story for another time.

The neuropathy Vitamin D connection probably is because Vitamin D is necessary for the body to manufacture some key neurotropic factors.

Neurotropins as they are often called are substances produced by the body to help nerves repair, and whenever possible regenerate.

There are a number different things that can influence your own neurotropin production, including key nutrition components and therapies like low-frequency nerve stimulation.

In fact, the research is so significant here I am “bullish” on neurostimulator kits being tried for most neuropathy and pain patients.

This is why our homecare kits have become a very popular choice and work well the vast majority of the time. If you are new to Beating Neuropathy can find these at NeuropathyDR

So how much vitamin D is enough?

Well, United States says around 600 international units per day is fine, but European countries recommend levels much higher, on the order of a few thousand international units per day for most healthy adults.

So who is correct? I would definitely side with Europeans on this because research supports that most people do not get nearly enough vitamin D either from their diet, or sunlight exposure.

Personally, I recommend a minimum of 2500 units of supplemental Vitamin D per day combined with The NeuropathyDR Diet.

There are unfortunately no good plant sources of active vitamin D. (cholecaliferol).

The best dietary sources of vitamin D come from fish and fish oils.

But the most important advice I will leave you with today is to have your baseline levels of vitamin D checked, you and your healthcare providers must then determine the most optimum dosage for YOU!

Retest after the first 90 days to make sure your body is absorbing this key neuropathy nutrient properly.

You also need to be very careful because vitamin D can be toxic in very large amounts.

To learn more, check back with us frequently as we will update you periodically as the research indicates.

For more information on coping with diabetic neuropathy, get your Free E-Book and subscription to the Weekly Ezine “Beating Neuropathy” at

Saturday, 20 January 2018

Alpha Lipoic Acid: Just How Useful Is It For Nerve Pain?

Today's post from (see link below) concerns a commonly used supplement for neuropathic symptoms and that is ALA (Alpha Lipoic Acid). ALA is a fatty acid present in the mitochondria. It is involved in energy metabolism and may decrease blood glucose acutely. It is commonly taken with L-Carnitine supplements, as they are related in mechanisms and are both anti-oxidants and co-enzymes. Considering how expensive it can be in higher doses and how little serious research has been done related directly to neuropathy, it's somewhat surprising that it is so widely recommended but enough people seem to benefit from it to validate its use. This article tells you much of what you need to know about Alpha Lipoic Acid (other articles about ALA and articles about Acetyl L-Carnitine can be found elsewhere here on the blog - use the search facility) but tends to be a tad over-praiseworthy - it's not a miracle cure as many people claim but it can help with nerve damage and its symptoms. You need to read the article but at the same time, keep an open mind and do a lot more research of your own before deciding to invest your hard-earned cash on an expensive supplement. That all said, serious side effects haven't been found and the potential benefits are very promising. Experienced neuropathy patients will know that what works for one doesn't work for everyone and you need to give it time to start working in your system but it's definitely worth considering.

Alpha Lipoic Acid: Improve Insulin Sensitivity & Fight Diabetes!

Dr. Axe

What is it about foods like broccoli and spinach that make them so healthy? There’s the fiber, vitamins and minerals, of course, but then there’s other important chemical compounds we call “antioxidants” too — like alpha lipoic acid (ALA).

Chances are you’ve heard a lot about the many benefits of various antioxidants and high-antioxidant foods — fighting inflammation, helping beat cancer or heart disease, warding off depression and cognitive decline, and so much more — but have you ever wondered what exactly antioxidants are and how they work in the body?

Alpha lipoic acid — one kind of antioxidant — is a type of compound found in plant foods we commonly eat that scavenges free radicals, fights inflammation and slows the aging process. But perhaps its most famous use is in treating diabetes naturally.

Humans also make a small amount of ALA on their own, although the concentration in our bloodstreams goes up substantially when we eat a healthy diet. Naturally abundant in foods like green veggies, potatoes and certain types of yeast, lipoic acid is similar to a vitamin in that it can also be man-made in a lab so it can be taken as an anti-inflammatory supplement (which is then called alpha lipoic acid). 

How Alpha Lipoic Acid Works

Lipoic acid is found in the body and also synthesized by plants and animals. It’s present in every cell inside the body and helps turn glucose into “fuel” for the body to run off of. Is it “essential” that you consume a certain doseage of alpha lipoic acid every day? Not exactly.

Even though we can make some of it on our own without supplements or outside food sources (which is why it’s not considered an “essential nutrient”), eating an antioxidant-packed diet plus potentially using ALA supplements can increase the amount circulating in the body, with studies show has far-reaching benefits. (1)

ALA’s most valuable role in the body is fighting the effects of free radicals, which are dangerous chemical-reaction byproducts that form during the process of oxidation. Within our cells, ALA is converted into dihydrolipoic acid, which has protective effects over normal cellular reactions.

As oxidation takes place in the body over time — due to normal chemical reactions like eating or moving, but also from exposure to environmental pollutants and toxins — certain compounds can become very reactive and damage cells. At times, this causes abnormal cells to grow and multiply, or it can have other effects like slowing metabolic efficiency and changing neuron signaling.

Like other antioxidants, alpha lipoic acid can help slow down cellular damage that is one of the root causes of diseases like cancer, heart disease and diabetes. It also works in the body to restore essential vitamin levels, such as vitamin E and vitamin C, along with helping the body digest and utilize carbohydrate molecules while turning them into usable energy. (2)

In addition, alpha lipoic acid works like a synergist with B vitamins, which are needed for turning all macronutrients from food into energy. And it’s synthesized and bound to protein molecules, making it act as a cofactor for several important mitochondrial enzymes. (3)

Something that makes ALA unique is that it’s both water-soluble and fat-soluble, unlike other nutrients (like B vitamins or vitamin A, C, D or E), which can only be properly absorbed with either one or the other. (4) There’s some evidence that ALA is acts as a “heavy metal chelator,” binding to metals (also called “toxins”) in the body, including mercury, arsenic, iron and other forms of free radicals that make their way into the bloodstream through water, air, chemical products and the food supply.

Finally (as if this wasn’t enough!), alpha lipoic acid can increase how the body uses a very important antioxidant known as glutathione, and it might increase energy metabolism too — which is why some athletes use ALA supplements for enhanced physical performance.

5 Alpha Lipoic Acid Health Benefits

Because it acts like an antidote to oxidative stress and inflammation, alpha lipoic acid seems to fight damage done to the blood vessels, brain, neurons, and organs like the heart or liver. This mean it offers numerous benefits throughout the whole body, from naturally treating Alzheimer’s disease to controlling liver disease.

Because ALA isn’t an official essential nutrient, there hasn’t been an established daily recommendation needed to prevent a deficiency. However, being low in antioxidants in general can speed up in the aging process, resulting in symptoms like a weakened immune function, decreased muscle mass, cardiovascular problems and memory problems.

Here are five ways that including more alpha lipoic acid in your diet (and for some people taking supplements too) can help keep you feeling young and healthy:

1. Fights Diabetes and Diabetic Complications

Because alpha lipoic acid can protect cells and neurons involved in hormone production, one benefit is it offers protection against diabetes. ALA is considered an effective drug in the treatment of diabetic distal sensory-motor neuropathy, which affects about 50 percent of people with diabetes. (5) In dietary supplement form, ALA seems to help improve insulin sensitivity and might also offer protection against metabolic syndrome — a term given to a cluster of conditions like high blood pressure, cholesterol and body weight. Some evidence also shows that it can help lower blood sugar levels.

ALA is used to help relieve complications and symptoms of diabetes caused by nerve damage, including numbness in the legs and arms, cardiovascular problems, eye-related disorders, pain, and swelling. That’s why it should be part of any diabetic diet plan to treat this common disorder. People who experience peripheral neuropathy as a side effect of diabetes can find relief from pain, burning, itching, tingling and numbness using ALA, although most studies show that high doses in IV form are most effective as opposed to eating ALA-rich foods.

A major benefit of alpha lipoic supplementation in diabetics is the lowered risk for neuropathic complications that affect the heart, since around 25 percent of people with diabetes develop cardiovascular autonomic neuropathy (CAN). CAN is characterized by reduced heart rate variability and is associated with an increased risk of mortality in people with diabetes. Research suggests that supplementing with 600 milligrams a day of ALA (or “LA” as it is sometimes called) for three weeks significantly reduces the symptoms of diabetic peripheral neuropathy, although some doctors choose to use doses up to 1,800 milligrams a day safely in their patients under supervision.

2. Preserves Eye Health

Oxidative stress can damage nerves in the eyes and cause vision problems, especially in people with diabetes or older adults. Alpha lipoic acid has been used successfully to help control symptoms of eye-related disorders, including vision loss, macular degeneration, retina damage, cataracts, glaucoma and Wilson’s disease.

Results from certain studies demonstrate that long-term use of alphalipoic acid has beneficial effects on the development of retinopathy since it halts oxidative damage that can result in modified DNA in the retina. (6) As people age, their vision becomes much more compromised, which is why it’s important to eat a nutrient-dense diet well before old age to prevent degeneration of eye tissue or vision loss early on.

3. Prevents Memory Loss and Cognitive Decline

We know that a nutrient-dense diet filled with various colorful “brain foods” helps protect memory. Some health care professionals use alpha lipoic acid supplements to further help prevent their patients from experiencing neuron damage, memory loss, motor impairment and changes in cognitive functioning because of it antioxidant activity. ALA seems to easily make its way into the brain by passing the blood-brain barrier, where it can protect delicate brain and nerve tissue. It’s also used to prevent strokes and other brain problems, including dementia in older adults.

Recent experiments using rats have shown that ALA can help reverse the damage in aging cells of the brain, improve performance in memory tasks, lower oxidative damage and improve mitochondrial function, although we still don’t know how well these benefits can apply to aging humans. (7)

4. Helps Boost Glutathione

Glutathione is considered the “master antioxidant” by many experts, since it’s crucial for immunity, cellular health and disease prevention. Some studies have found that 300–1,200 milligrams of alpha lipoic acid helps increase the ability of glutathione to regulate the body’s immune response and fight off diseases like diabetes/insulin resistance or even HIV/AIDS. (8) In adults, supplementation with alpha lipoic acid seems to positively impact patients with immune deficiency syndromes and serious viruses by restoring blood total glutathione levels and improving functional reactivity of lymphocytes to T-cell mitogens.

5. Might Help Protect Skin from Damage

When it comes to battling physical signs of aging on the skin, certain studies have found that topical treatment creams containing 5 percent alpha lipoic acid can help reduce fine lines caused by exposure to sun ways. Skin damage is one side effect of high amounts of free radicals, which is why antioxidant-packed fruits and veggies are said to keep you looking young. 

How Much Do We Need? Plus Best Sources of Alpha Lipoic Acid

The best way to get any nutrients is ideally through real food sources, since this is how your body knows how to absorb and use various chemicals best. ALA is found in many different plant and animal sources, since it’s bound to protein molecules (especially lysine).

The concentration of ALA in different foods can vary widely depending on where they’re grown, the quality of the soil, how fresh they are and how they’re prepared, so it’s hard to quantify how much is in each type of food. There hasn’t been much research done to draw conclusions about how much ALA is found in particular foods, although we know vegetables and certain organ meats seem to be highest.

That being said, when you eat a whole food-based diet and vary the types of things you eat, chances are you consume a decent amount in addition to what your body already makes on its own.

Here are some of the best food sources of alpha lipoic acid (9):

Red meat
Organ meat (sch as liver, hearts, kidneys from beef or chicken)
Brussel sprouts
Brewer’s yeast

Alpha Lipoic Acid Dosage Recommendations

If you do choose to take ALA supplements, keep in mind that taking more won’t always offer better results. While side effects and risks of taking more seem to be very rare (considering it’s a natural chemical found in the body at all times), as little as 20–50 milligrams per day seems to be beneficial for general preventative health. Larger doses up to 600–800 milligrams per day are sometimes used in patients with diabetes or cognitive disorders but not recommended for the general public.

Dosage recommendations differ depending on who you ask, but below are some general guidelines that are within the safe range:
50–100 milligrams for antioxidant purposes in generally healthy adults
600–800 milligrams for patients with diabetes (divided into two doses, usually tablets are 30–50 milligrams each)
600–1,800 milligrams for patients with neuropathy and diabetic neuropathy (dosages this high should only be taken with supervision from a doctor)

According to researchers from Oregon State University, the amounts of lipoic acid available in dietary supplements (ranging in dosage from 200–600 milligrams) can be as much as 1,000 times greater than the amounts that could be obtained through someone’s diet alone! Taking ALA supplements with a meal is believed to decrease its bioavailability, so most experts recommend taking it on an empty stomach (or at least one hour before or after) for the best results.

Possible Side Effects and Interactions of ALA

Alpha lipoic acid supplements haven’t been studied in children or women who are pregnant or breastfeeding, so right now it’s intended for use in adults only. Side effects of ALA in supplement form are generally rare but for some people can include: insomnia, fatigue, diarrhea, skin rash or low blood sugar levels (especially in people with diabetes or low blood sugar who are taking medications).

Some potential interactions, or circumstances where you want to speak to your doctor before taking extra alpha lipoic supplements, include:
if you have a thiamine deficiency (vitamin B1), which is associated with liver disease/alcohol abuse
if you’re taking any medications for diabetes for insulin control, since this can raise the risk for hypoglycemia and low blood sugar
if you’re recovering from chemotherapy treatment or taking cancer medications
if you have a history of a thyroid disorder

Friday, 19 January 2018

The Naked Foot: How Does This Affect Your Neuropathic Sensations?

Today's interesting (if somewhat complex) post from (see link below) looks at the differences in sensory feedback from your feet, between moving barefooted or wearing shoes, Apparently, this can significantly affect the gait or posture of people also living with neuropathy. The basic question is, whether blocking signals from the ground to your feet and further to the brain by wearing footwear, can have a greater or lesser impact on your balance and pain responses - and the question is...which? The article is fascinating but takes some wading through (if you'll excuse the pun) and you may need your Google dictionary to explain some of the references ('shod' running for instance, means wearing shoes). Nevertheless, you'll get the idea and may be able to evaluate your own responses to wearing shoes (and which sort) or not when out and about. Personally, I find that wearing socks and anything more than the lightest slippers in the house, can worsen my symptoms but for others with neuropathy, it can be the complete opposite. Plus, wearing footwear protects against injury that you may not feel due to any numbness you might have, so I've been told going barefoot is not wise. However, as we all know, with nerve damage, we have to find behaviours that suit us best. An interesting article - well worth a read. 

From barefoot running to diabetic neuropathy By Melissa Thompson, PhD, and Kristine Hoffman, DPM, FACFAS November 2017

Because footwear alters sensory perception, research examining the role of cutaneous feedback in barefoot running may provide important insight related to some of the gait changes that occur in patients with diabetes and others who suffer from distal symmetric peripheral neuropathy.

Shod running and peripheral neuropathy are two research topics that may seem unrelated, but they do have a key element in common—sensory feedback. Several studies have indicated footwear blocks sensory feedback, resulting in gait changes in runners.1-4 Similarly, peripheral neuropathy by definition alters sensory feedback, leading to gait changes in that patient population. Emerging research on how footwear affects the gait of runners may have implications for addressing gait changes in patients with diabetes and others who suffer from peripheral neuropathy.

Peripheral neuropathy is a common disorder affecting up to 7% of the US population.5 Peripheral neuropathy can result in numerous morbidities, including severe neuropathic pain, loss of sensation, foot ulceration, Charcot neuroarthropathy, amputation, falls, fracture, increased mortality, and impaired quality of life.6 Distal symmetric polyperipheral neuropathy (DSPN) presents as numbness, paresthesias, and/or pain that typically begins at the toes and spreads proximally. DSPN can be progressive and can eventually take on a stocking-and-glove distribution. Neuropathies are the most chronic complication of diabetes, with DSPN accounting for approximately 75% of cases of diabetic neuropathy.7,8 Other etiologies of DSPN include chronic alcohol abuse, nutritional deficiency, toxins including medications and chemotherapy, genetic disorders, inflammatory conditions, other metabolic disorders, chronic infections, neoplasms, and idiopathic causes. Given its high prevalence, diabetic neuropathy is the most frequently studied type of DSPN.

Footwear that blocks sensory feedback from the feet and results in gait changes may be a modifiable parameter in patients with diabetic peripheral neuropathy.

The pathogenesis of developing DSPN can be multifactorial. Numerous risk factors contribute to the development of DSPN in patients with diabetes, including genetic predisposition, hyperglycemia, hyperlipidemia, hypertension, increased height, smoking, and exposure to other neurotoxic agents.9-11 The exact mechanism for development of diabetic DSPN is unknown, but several biochemical mechanisms, including the polyol pathway, advanced glycation end products, and oxidative stress, are thought to contribute. Small fiber sensory neurons are damaged first in diabetic DSPN, affecting the modalities of light touch, pain, and temperature. With prolonged hyperglycemia, further damage occurs to the large sensory nerve fibers, affecting the modalities of limb proprioception, vibration, and deep pressure. Clinically, DSPN most commonly results in loss of vibratory sensation and loss of pressure sensation, as measured with a 5.07-g monofilament.12 

Neuropathy and gait

Numerous gait changes are associated with diabetic neuropathy. General gait changes seen in patients with diabetic neuropathy include reduced walking speed, reduced cadence, decreased step length, and altered acceleration patterns.13,14 With respect to walking speed, patients with diabetic peripheral neuropathy walk more slowly than healthy controls of the same age.13,15 Menz et al and Dingwell et al found that patients with loss of plantar cutaneous sensation secondary to diabetic DSPN tended to have a slower preferred walking speed.13,14

Diabetic neuropathy is associated with altered gait kinematics, reduced ankle dorsiflexion and plantar flexion, as well as reduced knee flexion and extension, seen in patients with diabetic neuropathy compared with controls.16,17 Gait kinetics are also altered in patients with diabetic peripheral neuropathy, who exhibit smaller peak plantar flexion moments than controls.18-20


Additionally, decreases in strength, as well as muscle mass, are seen in individuals with diabetic neuropathy. Specifically, reductions in ankle plantar flexion strength and knee maximal isokinetic strength have been identified in individuals with diabetic neuro­pathy.21,22 Muscular atrophy, beginning with the intrinsic foot muscles and progressing proximally, is thought to23 produce the muscle weakness seen in patients with diabetic neuropathy. Atrophy of the intrinsic foot musculature, in addition to compensation for sensory loss, contributes to increases in peak plantar pressure in the forefoot and midfoot seen in individuals with diabetic neuropathy.16,17,22 These increases in peak plantar pressures are a primary contributor to diabetic foot ulceration.

Similar to the gait adaptations that occur subsequent to sensory loss associated with peripheral neuropathy, sensory feedback is thought to trigger the gait alterations associated with running barefoot versus shod. Thus, barefoot running creates an interesting opportunity for further understanding the role of plantar sensory feedback in gait, as there are consistently reported gait changes that occur with barefoot running that have long been thought to be triggered by sensory feedback from the feet. Specifically, barefoot running is typically found to result in a shorter stride length than shod running, along with more frequent use of a forefoot or midfoot strike pattern rather than the rearfoot strike pattern that is common among shod runners.24 Along with these changes, we also see a reduction in peak ground reaction forces (GRFs) and vertical impact peak magnitudes, which have been proposed to have implications for injury risk.24 

Footwear and sensory feedback

Robbins and colleagues were the first to address the role of plantar sensory feedback in running. In a series of studies,1-4 they analyzed the effects of footwear on plantar loading and impact-attenuating gait alterations, concluding footwear blocks sensory feedback, resulting in a failure to adopt gait modifications that limit injurious loading.

Specifically, Robbins and Hanna1 evaluated the adaptive pattern of the medial longitudinal arch following four months of barefoot weightbearing activity in habitually shod recreational runners, finding positive changes that consisted of shortening of the medial arch and load redistribution to the digits, which they associated with improved activation of the intrinsic foot musculature. Further, they speculated that cutaneous plantar sensory feedback was largely responsible for the altered activation of the foot musculature and that shoes create a “pseudo-neuropathic” condition that blocks this sensory feedback, potentially leading to running-related injury.

Further, Robbins and Gouw4 assessed plantar discomfort associated with loading that simulated locomotion, and found shoes block the discomfort associated with potentially injurious plantar loading, which subsequently results in inadequate impact-moderating behaviors and consequent injury. Similarly, Robbins, Gouw, and Hanna3 examined pain thresholds at various locations of the plantar surface of the foot, and Robbins, Hanna, and Gouw2 assessed the avoidance behaviors associated with painful loading of the plantar foot, providing evidence that sensory feedback from loading of the plantar surface likely induces mechanical alterations associated with intrinsic foot shock absorption. Although these studies provided evidence that suggested a relationship between sensory feedback and impact-attenuating gait alterations (eg, decreased stride length and change in foot strike pattern), this relationship was not systematically addressed. 

Altering sensation in the lab

Currently, in vivo measurement of sensory feedback from cutaneous receptors is quite limited and not possible to assess during dynamic activities such as walking and running. An alternative approach has been to reduce or eliminate sensory feedback and examine the corresponding gait changes. Nurse and Nigg25 conducted one of the first studies to use such an approach to evaluate the role of plantar sensory feedback, using an ice immersion protocol to reduce sensation in healthy individuals. This study found minimizing sensory feedback from select areas of the foot resulted in altered plantar pressures and muscle activation patterns during walking, suggesting cutaneous sensory feedback is a key parameter in gait modification.

Although this was one of the first studies to use an anesthetization technique to evaluate the role of cutaneous sensory feedback in gait, this approach is limited in that the resulting anesthesia may not be complete, and associated cooling may potentially influence skin and muscle properties. Subsequently, researchers used intradermal anesthetization to eliminate sensory feedback and examined corresponding gait alterations.

Hohne et al26 examined the effect of plantar cutaneous sensation on plantar pressure distribution by applying intradermal anesthetic injections to the plantar foot surface in healthy individuals. They found no changes in plantar pressure distribution during walking following the reduction in plantar cutaneous sensation, which led them to suggest that peripheral sensory neuropathy, at least at a superficial level, may be not a decisive factor for altering plantar pressures. Further, a second study by Hohne et al27 examined the role of cutaneous sensory feedback on dynamic stability during walking by applying intradermal anesthetic injections to the plantar surface, finding that impaired plantar cutaneous afferent feedback does not inhibit adaptive dynamic stability alterations during walking or diminish dynamic stability following perturbation.

Additionally, a third study by Hohne et al28 reduced plantar-afferent feedback via intradermal injections and examined the corresponding alterations in gait dynamics, lower-limb kinematics, and muscle activity during walking. The results showed loss of plantar cutaneous sensation did not influence spatiotemporal variables of gait dynamics, but did lead to altered lower limb muscle activation patterns and lower limb kinematics, suggesting altered gait associated with DSPN is due to superficial sensory changes, even if those sensory changes do not affect plantar pressures or dynamic stability.

Intradermal anesthetic injections have the benefit of not affecting intrinsic foot musculature; with this methodology, only sensory feedback from peripheral sensory receptors is eliminated. However, it is possible that other sources of plantar sensory feedback influence gait, and that sensory feedback from deep cutaneous and subcutaneous sensory receptors remains intact following intradermal injections. To address this, Fiolkowski et al29 used a tibial nerve block to eliminate all sensory feedback from the feet of healthy volunteers and analyzed the corresponding changes in peak force and leg stiffness during a hopping task (a proxy for running). The tibial nerve block technique eliminated tactile sensation, as well as deep pressure sensation, and resulted in a significant decrease in leg stiffness during hopping, indicating deep plantar sensation does play a role in regulating leg mechanics during running. 

Our research

In a series of recent studies,30,31 we addressed the claims that shoes block sensory receptors and that this leads to a failure to adopt the barefoot gait adaptations of decreased stride length and a forefoot or midfoot strike pattern. Specifically, we minimized sensory feedback by anesthetizing the feet to further understand the role of plantar sensory feedback during running. We did this in two studies using anesthetization techniques similar to Hohne et al26 and Fiolkowski et al.29 #168827172

In the first study, we used intradermal anesthetic injections, which eliminated most of the superficial cutaneous sensory feedback from the soles of the feet. In the second, we used a tibial nerve block intervention, which eliminated all sensory feedback from the feet. We then compared participants’ barefoot gait adaptations relative to the shod condition under these anesthetized conditions. We hypothesized, based on the idea that shoes are thought to limit sensory feedback from the feet, that with the absence of sensory feedback individuals would run similar to the shod condition even when barefoot.

In our initial study30 we used intradermal injections of lidocaine to the plantar medial, central, and lateral metatarsal heads, lateral column, and heel to anesthetize the superficial plantar surface of the foot. Anesthesia was confirmed as the absence of sensation when a 10-g monofilament was pressed on the foot sole with enough pressure to buckle. Vibratory sensation (an indicator of deep sensory feedback) was evaluated with a 128-Hz tuning fork, and remained intact in all participants. In this study 10 healthy, physically active individuals completed 10 successful trials of overground running in which kinematics and kinetics were measured for each of four conditions: shod running, barefoot running, anesthetized shod running, and anesthetized barefoot running. The results showed the classic changes of decreased stride length and adoption of a forefoot or midfoot strike position at ground contact associated with barefoot running, but we did not observe any effect of anesthesia on gait. This finding indicates superficial sensory feedback from the plantar surface of the foot is not responsible for the gait alterations associated with barefoot running.

In the second study,31 11 healthy, active participants completed the same combination of normal and anesthetized barefoot/shod overground running trials as in our first study, during which kinematics and kinetics were measured. Anesthesia was confirmed as the absence of both protective sensation (evaluated by 10-g monofilament) and vibratory sensation (evaluated with the 128-Hz tuning fork). In this study, which utilized the tibial nerve block, we did see a significant effect of anesthesia, with participants maintaining a longer stride length and a rearfoot strike pattern in the anesthetized barefoot condition. Together with our findings regarding superficial sensory feedback, this indicates deep cutaneous and subcutaneous sensory receptors are responsible for the gait changes associated with barefoot running. 

Future directions

These insights gained from examining the role of cutaneous feedback in barefoot running may provide important insight into addressing some of the gait changes that occur in patients with DSPN. To evaluate this further, an initial aim of our future research is to examine the role of cutaneous feedback in walking instead of running. Second, we plan to examine the role of cutaneous sensory feedback in patients with DSPN by making comparisons with sensory-based alterations observed with the use of anesthetic techniques in healthy controls. Finally, we will examine the role shoes play in affecting cutaneous feedback in patients with DSPN.

Shoe gear that blocks sensory feedback from the feet and results in gait changes may be a modifiable parameter in patients with DSPN. It is clear that abnormal mechanical loading of the foot, which may be due to gait alterations, can lead to ulceration in DSPN patients.23 Loss of protective sensation puts patients with DSPN at a higher risk of ulceration, so shoe gear remains important for protecting the feet; however, modification of shoe gear and/or inserts to enhance sensation may help to improve gait in patients with DSPN. Bartold et al, for example, found modifying shoes to enhance plantar sensory feedback in the midfoot reduced plantar foot pronation compared with a neutral shoe.32 Similar shoe gear modifications may be an option to alter plantar sensory feedback and reduce injury risk in patients with DSPN.

Decreasing the gait changes associated with DSPN will lessen the morbidities associated with neuropathic gait changes, including the risk of foot ulceration and amputation.

Missy Thompson, PhD, is an assistant professor of exercise science at Fort Lewis College in Durango, CO. Kristine Hoffman, DPM, FACFAS, is an attending physician in the Department of Orthopedics at Denver Health Medical Center and an assistant professor in the Department of Orthopedics at the University of Colorado School of Medicine in Denver.

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Robbins SE, Hanna AM. Running-related injury prevention through barefoot adaptations. Med Sci Sports Exerc 1987;19(2):148-156.
Robbins SE, Hanna AM, Gouw GJ. Overload protection: avoidance response to heavy plantar surface loading. Med Sci Sports Exerc 1988;20(1):85-92.
Robbins SE, Gouw GJ, Hanna AM. Running-related injury prevention through innate impact-moderating behavior. Med Sci Sports Exerc 1989;21(2):130-139.
Robbins SE, Gouw GJ. Athletic footwear: unsafe due to perceptual illusions. Med Sci Sports Exerc 1991;23(2):217-224.
Callaghan BC, Price RS, Feldman EL. Distal symmetric polyneuropathy: a review. JAMA 2015;314(20):2172-2181.
Ziegler D. Treatment of diabetic neuropathy and neuropathic pain: how far have we come? Diabetes care 2008;31(Suppl 2):S255-S261.
Dyck PJ, Albers JW, Andersen H, et al. Diabetic polyneuropathies: update on research definition, diagnostic criteria and estimation of severity. Diabetes Metab Res Rev 2011;27(7):620-628.
Albers JW, Pop-Busui R. Diabetic neuropathy: mechanisms, emerging treatments, and subtypes. Curr Neurol Neurosci Rep 2014;14(8):473.
Papanas N, Ziegler D. Risk factors and comorbidities in diabetic neuropathy: an update 2015. Rev Diabet Stud 2015;12(1-2):48-62.
Smith AG, Singleton JR. Obesity and hyperlipidemia are risk factors for early diabetic neuropathy. J Diabet Compl 2013;27(5):436-442.
Tavakkoly-Bazzaz J, Amoli MM, Pravica V, et al. VEGF gene polymorphism association with diabetic neuropathy. Mol Biol Rep 2010;37(7):3625-3630.
Kanji JN, Anglin RE, Hunt DL, Panju A. Does this patient with diabetes have large-fiber peripheral neuropathy? JAMA 2010;303(15):1526-1532.
Menz HB, Lord SR, St George R, Fitzpatrick RC. Walking stability and sensorimotor function in older people with diabetic peripheral neuropathy. Arch Phys Med Rehabil 2004;85(2):245-252.
Dingwell JB, Cusumano JP, Sternad D, Cavanagh PR. Slower speeds in patients with diabetic neuropathy lead to improved local dynamic stability of continuous overground walking. J Biomech 2000;33(10):1269-1277.
Dingwell JB, Cavanagh PR. Increased variability of continuous overground walking in neuropathic patients is only indirectly related to sensory loss. Gait Posture 2001;14(1):1-10.
Hazari A, Maiya AG, Shivashankara KN, et al. Kinetics and kinematics of diabetic foot in type 2 diabetes mellitus with and without peripheral neuropathy: a systematic review and meta-analysis. Springerplus 2016;5(1):1819.
Fernando M, Crowther R, Lazzarini P, et al. Biomechanical characteristics of peripheral diabetic neuropathy: A systematic review and meta-analysis of findings from the gait cycle, muscle activity and dynamic barefoot plantar pressure. Clin Biomech 2013;28(8):831-845.
Yavuzer G, Yetkin I, Toruner FB, et al. Gait deviations of patients with diabetes mellitus: looking beyond peripheral neuropathy. Eura Medicophys 2006;42(2):127-133.
Savelberg HH, Schaper NC, Willems PJ, et al. Redistribution of joint moments is associated with changed plantar pressure in diabetic polyneuropathy. BMC Musculoskelet Disord 2009;10:16.
Sacco IC, Picon AP, Macedo DO, et al. Alterations in the lower limb joint moments precede the peripheral neuropathy diagnosis in diabetes patients. Diabetes Technol Ther 2015;17(6):405-412.
Mueller MJ, Minor SD, Sahrmann SA, et al. Differences in the gait characteristics of patients with diabetes and peripheral neuropathy compared with age-matched controls. Phys Ther 1994;74(4):299-308.
Andersen H. Motor dysfunction in diabetes. Diabetes Metab Res Rev 2012;28(Suppl 1):89-92.
van Schie CH. A review of the biomechanics of the diabetic foot. Int J Low Extrem Wounds 2005;4(3):160-170.
Altman AR, Davis IS. Barefoot running: biomechanics and implications for running injuries. Curr Sports Med Rep 2012;11(5):244-250.
Nurse MA, Nigg BM. The effect of changes in foot sensation on plantar pressure and muscle activity. Clin Biomech 2001;16(9):719-727.
Hohne A, Stark C, Bruggemann GP. Plantar pressure distribution in gait is not affected by targeted reduced plantar cutaneous sensation. Clin Biomech 2009;24(3):308-313.
Hohne A, Stark C, Bruggemann GP, Arampatzis A. Effects of reduced plantar cutaneous afferent feedback on locomotor adjustments in dynamic stability during perturbed walking. J Biomech 2011;44(12):2194-2200.
Hohne A, Ali S, Stark C, Bruggemann GP. Reduced plantar cutaneous sensation modifies gait dynamics, lower-limb kinematics and muscle activity during walking. Eur J Appl Physiol 2012;112(11):3829-3838.
Fiolkowski P, Bishop M, Brunt D, Williams B. Plantar feedback contributes to the regulation of leg stiffness. Clin Biomech 2005;20(9):952-958.
Thompson MA, Hoffman KM. Superficial plantar cutaneous sensation does not trigger barefoot running adaptations. Gait Posture 2017;57:305-309.
Thompson M.; Hoffman K. Cutaneous sensory feedback is a primary determinant of gait changes observed in barefoot running. Presented at American Society of Biomechanics Annual Meeting; August 2-5, 2016, Raleigh, NC.
Bartold S, Bryant A, Clark R, et al. Acute effects of a shoe with enhanced plantar sensory feed back on midfoot kinematics whilst walking. J Footwear Science 2011;3(Suppl 1):S7-S8.

Thursday, 18 January 2018

Common Antibiotics That Can Give You Nerve Damage

Today's post from (see link below) returns to the subject of fluoroquinolone antibiotics and how they can cause nerve damage (neuropathy). It cannot be stressed enough how potentially dangerous these antibiotics are for people prone to neuropathy. This blog has mentioned this many times before (along with many others up to the FDA itself) and still doctors commonly prescribe them for random infections. How long will it take before the message gets through!! If your doctor prescribes any of the fluoroquinolone family for you, you should seriously question the decision and if necessary refer to the FDA warning (and articles such as this one below). Alternatives are available and the right decision may save you from a lifetime of pain.

NEW FDA WARNING for Cipro, Levaquin, Avelox-Permanent Peripheral Neuropathy- Mixed Emotions
By Erin Wilson First Posted Friday, August 16, 2013

The FDA announced on August 15, 2013, that fluoroquinolone drugs such as Levaquin, Cipro and Avelox will be required to change packaging inserts to contain a warning for severe, permanent and disabling peripheral neuropathy. The FDA states that the damage may occur very soon into the administration of the drugs and the damage may be permanent.

If you as the reader, are not familiar with exactly what peripheral neuropathy is, here is the FDA’s description: Peripheral neuropathy is a nerve disorder occurring in the arms or legs. Symptoms include pain, burning, tingling, numbness, weakness, or a change in sensation to light touch, pain or temperature, or the sense of body position. It can occur at any time during treatment with fluoroquinolones and can last for months to years after the drug is stopped or be permanent. Permanent. Yes, forever. Never going to stop burning for the remainder of your life. It’s the feeling of spontaneous human combustion with out all the nasty fire and flames. Holy cow. How is this even acceptable?

I have very mixed emotions about the FDA’s announcement today. As a victim of Fluoroquinolone Toxicity and peripheral neuropathy, I am caught between being pleased and being angry. Very, very angry. Most victims, and I know thousands of them, will tell you that they told their doctor about their peripheral neuropathy as well as their other grocery list of horrific symptoms and doctors simply smirked and informed them “These drugs don’t cause that”. Patients were then recommended an anxiety drug, psychotropic drug or asked if someone at home was abusing them. I wonder where doctors get their information regarding drugs that they throw out like beads at a Mardi Gras parade? Some physicians are completely unaware of the Black Box warning placed on fluoroquinolones in 2008 for tendon tears and those who know about it never ask the tendon tear victim “Did you take a quinolone?”. Victims who themselves have become aware of fluoroquinolones and their resulting tears (God bless the internet) have informed their doctors. Not many victims report that their doctor informed THEM that they had a tear as a result/side effect of the drug. Doctors are in denial and they are in deep. There is also money. Yes sireeeee! Good old money. It’s always found where shady deals are done and pacts are made with the Devil. If you don’t believe me Google Dollars for Doctors, put in your physicians name and magically (God bless the internet, again), you are informed as to how much he/she made from drug companies this last year. You also get too see which drug companies are lining the pockets of the people we entrust with our lives to. It’s business. BIG business, so don’t kid yourself for a moment that it’s not.

My next thought is the FDA is covering it’s hiney and trying to cover it fast. Victims are becoming more and more vocal, gathering in groups on Facebook (God bless the internet, again), having Floxie meet ups, organizing in an underground network. If you as the reader are not familiar with the term “Floxie”, it is a darling colloquialism fashioned by author Stephen Freid in his best selling book Bitter Pills-Inside the Hazardous World of Legal Drugs . The term has probably stuck because” Floxie” is much cuter than “disabled” or “eternally suffering human being”. Websites devoted entirely to flouorquinolone victims abound. Google Cipro is Poison or Death by Levaquin or even just the drug names and you will get more than you can wrap your head around. These groups have initiated petitions, organized a lawsuit registry for a potential lawsuit and last May, marched on the Washington Capitol and met with legislators proclaiming the dangers and devastating side effects of these drugs. Victims will no longer take this sitting down. They are no longer being strong armed into believing they are the one in a million, the 1% or just genetically inferior. Lets not forget Medwatch, the FDA’s reporting system. Floxies are reporting in massive numbers and re-reporting each year that they are symptomatic from the drug. (To file a report go to ). There is a lot of boat rocking going on in the Flox world these days and I think the FDA is feeling it.

The warning also states that this is only for injections or oral doses. Many victims report the same symptoms of fluorquinolone toxicity by IV and eye drops and the symptoms are exactly the same. My own mother was floxed with Zymaxid eye drops for cataract surgery. Zymaxid is the eye drop form of Gatifloxacin which was banned by the FDA in 2006 for severe hepatic failure as a result of the drug. It’s poison orally but go ahead and drop it in your eyes and it’s fine. HUH??? The reality is the results are the same. Children are also given these drops for pink eye and ear infections with regularity. The results are the same but young children are not fully capable of communicating their symptoms so many of the symptoms are unnoticed, blamed on behavior or the illness for which the drugs were prescribed. With the ear drops, the busted ear drum is the only obvious tell tale sign of a child’s severe reaction.

I tend to write very tongue -in-cheek when I write about these drugs. The reality is pretty horrific and terrifying. The day in and day out suffering of Fluoroquinolone Victims should be recognized by doctors, family members, husbands, wives, partners and society as a whole and yes, the FDA. So is a warning on packaging for drugs that steal lives seems almost trivial and somewhat of an insult. It also feels like redemption for victims that have been called crazy by family members or hypochondriac by doctors. I have mixed emotions. It’s a win but it feels like a “gimme”. Like the FDA is tossing a bread crumb and ignoring all the other disabling effects of these drugs. My only hope is that doctors will no longer use these drugs on high risk patients with known chronic diseases like diabetes, Crohns, ulcerative colitis and Lyme.

It looks like a win but it feels like a loss. One thing I do know it that it not GAME OVER. Not by any measure.

Find help here: Fluoroquinolone Victims Advocacy Network – sign the petition for a BLACK BOX WARNING for peripheral neuropathy.

Read victims stories here

Support groups:

About me, the author. My name is Erin Wilson and I am an advocate and peer counselor for victims of fluoroquinolone toxicity. A two time victim of Levaquin, I have lived it and seen it all. I now counsel victims in recovery and make the public aware of the devastating effects of these drugs. If you have been harmed by Cipro, Levaquin or Avelox or any fluoroquinolone drugs, there is help. Please visit . There is support and help for recovery.

Wednesday, 17 January 2018

Supplement Options For Neuropathy - A Personal Story

Today's post from (see link below) is a personal story from someone who has nerve damage as a result of chemotherapy but it applies to almost all people with neuropathy who are searching for supplements and vitamins to help reduce the symptoms that the painkillers barely touch. There are no guarantees - everyone is different and what's more these supplements are not cheap, so it's a question of trying one thing or another until something works for you. Nevertheless, there's some good advice here and the story will be recognisable to many. Do your own research and see what best fits your lifestyle, budget (and doctor's advice if necessary).

Peripheral Neuropathy after Chemotherapy – Supplements Suggestions
May 31, 2013 by Rachel - Cha Ching Queen 

Vitamin and Supplement Suggestions for Peripheral Neuropathy after Chemo for Breast Cancer

Chemotherapy has many side effects, some of which can be long-term or even permanent. I was diagnosed with breast cancer in 2009 (read about my breast cancer here). Even though I finished my treatment about 3 1/2 years ago I still have lingering effects from the the chemo. One of the most bothersome is pain in my feet and hands, which as I found out a few days ago, is Peripheral Neuropathy from Chemotherapy most likely caused by the Taxotere.

I have been to many different doctors and tried a variety of homeopathic and pharmaceutical treatments. It’s hard to exactly describe the long-term chemo side-effects pain I have. At first I believed I had arthritis. I am not able to stand for long periods of time. The area around my joints hurt, with the majority of the pain about my big toe joint and the ball of my foot. It feels like I don’t have enough padding on the bottom part of my feet and the bone is hitting the hard floor.

My hands feel somewhat the same, although not quite as bad. I still have a hard time with some fine motor skills such as opening bottles and using a kitchen knife.

During my most recent appointment with the oncologist, she recommended I see a neurologist. My appointment with a neurological oncologist was earlier this week. I was a little nervous about seeing a cancer neurologist. That sounds scary, and I started worrying that maybe something was horribly wrong with my brain.

The neurologist did a ton of tests checking my reflexes, range of motion, vision, sensitivity, and more. He poked a safety pin up and down my feet, legs, hands, and arms. I never realized how bad my neuropathy really was. At the tips of my fingers and toes I could feel a sensation, but it wasn’t until the pin made it’s way further down my toe or finger, that I could really feel the prick. That was interesting.

So, here I am now with a diagnosis of chemo induced peripheral neuropathy. In addition to a few other daily medications, vitamins, and supplements I already take, the neurologist recommended quite a few others as well. Here are the recommended supplements and vitamins my neurologist suggests for peripheral neuropathy after chemotherapy. 

Alpha Lipoic Acid 800-600mg BD
Vitamin B12 500mcg QD
Vitamin B6 25-50mg (I’m not taking this extra B6 because I get it in my multi-vitamin) QD
Vitamin B1 50-100mg QD
Gamma Amino Butyric Acid QHS
Phosphotidylserine and Phosphotidylcholine 300-900mg

Then, in addition to this, this is what I take daily to be healthy and help some of my lingering joint pain that was originally diagnosed as Fibromyalgia.
Tums (for Calcium)
Probiotics (digestive issues with occasional IBS attacks)
Alive Multi-Vitamin

Here’s a picture of what my morning looks like and all the pills I take.

L-carnitine can be used to control certain heart conditions such as chest pain, heart attacks, high cholesterol, and more. Get the best L-carnitine reviewed and tested at Monica’s Health Mag.

Tuesday, 16 January 2018

Lupus: The Wolf In Sheep's Clothing Of Nervous System Diseases

Today's post from (see link below) looks at the links between Lupus and neuropathy. Many readers ask about lupus but it remains an elusive and difficult to diagnose disease which essentially is a systemic autoimmune disease that occurs when your body's immune system attacks your own tissues and organs.The resulting inflammation can lead to all sorts of complaints but is difficult to diagnose and as all nerve damage patients will equally difficult to treat. Nevertheless, many neuropathy patients also have been diagnosed with lupus and this article explains how that can happen. If you're confused or suspect that you may have lupus, talk to your doctor or neurologist about it but read this article first - it may help to clear up some preliminary questions.

How lupus affects the nervous system 
Lupus Foundation of America September 26, 2017

Resource Content

Lupus is an autoimmune disease that can affect almost any part of your body, including your joints, skin, kidneys, heart, lungs, or blood. Lupus can also affect the nervous system and brain. There are several terms doctors use to describe this: neuropsychiatric lupus (NPSLE), neurocognitive dysfunction, or central nervous system lupus (CNS lupus).

The nervous system has three parts, any of which may be affected by lupus: 

The central nervous system (CNS)
—The brain and spinal cord.
The peripheral nervous system (PNS)—The network of nerves that connects the brain and spinal cord to the rest of the body, and gives skin and muscles the signals needed for sensation and movement.
The autonomic nervous system (ANS)—Allows communication between spinal and peripheral nerves and the brain and internal organs, and controls functions like breathing, blood flow, and heart rate.

People with lupus can experience a number of complications when their nervous system is affected. The symptoms may come on suddenly or may come and go, but they will vary depending upon the location and extent of the tissue injury. These symptoms also can be present in other diseases, so diagnosing lupus-related nervous system disorders is often difficult.

Neurologists are physicians who specialize in the nervous system. They may rely on a number of diagnostic tools to determine whether lupus is involved in cognitive problems:

Brain scans (magnetic resonance imaging (MRI) and computed tomography (CT)
Electroencephalograms (to capture the electrical pattern of brain activity)
Spinal tap (to examine fluid in the spinal column)

Behavioral and cognitive tests may also be done to find out if your memory or other mental abilities have been affected.

Depending on the symptoms, a variety of medications are available to treat lupus-related nervous system disorders, including non-steroidal anti-inflammatory drugs, antimalarials, and steroids. Your response to treatment may be rapid or gradual over several months.

For many people with lupus, nervous system involvement is completely reversible.

Central Nervous System (CNS) 

When lupus affects your central nervous system, many symptoms may occur, including:

Vision problems
Mood swings
Difficulty concentrating
Lupus fog or cognitive dysfunction

As many as half of all people with lupus describe feelings of confusion, fatigue, memory loss, and difficulty expressing their thoughts. This collection of symptoms is termed cognitive dysfunction, although many people with lupus call it "lupus fog." Cognitive dysfunction most often affects people with mild to moderately active lupus. The causes of these symptoms, and the reasons the symptoms tend to come and go, are unknown. Living with cognitive dysfunction can be very frustrating. However, you can learn to improve your concentration and lessen confusion and memory loss with a variety of coping skills, including puzzles, games, biofeedback, using a daily appointment calendar, and balancing daily activities to reduce stress.

Lupus fog can be frustrating but there are a variety of coping skills that can help you learn to improve your concentration and lessen confusion. 

Lupus headache

Compared with the general population, people with lupus may be twice as likely to experience migraine-like lupus headaches, commonly known as lupus headaches. The features of lupus headaches are similar to migraines and may be seen more often in people who also have Raynaud’s phenomenon. However, headaches can also be caused by vasculitis, a symptom of active lupus due to inflammation of the blood vessels. If you are experiencing headaches that are not improved by an over-the-counter headache medication, be sure to tell your doctor. 

Medication side effects

Medications used to treat lupus can cause side effects that are similar to the symptoms of CNS lupus. If you have symptoms of CNS lupus you should consult a neurologist who can determine which symptoms are side effects of medication and which are due to lupus. The drugs most known for causing symptoms like those of CNS lupus are: 

Non-steroidal anti-inflammatory drugs (NSAIDs) – May cause headache, dizziness, confusion, and in rare instances, meningitis-like symptoms
Antimalarials – Very high doses (not usually given for lupus) may cause manic behavior, seizures, psychosis
Corticosteroids – May cause agitation, confusion, mood swings, psychosis, depression
Anti-hypertensive medications – May cause depression or loss of sex drive

A serious form of lupus called CNS vasculitis may occur when there is inflammation of the blood vessels of the brain. Characterized by high fevers, seizures, psychosis, and meningitis-like stiffness of the neck, CNS vasculitis is the most dangerous form of lupus involving the nervous system and usually requires hospitalization and high doses of corticosteroids to suppress the inflammation. 

Peripheral Nervous System (PNS)

The nerves of the peripheral nervous system control motor responses and sensation, so symptoms of numbness or tingling, or inability to move a part of your body, may be the result of lupus affecting these nerves. Known as peripheral neuropathies, symptoms of PNS nerve damage are caused by inflammation or compression of the nerves due to swelling in the tissue around them. 

The types of symptoms you might experience include: 

Vision problems
Facial pain
Ringing in the ears
Drooping of an eyelid
Carpel tunnel syndrome 

Autonomic Nervous System (ANS)

The autonomic nervous system regulates many of the body’s functions that happen almost automatically: heart rate, blood pressure, feeling hot or cold, bladder and bowel functions, release of adrenaline, breathing, sweating, and muscle movement. Lupus can cause these nerve signals to be overactive, which can lead to a wide range of symptoms:
Mental confusion
Gastrointestinal problems such as nausea, vomiting, constipation, or diarrhea

Raynaud’s phenomenon is a condition of ANS involvement caused by inflammation of nerves or blood vessels. Blood vessels in the hands and feet go into spasm and restrict blood flow, usually as a reaction to cold temperatures, with the tips of the fingers or toes turning red, white, or blue. Raynaud’s can also cause pain, numbness, or tingling in fingers and/or toes. People who have Raynaud’s phenomenon are advised to avoid cold conditions when possible, and may have to wear gloves or mittens when in air-conditioned surroundings.

Livedo reticularis and palmar erythema are two other skin disorders that may affect you if you have autonomic nerve damage. Both of these conditions can cause a bluish, lacelike mottling under your skin, especially on your legs, giving your skin a "fishnet" look.

Monday, 15 January 2018

Is Ketamine The Answer To Controlling Nerve Pain?

Today's short post from (see link below) looks at the potential of ketamine in solving chronic pain problems (including nerve pain). Now ketamine, just like methadon, is already quietly, quite widely prescribed for neuropathy pain suppression but that doesn't mean that it's included in the list of standard nerve pain treatments. However, because of the nature of how the drug works, it has been proven to be a successful treatment for stubborn and drug resistant chronic pain. You can ignore the prices quoted in this article; in many countries, ketamine should be available free or be covered by insurance policies. This article is basically an advertisement for the doctor's own practice.The problem is (just as with methadon) ketamine has an image problem and is lumped alongside opioids as being a recreational and easily abused drug that features on many black market lists. Medically, this bad rap is totally unjustified and if you look at the science behind its workings, it has every right to be seen as a potentially effective drug for severe nerve pain. The current climate means that ketamine, methadon and others will face a hostile reception from the medical authorities but if all else has failed, it would be worthwhile talking to your medical specialists about the possibility of it being prescribed. However, first do plenty of  your own research on reputable medical sites; you may be surprised at what you learn.

The Renaissance of Ketamine for the Treatment of Chronic Pain
Posted on January 13, 2018 in Pain Medication By Ed Coghlan.

Dr. Adam C. Young, MD is the Director, Acute Pain Service and Assistant Professor for Anesthesiology & Interventional Pain Medicine at Rush University Medical Center. Recently he agreed to share his thoughts with the National Pain Report on the use of ketamine for the treatment of chronic pain.

National Pain Report: “Ketamine has been around for a long time, and yet it seems to have a new momentum in helping treat some elements of chronic pain. What’s new in 2018?”

Adam C. Young, MD

Dr. Young: “Indeed, ketamine is an old drug that has seemed to found new meaning in the past 2 decades. One of the reasons is published evidence of the utility of ketamine in the operative setting has shown to have promising results in reducing acute (short-term) and chronic (long-term) pain. Another is the current crisis known as the ‘opioid epidemic.’ Ketamine is known to possess properties that reduce tolerance to opioid medications, provide pain relief via other mechanisms, and provide effects that can be long-lasting. As the dangers of chronic opioid use have become better understood, physicians are suggesting ketamine to patients for these reasons.”

National Pain Report: “Obviously, every patient case is a little different. What do you recommend a patient who hasn’t tried ketamine do, in terms of educating one’s self, talking with a physician, how often to have the treatments etc.?”

Dr. Young: “Discussing the nature of a ketamine treatment with your physician is essential. Ketamine is administered typically as an intravenous infusion. Beyond that the duration of treatment, dose of treatment, and number or treatments can vary from one physician to another. Talk to your physician regarding the dose- how they determine it and if there are changes to it throughout treatment. Ask about how long infusions last and how often they are performed. Repeat infusions are fairly common and there may be a benefit to doing so at short intervals as a series. You should ask your physician about other medications that are given during the infusion. In my practice we administer medications to blunt some of the side effects of ketamine in order to make the infusion better tolerated and provide the patient with a better experience overall.”

National Pain Report: “What are the side effects you warn patients of when discussing ketamine treatment with them?”

Dr. Young: “Ketamine is a good drug, despite some of the aforementioned benefits it does have side effects which can be particularly bothersome. Common side effects include nausea, vomiting, increased saliva production, and vivid dreams. Ketamine is also known as a dissociative anesthetic, meaning it induces a trance-like state where patients can maintain consciousness but have an inability to move. There have been cases where patients can hallucinate or experience dysphoria, an unpleasant state of consciousness.”

National Pain Report: “How much does a treatment cost?”

Dr. Young: “Costs vary from office to office and have a wide range. I can only share what my office charges, which is roughly $1000 per treatment. I administer ketamine in a series of 3 infusions, on consecutive days. If a patient proceeds with all three it is roughly $3000 for the entire series.”

National Pain Report: “Looking forward to 2018, what do you think should occur regarding the use of ketamine for chronic pain?”

Dr. Young: “I wholeheartedly believe in the utility of ketamine as an adjunct in the treatment of chronic pain. The United States’ opioid epidemic has underscored the need to treat pain without opioids- ketamine gives us a viable option to do so. Pain physicians have embraced the use of ketamine given its spectrum of benefits with tolerable side effects. We have seen chronic pain patient improve, wean or stop stronger oral pain medications, and see improvements in mood. The medical literature is catching up with our clinical experience; I hope this will encourage insurance carriers to cover this treatment in the future.”

National Pain Report: “Thanks, Dr. Young.”

Sunday, 14 January 2018

Can Electroceuticals Be The Future For Nerve Pain Relief?

Today's post from (see link below) discusses the pain-killing possibilities of various electro-stimulatory devices and suggests that they are the answer to opioids and other very strong pain killers. Perhaps more importantly for the general neuropathy patient; there is a paragraph explaining the mechanics of nerve pain in a readable and educative manner - that's well worth a read for all neuropathy patients wondering how their symptoms occur. However, back to the promotion of electrostimulation as an effective nerve pain killer. The article describes several devices and their manufacturers and may well have you wondering if this is possibly something for you. The answer to that lies in discussions with your doctor and (preferably) a neurologist but it's true that technological developments are making these devices more effective and easier to use. Worth a read.

In The WEEKLY by Emily Burke November 16, 2017


Migraine relief without drugs? No “digestive issues” due to pain meds after surgery? Better still, no worry about addiction after that appendectomy or hip replacement? Sounds a bit science-fictiony, does it not?

The news reminds us nearly every day of the profound need for pain management without opioids. As you read last week, alternatives to analgesics such as morphine, codeine, or fentanyl exist. But science also takes us beyond medicine: researchers have developed devices that control pain and inflammation electronically. This drug-free approach is called electrostimulation–using low levels of electricity to zap pain. 


How does one feel pain in the first place? Pain, and more pleasant sensations (the taste of chocolate, for instance) come courtesy of the nervous system. This system serves as the wiring that enables the machines of our bodies to move, experience, and interpret the world.

Our nervous system has two main parts that work in tandem: the central and peripheral nervous systems. The central nervous system functions as the “switchboard” that sends and receives information from peripheral nervous system’s local lines. The peripheral nervous system is a vast network of nerves found everywhere in body.

The central nervous system is made up of neurons. These cells send and receive signals electrochemically, through signaling molecules called neurotransmitters. These chemicals are converted into electrical signals in the neuron. Here’s how: when a neurotransmitter reaches one edge of a neuron, the dendrite, it opens ion channels in the cell membrane. These tiny openings allow the positively charged sodium ions to pass through. These positive ions travel down the other side of the neuron through an extension called an axon. When the electrical charge reaches the end of the axon, it signals the release of other neurotransmitters, which then switch on other neurons and the chain of sensation unfurls.

Groups of neurons form nerves outside the central nervous system. Nerves transmit sensory information such as touch, temperature, and pain. Different kinds of nerves respond according to the specific receptor on their surface. Pain receptors detect chemicals that tissue damage releases. The pain signal then zooms along the nerve to the central nervous system for interpretation and response by the brain. Pain can also be caused by direct damage to the nerves themselves (think pinched nerve).

As you no doubt noticed, pain perception is complex. Remember the last time you bashed your knee? Did you rub it? The Gate Theory of Pain says this rubbing action does temporarily reduce pain. In that moment, signals from your non-pain nerves block signals from your pain nerves. In other words, non-pain nerves prevent pain from reaching your brain.

Electrostimulation relies on the body’s ability to run interference on pain. It uses electricity to treat chronic pain by stimulating a patient’s peripheral nerves or spinal cord. In either case, a small pulse generator sends electrical pulses to the nerves or spinal cord, “shutting the gate” on pain.

Several companies already have electrostimulation-based devices on the market, including:

• Medtronic (Fridley, MN). Its Intellis spinal cord neurostimulation system gained FDA approval in September and European Union approval for managing chronic pain earlier this month. This small, implantable neurostimulator communicates wirelessly with a Samsung tablet that a doctor uses to adjust pain relief and monitor patients’ activity. More activity indicates that the patient’s level of pain is lessening.

• Stimwave (Pompano Beach, FL). This company’s latest device, the StimQ Peripheral Nerve Stimulator, was approved in August for chronic pain. Tiny enough to be inserted by needle, it communicates wirelessly with an external transmitter that delivers electrical pulses. The device is also safe to wear in MRI machines. This innovation makes neurostimulation available to people whose treatment requires ongoing imaging.

• Abbott (North Chicago, IL) also offers neurostimulation systems. Their most recent is the BurstDR system. Developed by St. Jude Medical in St. Paul, MN, this proprietary technology delivers bursts of electrical stimulation in a way that mimics the body’s natural response to pain.


While neurostimulation can treat chronic pain, the technology may provide other therapies as well. Because nerve signals permeate the entire body, modulating them may work for other medical conditions. For example, neural signaling partially controls inflammation, the body’s response to injury. This suggests that neurostimulation may treat inflammatory disorders such as Crohn’s disease and rheumatoid arthritis.

Federal agencies, large pharmaceutical companies, and small start-ups are taking note. The National Institutes of Health (Bethesda MD) has established the Stimulating Peripheral Activity to Relieve Conditions (SPARC) program to fund the basic exploration of how peripheral nerves’ electrical signals control the function of internal organs. This effort may lay the groundwork for electroceuticals–the next generation of tiny neurostimulation devices.

In the private sphere, GlaxoSmithKline (GSK; Middlesex, U.K.) leads the charge. The corporation is heavily involved in creating a Nerve Atlas to map the nervous system’s role in disease. GSK is also investing in start-ups such as SetPoint Medical (Santa Clarita, CA), which has already produced clinical data supporting the use of electroceuticals on rheumatoid arthritis . Another of GSK’s notable investments in electroceuticals was the launch of Galvani (Stevenage, England) in 2016, in partnership with Verily (San Francisco, CA). Galvani is developing electroceuticals for chronic conditions including Type 2 diabetes, autoimmune, and endocrine disorders. 


Feeling no pain sounds great, doesn’t it? Yet people born with congenital analgesia suffer greatly from injury and illness, because they never feel the pain associated with them. In a BBC interview, sufferer Steven Pete talked about breaking a limb roller skating as a boy, noticing it only when friends pointed out the bloody wound caused by the bone protruding from his leg! Fortunately, this inherited nervous system disorder is extremely rare, with only 20 or so cases known in the medical literature.

Saturday, 13 January 2018

Apptastic Ways To Help You Survive Life With Chronic Pain

Today's slightly off-beat post from (see link below) is a fantastic way to adapt modern technology to the needs of those with a chronic illness, who have difficulties organising their lives around medications, appointments, household tasks and numerous other activities. You need a smart phone or (I assume) a pc but as that already applies to most of the population, one or more of the apps mentioned below may give you the right sort of help when life just becomes a bit too overwhelming. People in chronic pain including neuropathy patients, often have trouble concentrating on the mundane things in life, that seem like distractions but have to be done. These apps are designed to help you organise and keep track of your daily 'must-dos' in a relatively fun way. That all said, many people become technophobic when pain takes over but if your smartphone is already an unmissable part of your life, the options shown below may well help you survive the day without tearing your hair out!

17 Apps That Can Make Life Easier When Brain Fog Takes Over
August 31, 2017

If you struggle with brain fog due to chronic illness or medication, it can be difficult to keep track of all your doctor appointments, medications and symptoms – not to mention all your other responsibilities, such as work, chores or taking care of your family. Staying organized and remembering everything you put on your mental to-do list can be a challenge for anyone, but with brain fog and a chronic illness thrown into the mix, it becomes especially important to find the methods that most help you stay on top of things.

For many with chronic illness, smartphones can be a lifesaver. Many of us carry our phones everywhere we go anyway, so utilizing them as a tool to keep track of our lives and our illnesses can be extremely helpful. Most smartphones nowadays come with apps already programmed in, such as a notepad, a calendar or a voice memo recorder, which are simple, easy to use and great for jotting down important notes or dates.

However, if you struggle with brain fog and are looking for a different way to organize your notes, lists, calendar and medical information, then there are a number of other apps you may find to be extremely useful.

To help you manage your personal life, professional life, and physical and mental health, we asked our Mighty community to share which apps help them navigate their day-to-day lives despite the effects of brain fog. Here are their recommendations.

Just so you know, we’ve selected these links to make shopping easier for you. We do not receive any funds from purchases or downloads you make. 

1. Habitica

Habitica is a video game that allows you to “gamify” your life by turning your daily activities and to-do lists into monsters to conquer. It can help motivate you to change your habits by giving you in-game incentives every time you complete a task. You can play on your computer or download the app for either iOS and Android.

Jess Van Meter told The Mighty, “It’s amazing. It helps me pretend my life is a video game and doing self-care, building habits and performing daily tasks actually does help me ‘level up.’ It has a built in community and reward system too.”

Sara Wilson added, “I can put as many tasks on it as I want, little or large, and it’s also a game, so I get coins whenever I complete a task! I can set up IRL [in real life] rewards for myself for earning so many coins and that helps keep me motivated. I check it several times a day and one last time before bed. I put everything on there from medications to everyday tasks to important, one-time events.”

Download Habitica for free from Apple or Google Play

2. Medisafe

Medisafe helps you keep track of which medications you need to take and when. Each day is divided into four quadrants – morning, afternoon, evening, night – with visual representations of which pills you should be taking at which time. The app will send you reminders when it’s time to take your pills, and it also provides you with information about each medication. Physicians and pharmacists are also able to connect with patients and communicate through Medisafe.

“It has the details of all my meds and alerts me to what I need to take and when. I always forget to take anything without the app reminders! Now I only have to worry about brain fog making me forget if I actually did take the meds it told me to before I pressed the ‘take all’ button,” Amie Addison wrote.

“It reminds me to take my meds and business calendar reminds me of all my day to day stuff,” Marnie Dueck told us.

Download Medisafe for free from Apple or Google Play

3. Daylio

Daylio is a mobile diary that lets you easily track how you’re feeling and what you’re doing. Over time, the app can help you discover patterns in your moods, behavior and activities so you can make changes to your daily routine that will help you to feel your best.

Liberty White wrote, “Great for symptom tracking and customizing. It beeps at the end of the day and I tell it how my day went. It tracks trends in my activities (or lack of activities) and helps me keep track of when I’m having a bad time.”

Download Daylio for free from Apple or Google Play

4. Flaredown

Flaredown was made just for people with chronic illness as a way to track symptoms, record treatments and reactions, track triggers and connect with others who have similar conditions. There are also places where you can easily note other important parts of your day, such as what you ate, what the weather was like, and any activities or events that took place.

“By far my favorite app to track my various symptoms!” Bay Howe said. “Makes it much easier to discuss symptoms and illnesses when you can remember what they are and when they happen.”

Download Flaredown for free from Apple or Google Play

5. Evernote

Evernote is a note-taking app that helps you stay organized in your personal and/or professional life. You can add notes in a variety of forms, including text, sketches, photos, audio, video, PDF and web clippings, and have everything saved in one place.

Morgan Storm Ray said, “I use Evernote. I also have memory loss so it helps with that too. It is a simple note-taking app. But it has a bunch of different ways to take notes. By voice, picture, text, etc.”

Jess N. Law added, “Evernote – for notes on anything and everything I can’t remember. I also use it to record meetings because multitasking has gotten too difficult.”

Download Evernote Basic for free from Apple or Google Play

6. CareZone

CareZone offers patients a simple way to keep track of all their medical information. Several of its features include a journal for documenting symptoms, to-do lists, contacts (doctors, pharmacies, insurance providers, etc.), medication information (names, dosages, reminders for when it’s time to refill, etc.) and a calendar for keeping track of appointments and other important dates. Any information you input remains private and secure.

Nancy Lea Martine Koontz told us, “I use CareZone which includes all kinds of daily trackers and makes sharing information with doctors quite easy.“

Download CareZone for free from Apple or Google Play

7. Asana

For those who work with a company or business, Asana is an app that can help you and your team stay organized, manage projects and track your progress. This app allows you to create project task lists and personal to-do lists, track when work is due with a calendar and converse with coworkers about various tasks or projects.

“[I use] Asana – a project management app. I can list phone calls, emails, work, everything I need to do today or in the future. It’s free and has saved my business,” Jess N. Law wrote.

Download Asana for free from Apple or Google Play

8. myHomework

The myHomework app is a virtual planner for students. You can track when assignments, essays or projects are due, track your class schedule and receive due date or test reminders.

“I’m a full-time student,” said Eri Rhodes. “The myHomework app is critical to me not forgetting due dates.”

Download myHomework Basic for free from Apple, Google Play, Microsoft or Amazon

9. Microsoft OneNote

Microsoft OneNote is a place you can jot down any important notes, information or thoughts that cross your mind – in whichever way works best for you. You can type, write, draw, make to-do lists or clip things from the web, and OneNote keeps everything organized and easy to find.

“I have OneNote on my phone. It’s basically an electronic notebook and you can make as many [notes] as you want, but I find it helpful because if I want to remember something for later, I can just open it and type it out then go back to look at it later when I need the information. Also have it on my computer and tablet all connected so I always have access to it,” said Chelsea Smith.

Download Microsoft OneNote from Microsoft, Apple or Google Play

10. MyTherapy

MyTherapy gives you reminders when it’s time to take your medication, take measurements or do exercises, and it also serves as a journal where you can track your symptoms and overall health.

Anna A. Legault told us, “MyTherapy helps me remember medications, measurements and log symptoms.”

Download MyTherapy for free from Apple or Google Play

11. TaoMix 2

Living with chronic illness and brain fog can be stressful, and while it’s important to keep track of your physical health, caring for your mental health is necessary, too. TaoMix 2 provides you with soundscapes you can mix and match to help you relax or meditate. Whether you’re soothed by the sounds of waves crashing on the beach or the quiet chatter of people in a cafĂ©, this app can help take your mind off the stresses of chronic illness.

“All kinds of reminders and calendar apps are a must,” said Irma-Helen Lorentzon. “But something that really helps me is TaoMix – it has great nature sounds and I use it to help my brain focus and/or relax.”

Download TaoMix 2 for free from Apple or Google Play

12. Google Calendar

Google Calendar can help you keep track of important dates or events. You can view the calendar by day, week or month, color code events and, if you use Gmail, import dates from there. You can also schedule reminders to give you a heads up about upcoming events.

Tiffany Anne told us, “I use Google Calendar to remind myself if I need to bring something somewhere, follow up on something or anything that requires reminders since I pay attention to those.”

Heather Jo Skidmore said, “Google Calendar. One for work, one for my MA program, one for my three kids’ activities. Color coded, and shared with my husband.”

Download Google Calendar app for free from Apple or Google Play

13. ColorNote

This Android app lets you make color-coded notes and checklists to help you stay organized. You can also set reminders for each note to make sure you get each task done on time.

Christine Cousins wrote, “I love ColorNote. I can make checklists for groceries or things I need to get done or write myself notes about things I need to discuss with my doctors so I’m prepared for my appointment. The app automatically backs everything up, so when my phone took a swim and I downloaded ColorNote on a new device, all of my stuff was there!”

Download ColorNote for free from Google Play or Amazon

14. Stop, Breathe & Think

This meditation app encourages you to stop what you’re doing and check in with how you’re feeling, practice some mindful breathing and think deeply to broaden your perspectives and increase your level of relaxation.

“SBT is an amazing app that allows you to rate how you’re feeling physically and mentally and specify certain emotions. It then tabulates and suggests meditation/mindfulness exercises in order to attend to whatever issues you’re experiencing. Once finished with an exercise, you can again rate how you’re feeling. You can earn stickers as you accomplish certain exercises, and it keeps track of your emotional and physical check-ins. Pretty cool,” Meghan Leigh explained.

Download Stop, Breathe & Think for free from Apple or Google Play or use on your web browser

15. ICE Contact

If you have a medical condition and ever find yourself in an emergency situation, an ICE (In Case of Emergency) app may be of use. You can store all your personal and medical information here for either yourself or others to access in an emergency. Having this information handy can also be useful if you struggle with brain fog.

Stephanie Bowman told us, “I use an ICE app. It stores a list of all my illnesses, medication, people to contact and my allergies. I’m never stuck when put on the spot to think of important information.”

Download ICE for free from Apple

16. Cozi

Cozi is an organization app specifically designed for families. You can keep all of your family’s activities and appointments in one place, and create checklists (grocery lists, chore lists, to-do lists, etc.) to share with other family members.

Crystal Dewey said, “It’s a calendar app on steroids! It connects with my family members, sends reminders, we can all add to-do and grocery lists… It’s my electronic brain!”

Download Cozi for free from Apple, Google Play or Microsoft

17. Waze

Waze is a navigation app that lets you know what traffic conditions are like in real time and which route you should take. Waze can also give you reminders when it’s time to leave based on both the time you need to arrive and current traffic. After you arrive at your destination, park your car and close Waze, it will automatically drop a pin to remind you later on exactly where you parked.

Jess N. Law recommends integrating Waze with Google Calendar. “Reminds me of everything I have planned and when to leave. Lifesaver some days.”

Download Waze for free from Apple or Google Play.

Have an app you’d recommend? Let us know in the comments below.

Paige Wyant