NEUROPATHY

Neuropathy is the medical term to describe disease of the nerves going to the body’s organs, including muscle and skin. The damage can affect ability to sense (pain, temperature, pressure) and the ability to cause muscle movement. Typical symptoms include burning pain, numbness and weakness of the muscle. The arms and legs are most commonly involved. In some cases, the autonomic nerves are affected. This can cause gastrointestinal disturbances (diarrhea, cramps, nausea), low blood pressure, inability to have erections, and a variety of other problems.

This most common cause of neuropathy is poorly controlled diabetes. Other causes include drug side effects, alcohol, tobacco, cocaine, poor circulation to the nerves, poisoning, nutritional deficiency and infections. Drugs known to cause neuropathy include several anticancer agents, nitrofurantoin and isoniazid (antibiotics), gold salts, Dilantin, Antabuse, and many others. Substances toxic to nerves include lead, mercury, organophophates (pesticides), hexacarbons and other solvents. Standard therapy is to stop offending drugs, assist in stopping alcohol and tobacco use, and to use a variety of different drugs to control the symptom of pain in the nerve. The drugs include narcotics, antidepressants and antiseizure medications. These types of medications are sometimes helpful. Often they do not help and can cause significant side effects.

A variety of alternative treatments have been investigated and many have some basic science evidence of possible effectiveness. Human clinical trials of these alternatives are scanty so a therapeutic trial in each individual is warranted after consideration of the risk-benefit ratio.

Because nerve damage is promoted by free radicals (damaging chemicals that occur in the body), taking anti-oxidants in high doses should have a protective effect. Of particular importance are Vitamin C, alpha-lipoic acid, acetyl-L-carnitine, N-acetylcysteine, Vitamin E, folic acid and Vitamin B12. Fatty acid imbalances in diabetes and other conditions are contributors to nerve damage. These can be corrected by taking GLA (gamma linolenic acid), fish oil concentrate (omega-3 oils), and ascorbyl palmitate.

Symptoms of heavy metal poisoning by lead and mercury are often nonspecific but may include neuropathy of unknown origin. Measurements of blood and urine levels of heavy metals may be useful since detoxification therapies are effective in removing these from the body. Other treatments that may be effective include acupuncture and magnets.

NEUROPATHY TREATMENT

Daniel Blodgett MD

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