Ulnar Neuropathy: Sane Treatment of a Crazy Bone

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Ulnar Neuropathy: Sane Treatment of a Crazy Bone

Do you remember what it seemed like when you banged your joint on a difficult surface area as well as it sent out shocks via your lower arm and also right into your little finger? Not as well enjoyable, to ensure. On the bonus side, the discomfort was just momentary and also, for the time being, you bore in mind not to do that once more.

The component of the nerve system in charge of this frustrating sign is the ulnar nerve, an outer nerve-bundle whose private nerve-fibers come from the spine where it travels through the neck. The nerve-fibers run a lot of the size of the arm, consisting of with the “ulnar groove” which you might called the “amusing bone” or “insane bone.”

Some individuals experience an even more continuing disability of the ulnar nerve called ulnar neuropathy. With “- pathy” as the clinical suffix definition health problem or disability, an “ulnar neuropathy” implies a disease or problems of the ulnar nerve.

When the ulnar nerve is hurt, both electric motor as well as sensory signs and symptoms are feasible. Many of the muscular tissues of the hand get their marching orders using the ulnar nerve, so when the ulnar nerve is out of whack, there can be weak point in hand muscle mass. Damages to the ulnar nerve likewise triggers adjustments in feeling.

The ulnar nerve can come to damage in even more than one method. Provided, lots of individuals lean on their elbow joints without harming their ulnar nerves, however like the majority of points in medication, an ulnar neuropathy is normally created by a mix of aspects, and also it is most likely that some individuals are extra prone than others based on their specific makeups.

An additional method to hurt the ulnar nerve is by over-stretching it. In the writer’s scientific technique a slim, girl with loosened elbow-joints that functioned as a lifesaver hurt her ulnar nerves continuously while raising hefty clients. For her, it was an issue that would not vanish, and also she ultimately altered occupations.

As reviewed, the ulnar nerve at the arm joint is specifically prone to injuries, it can additionally come to damage by obtaining pressed or squeezed by close-by unusual cells. The common perpetrators are ligaments, tendons, blood cysts, vessels and also marks.

Occasionally, an ulnar neuropathy is the leading signs and symptom of a “polyneuropathy,” suggesting that all the outer nerves in the body are rather damaged, however the ulnar nerve is the initial one to create signs and symptoms recognizable to the influenced person. Polyneuropathy is not the outcome of injury, yet can be seen in a selection of health problems, consisting of diabetes mellitus, alcohol addiction as well as additionally on an acquired basis.

Detecting an ulnar neuropathy begins with the tale of the signs as well as a medical professional’s exam. The medical professional may ultimately buy nerve transmission screening which takes a look at the nerve as well as muscle mass power, and also can establish the level of disability. Nerve transmission research studies can likewise assess various other nerves to see if the ulnar nerve is the just one damaged, or just one of lots of.

What if a straightforward injury to the ulnar nerve at the elbow joint is identified? The outer nerves have some capability to recover themselves. If the level of nerve disability is not as well extreme, traditional therapy is called for.

A regular traditional therapy is composed of placing a sport-pad (not a clinical support) on the elbow joint with the foam covering the ulnar groove. In enhancement, consuming nourishing, versatile dishes, with each other with vitamins, offers the ulnar nerve the building-blocks it requires in order to make the ideal feasible recuperation.

If the nerve injury is extreme, or falls short to reply to conventional therapy, after that surgical treatment may be helpful. When the nerve is bound in mark cells or pressed by close-by uncommon cells, a straightforward launch procedure may be adequate in which the nerve is maximized. Or else, in a treatment called “former transposition” the nerve is moved out of the ulnar groove so it runs out injury’s method from leaning on the elbow joint, as well as additionally reaches require to the brief means around when the joint is bent.

Neurosurgical scientists at Radboud University Nijmegen in The Netherlands performed a randomized, managed test of individuals with ulnar neuropathy at the joint in which half the individuals got easy launch surgical procedure as well as the various other fifty percent got former transposition. There were even more problems in the clients obtaining the former transposition treatment, so the outcomes of this research study preferred the easy launch method.

( C) 2005 by Gary Cordingley

Some individuals experience an even more lingering problems of the ulnar nerve called ulnar neuropathy. With “- pathy” as the clinical suffix significance disease or disability, an “ulnar neuropathy” suggests a disease or problems of the ulnar nerve. The ulnar nerve is at risk to injury or squeeze in the ulnar groove for even more than one factor. Many of the muscle mass of the hand obtain their marching orders by means of the ulnar nerve, so when the ulnar nerve is out of whack, there can be weak point in hand muscular tissues. Given, numerous individuals lean on their arm joints without harming their ulnar nerves, however like the majority of points in medication, an ulnar neuropathy is normally triggered by a mix of aspects, as well as it is most likely that some individuals are much more at risk than others based on their specific compositions.

Peroneal Neuropathy: Waiting for the Other Foot to Drop

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Peroneal Neuropathy: Waiting for the Other Foot to Drop

A “foot-drop” is a clinical term which– fortunately– does not suggest that the foot instantly separates from the leg. Instead, it suggests that when the leg is raised from the ground, the foot sags downward at the ankle joint.

In reality, there are numerous feasible reasons, yet one of the most usual wrongdoers is injury to a nerve-bundle in the leg recognized as the peroneal nerve. There is simply one bone, a huge one, that attaches the hip to the knee, as well as that is the thigh. The shin is the bigger one and also exists even more to the within, while the fibula is the thinner one as well as exists even more to the exterior.

The nerve-fibers making up the peroneal nerve traveling with the massive sciatic nerve that runs behind the thigh from the butt to the reduced upper leg. That’s where the “usual peroneal nerve” divides out from the pack and also runs along the exterior of the knee, putting behind the head of the fibular bone (a bumpy outcropping simply past the knee) as well as after that snaking around the neck of the fibula simply listed below its head.

Within this passage the typical peroneal nerve divides right into 2 branches, the “deep peroneal nerve” (further from the leg’s surface area) as well as the “shallow peroneal nerve” (closer to the leg’s surface area). Injury to one creates various problems than are created by injury to the various other since the 2 branches have various links to muscle mass as well as skin.

The deep peroneal nerve is in charge of cocking up the ankle joint as well as toes, so injury to this branch creates weak point or paralysis of the muscle mass in charge of these activities. There is simply a little spot of skin, situated in between the large toe as well as the toe beside it, linked to the deep peroneal nerve, so damages to this branch generates feeling numb restricted to this tiny location.

The shallow peroneal nerve, by comparison, is in charge of skin experience on the majority of the beyond the calf bone and also top of the foot, so these locations can end up being numb when the surface peroneal nerve is hurt. This branch is additionally in charge of raising the outdoors side of the foot, so this activity is gone when the shallow peroneal nerve is not working appropriately.

Problems because of injury of the usual peroneal nerve (the moms and dad of both branches) are the amount of the disabilities connected with each of the branches. This suggests that the ankle joint and also toes can not cock upwards, the outdoors side of the foot can not raise, as well as there is pins and needles on the exterior of the calf bone as well as top of the foot.

” Peroneal neuropathy” indicates disability of the peroneal nerve. Peroneal neuropathies are the most typical neuropathies (of the kind that impacts simply one nerve at a time) in the reduced extremities.

Some of the injuries were extreme sufficient to damage or disjoint bones, while others included deep cuts in the soft cells, and also still others included simply a stretch or swelling. One more typical reason was medical procedures.

Lots of instances were due to extreme outside stress being used to the nerve. In long term leg-crossing the knee of the lower leg presses continuously versus the peroneal nerve of the going across leg.

A remarkably huge team of individuals had peroneal neuropathy because of weight reduction, additionally called “slimmer’s paralysis.” Greater than one element may have gone to play in these instances, consisting of absence of nutrients, stress on the nerve, or both.

Clinicians and also scientists discover that in some individuals an obviously separated peroneal neuropathy is in fact the leading side of a much more extensive polyneuropathy. “Polyneuropathy” implies that outer nerves suffer in an extra scattered pattern– not simply solitary nerves in solitary areas. In some instances of noticeable peroneal neuropathy more examinations transform up polyneuropathy due to various other reasons, for instance, diabetic issues, extreme alcohol intake or hereditary variables.

Just how are situations reviewed? Extra screening with electromyography as well as nerve transmission research studies, which inspect on electric features of the nerves and also muscle mass, commonly gives important details, consisting of whether extra nerves are influenced and also just how negative the problems are.

Nonsurgical methods are typically attempted initially, consisting of evasion of more stress on the peroneal nerve, enhanced nourishment and also supplements of the diet plan with vitamins. In numerous situations the nerve recoups without anything extra extreme being done. If the nerve is squeezed, after that the cosmetic surgeon releases up the nerve from whatever was squeezing it.

( C) 2005 by Gary Cordingley

The nerve-fibers making up the peroneal nerve traveling with the big sciatic nerve that runs behind the thigh from the butt to the reduced upper leg.” Peroneal neuropathy” suggests disability of the peroneal nerve. “Polyneuropathy” suggests that outer nerves are damaged in an extra scattered pattern– not simply solitary nerves in solitary locations. Extra screening with electromyography as well as nerve transmission researches, which inspect on electric features of the nerves as well as muscle mass, typically supplies beneficial info, consisting of whether added nerves are impacted and also exactly how poor the disabilities are.

If the nerve is squeezed, after that the cosmetic surgeon releases up the nerve from whatever was squeezing it.

Alcoholic Neuropathy

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Dr. Martin Rutherford: Okay. We’re going to talk about alcoholic peripheral neuropathy. I’m Dr. Martin Rutherford. I’m a certified functional medicine doctor. Dr. Gates is a board certified chiropractic neurologist who practices functional neurology. We work together on chronic problems.

One of the chronic problems that we see frequently as a large part of our practice is peripheral neuropathy. If my understanding is correct from the probably hundreds of patients that we’ve seen about peripheral neuropathy, most come in and are told your neuropathy is either diabetic, it could be your neck, it could be your lower back, it could be your ankle. Now I’m hearing a little bit more about try B12, try alpha lipoic acid, and if it’s not any of that, or if you’re doing all that and you’re fixing your diabetes and you still have it, then basically you have to live with it.

The contemporary neurology series put out by the American Medical, is it Association…

Dr. Randall Gates: It’s by the American Academy of Neurology.

Dr. Martin Rutherford: American Academy of Neurology has put out every four years, something like that?

Dr. Randall Gates: They come out with books every year.

Dr. Martin Rutherford: Every year.

Dr. Randall Gates: They’re continually updating it.

Dr. Martin Rutherford: Okay. That’s kind of the Bible of peripheral neuropathy. They list approximately 80 different causes of peripheral neuropathy in there. We kind of think they’re right, based on what we have seen in our practice.

One of the causative factors of a certain type of peripheral neuropathy is alcoholism and alcoholic peripheral neuropathy. As Dr. Gates pointed out to me before we started doing this, we’re probably usually communicating with people who deserve a pat on the back if you’re watching this and you are in the process of stopping drinking alcohol. That’s not an easy thing to do. It’s not an easy thing to accomplish. The percentage of people who try to do that and are able to do it is pretty low.

However, we do see them, and they come in with peripheral neuropathy. There are uniquenesses to the alcoholic peripheral neuropathy that differ from some of these other 79 different things that will create burning, numbness, tingling, sharp shooting pain, and a variety of different symptoms that you get in your feet.

Dr. Gates has worked with patients on these. He’s currently working with one as we speak, and he’d like to share with you his findings on how this comes about, the physiology of it, and what are the prospects of you resolving that peripheral neuropathy.

Dr. Randall Gates: Okay. With alcoholic peripheral neuropathy, we know that alcoholism by itself can cause a vitamin B1 deficiency. Vitamin B1 is thiamine. Thiamine basically is important in a lot of biochemical pathways including processing carbohydrates. When we drink alcohol in excess, it can, in essence, cause us not to absorb thiamine, and it can also decrease your liver stores of thiamine.

With that being said, we’re now seeing that alcoholic neuropathy is a separate entity from thiamine deficient neuropathy. The reason is that in the literature they have observed patients who have peripheral neuropathy, who were alcoholics, who were drinking basically in excess of 100 grams of alcohol a day for ten years, and they have normal thiamine levels. Lots of times these are well nourished alcoholics where they’re eating good while they were drinking in excess.

We see that the alcohol by itself can form into acetaldehyde which can damage the nerve tissue, also. This is important in its designation because alcoholic neuropathy patients have a tendency to have what are termed small fiber neuropathy symptoms and signs. With peripheral neuropathy, we have the nerves that are in essence dying down there in the feet.

With that, there are many sizes of other nerves within a big nerve like your sciatic nerve. Some are really small in diameter, some are big in diameter. It’s the small diameter ones that are preferentially affected in alcoholic neuropathy, again those who drink in excess and were well-nourished.

When we get small fiber neuropathy occurring, basically, small nerve fibers encode pain and temperature, so it’s not uncommon that the alcoholic neuropathy patient has burning pain in their feet, sharp shooting pains in their feet. When we examine them, they preferentially lose things like pain temperature or their pain temperature, pinprick senses are heightened down there in the feet.

One other way of diagnosing this small fiber neuropathy is by doing what is termed an intraepidermal nerve fiber density test which is where we go in and we cut out a little piece of skin. They put it under a microscope slide and they look and see how many little nerves are there.

You can diagnose small fiber neuropathy on a clinical basis without having to use something called a QSART test. That is what a lot of you alcoholic neuropathy patients are facing now that you basically are detoxing in your rehabilitation from that disease. Many people come to us complaining of these burning pains in their feet not knowing really what’s going on, and it’s neuropathy so commonly. That is what I really wanted to…

Dr. Martin Rutherford: Go back to your diagnosis. You can get the electrodiagnostic test on small fiber peripheral neuropathy.

Dr. Randall Gates: And lots of times, if you get electrodiagnostic testing, it will be normal, so you’ll go to your neurologist…

Dr. Martin Rutherford: A lot of people come in and go why, I can’t have that.

Dr. Randall Gates: And neurologists are very busy, and lots of times may not be really thinking small fiber neuropathy. Just in my clinical experience, we see it all the time where the person goes in for a nerve conduction velocity test and EMG test, and it will come back normal and the person’s told they’re normal.

Dr. Martin Rutherford: They stick needles in you down there, and they run an electrical current in there, and they see how the nerve’s functioning or how it’s transmitting the nerve impulse, how quickly or whatever. The reason I mention that is because I have a lot of people come in. I do the intake interviews. I get a lot of people, but my test was normal, they said I didn’t have it.

Dr. Randall Gates: Right.

Dr. Martin Rutherford: Just another quick point, because you mentioned this, what type of in-office test would show that they have it, that’s so simple?

Dr. Randall Gates: Lots of times, running a pinwheel down the person’s leg and seeing what happens as we get into the foot. You’ll be surprised.

Dr. Martin Rutherford: We’re checking your Achilles tendon, reflexes…

Dr. Randall Gates: Checking the reflexes and checking your…

Dr. Martin Rutherford: [Inaudible 0:06:53] is absent.

Dr. Randall Gates: There are temperature thresholds that we do where we can see okay can you feel a certain temperature at a certain point, very simple tests. I wasn’t being denigrating at all to the medical neurologists.

Dr. Martin Rutherford: Right, right.

Dr. Randall Gates: Please know that. We love and acknowledge…

Dr. Martin Rutherford: No, I just wanted to draw it because these are the things that folks want to know.

Dr. Randall Gates: Right, and people need to know both sides of the equation.

Dr. Martin Rutherford: Yeah.

Dr.Randall Gates: There are other tests for small fiber neuropathy that are more laboratory tests like I talked about, the intraepidermal nerve fiber density, also something called a QSART test which is a quantitative sudomotor axon reflex technique. Big word…

Dr. Martin Rutherford: Whatever that’s testing…

Dr. Randall Gates: …done at specialty centers where basically they test how well you sweat. There are other simpler tests that are coming out which have some pretty good sensitivity, and specificity varies, termed the neuroderm test I believe. Basically, it tests how well you sweat on your foot, which is a function mediated by small fiber, nerve fibers.

Dr. Martin Rutherford: Yeah, but you can have it tested in an office environment with simply a pinwheel, Achilles tendon, using a piece of cotton, using toothpicks or whatever you want. I don’t want to denigrate it. I’m just saying that if you do a good history, if you understand what the symptoms of alcoholic peripheral neuropathy are, and then you do this test, and then you find out that all of these or three quarters of these tests are positive, the pin and this, you’ve got it.

I mean I know we’re enamored by the sophisticated, but a lot of times the sophisticated is not as sensitive as doing the history and the exam.

Dr. Randall Gates: And really not readily available, especially these QSART tests.

Dr. Martin Rutherford: Yeah.

Dr. Randall Gates: I said they’re available at specialty centers. We live here in Reno, Nevada. We have a population of approximately 300,000 in this basin, but to my knowledge, no one is doing QSART tests in this area. That’s where I think some medical neurologists are a little weary of making the small fiber neuropathy…

Dr. Martin Rutherford: Diagnosis.

Dr. Randall Gates: …diagnosis because they commonly can use the nerve conduction velocity and the EMG to solidify their diagnosis that it is peripheral neuropathy involving all fiber types. But for a small fiber neuropathy, it gets a little more nuanced, hard to diagnose. You also have to look for other things that could potentially be going on like with the spinal cord and things of that nature.

Dr. Martin Rutherford: Right.

Dr. Randall Gates: We rule those things out when making our diagnosis. Just know if you have alcoholic neuropathy, another thing that we haven’t talked about is that we do use techniques to stimulate the nerves in our office, electrical stimulation. We’ve talked in other videos regarding neuropathy that basically, the literature shows that you can go in and you can stimulate these nerves back into life for at least a couple of days. But the underlying metabolic cause has to be addressed. If you can address the metabolic cause, in your case it was alcoholism, you eliminated that, and if we can go back in and give you certain nutrients maybe to rebuild your nerves back while stimulating your nerves, there’s a possibility, and I say that because we see it clinically, where people feel better.

Dr. Martin Rutherford: Yeah.

Dr. Randall Gates: We’re not saying it’s a cure for everybody, but we have cases that we hand pick who we think are going to do well that go through our program where we stimulate the nerves and we address the metabolic components, and lots of times they’re pretty happy…

Dr. Martin Rutherford: Yeah, most people can do better. The question is how much.

Dr. Randall Gates: Right.

Dr. Martin Rutherford: You know, substantially, or whatever.

Dr. Randall Gates: And for how long.

Dr. Martin Rutherford: For some people 50% might be substantial, but we see some pretty consistently good results with those techniques. Okay.

Dr. Randall Gates: Yeah.

Dr. Martin Rutherford: That’s all I wanted to point out.

Dr. Randall Gates If you have any other questions on this matter, you can go to powerhealthtalk.com and leave us a question there, or you can go to our Power Health Facebook page and send us a message and like us. All right. Thanks for watching. Have a good day.

Diabetic Neuropathy

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Dr. Martin Rutherford: We’re going to talk a little bit about diabetic neuropathy today. We see a lot of it. We have a number of patients who come in. I think to frame this for those of you who are interested in this topic; I do most of the interviews for patients coming in to our office. I’m Dr. Rutherford. I’m still not sure if we’re supposed to talk or we are not. I think it’s on the bottom line there, but I’m a certified functional medicine practitioner as well as a chiropractor. Dr. Gates is a board certified chiropractic neurologist who practices functional neurology. Together, we work with the brain, the nervous system, and the metabolism to address chronic problems. Our practice developed into a chronic pain practice on its own. One of the things we see a lot is diabetic patients because there are a lot of diabetic people in the country right now, mostly diabetes type two, some diabetes type ones we see. The most common conversation I have with patients is well, I’ve got this problem and they told me my peripheral neuropathy is probably from diabetes.

“I went to the doctor and the doctor told me I’m not diabetic, so that couldn’t be what’s causing my peripheral neuropathy” or “I am diabetic and 50% of peripherally neuropathy is diabetes and 50% of it, we don’t know what it is.” Some doctors will say, “Okay, you’ve been treated for the diabetes. It’s not working. You’ve got to live with it.” Some will say, “You’ve been treated for the diabetes. It’s not working. Go check your neck and your low back and your ankles.” Once you’re done with those four scenarios, then you pretty much end up at our office or some office, similar telling me that, “Well, it’s not my diabetes, the doctor told me. It couldn’t be my diabetes and yet you’re sitting there screaming the diabetes relative to your history and your burning feet and so on and so forth.” So we’d only spend a few minutes to kind of tease that little Rubik cube for you and relative to diabetes and peripheral neuropathy.

I’m going to defer to Dr. Gates on this. Dr. Gates does the vast majority of the treatment here with this subject. It’s a bit of a complex subject and I’m going to turn it over to him. I’ll probably interrupt him like I usually do all that.

Dr. Randall Gates: A large percentage of diabetics will develop peripheral neuropathy. The estimates are from the Rochester Diabetic Study conducted by Dr. Dyck, who is the world’s foremost researcher on peripheral neuropathy.

Dr. Martin Rutherford: I prefer to pronounce it Dyke.

Dr. Randall Gates: I may be pronouncing it incorrectly.

Dr. Martin Rutherford: D-Y-K-E?

Dr. Randall Gates: D-Y-C-K.

Dr. Martin Rutherford: D-Y-C-K, okay.

Dr. Randall Gates: He showed that upwards of 66% Type I diabetics who are insulin dependent have peripheral neuropathy and 59% of Type II diabetics have peripheral neuropathy. Under that heading, know that some of those cases are due to things like carpal tunnel syndrome and other neurologic, peripheral nerve disorders separate from what is commonly termed peripheral neuropathy. See, peripheral neuropathy in the lay language is like sciatica. Peripheral neuropathy really means what is commonly termed a ‘polyneuropathy’, where you start to lose sensation in your feet and it can spread up like socks up to your knees and then, hit the hands. With diabetic peripheral neuropathy, it’s an insidious process. Lots of times, it comes on over a period of years. As Dr. Rutherford alluded to, if you try to correct the blood sugar once the peripheral neuropathy has started, there’s so much nerve damage at that point that the person is not going to feel better by really getting their blood sugar under tight control.

However, studies have been done that have shown that if you really control the blood sugar very tightly with diabetes, that, in essence, peripheral neuropathy will be much later to onset if it’s going to or it may not onset at all. What’s unique about our program is that we look at correcting not only the metabolic side of the equation also rehabbing the nerves. Back up. So, we’re writing a book on peripheral neuropathy and it’s termed, “Peripheral Neuropathy Success Stories” and I’m going to tangent again into another book we just read about Lyme’s disease. That author, Dr. Horowitz, just did a fantastic job talking about what the Lyme’s disease patient is up against.

Dr. Martin Rutherford: If you have Lyme, you need to read this book.

Dr. Randall Gates: Yeah. They’re going to go to their infectious disease specialist and they’re going to be told, “You’re on antibiotics for 30 days. If you’re not better, we don’t know what the cause is. You’re crazy. Go home.” Many neuropathy patients are told, “You have neuropathy? Go home and live with it. There’s nothing that can be done for you.” Really, the more accurate statement is that there’s nothing in the medical model right now that can be done for you. There’s no insurance reimbursement program basically for your doctors to put you through a rehabilitative program, coupling that with metabolic treatments to get you better. It just doesn’t really exist, just like there isn’t a 6-month Lyme disease program that’s really sanctioned by many insurance companies. So, the average neurologist out there is going to tell the diabetic peripheral neuropathy patient, “There’s nothing that can be done.

Take some Gabapentin if you have some burning pain as an example. We’re not telling you to do that and basically that’s going to help alleviate your symptoms to a minor degree. Deal with it.” Our approach is unique in that we look at really trying to really correct the underlying metabolic cause, in this case, it’s diabetes obviously. We know with diabetes that when someone’s diabetic, it attracts water, in essence and the three tissues of the body; the retina in your eye, your kidney, and nerves. In doing so, that can cause the peripheral neuropathy. There are also studies that have been done that have shown that the nerves can be regenerated or stimulated to change someone’s sensation. Largely, that’s done through electrical stimulation. The problem is when they’ve done it with diabetics, the results are short-lived. They last a couple of days. Then, the person goes back to their feet feeling numb, tingling or burning. Our emphasis is on controlling blood sugar as tightly as humanly possible. You’re probably saying, “My blood sugar is sitting at 150 and my A1C is at 7.2 and I don’t like taking core blood sugar medications.”

Dr. Martin Rutherford: Okay. We’ll talk about that. Yeah. Go back to what you said about the electrical stimulation.

Dr. Randall Gates: What about it?

Dr. Martin Rutherford: So, you were saying the problem with that is that you’re not handling the other things and it’s short-lived.

Dr. Randall Gates: Right.

Dr. Martin Rutherford: The thing I run into is patients will say, “My doctor told me they can’t do the stimulation.” The stimulation is short-lived because the study didn’t do all of the things that you’re about to talk to. So, you can use those stimulations. But if you use those stimulations, there are some things online that’ll tell you to use these stimulators and you will get some temporary relief. But, unless you start doing everything that Dr. Gates is talking about in the functional model, you’re not going to get any long-term relief. The combination of those two is where Dr. Gates is going and is a very successful model.

Dr. Randall Gates: That is a perfect point. I’ve scoured the literature, but if you can find something different from me, please bring it to our attention at powerhealthtalk.com. Basically, the studies have been, “Okay, how tightly can we control a diabetics blood sugar?” And that’s where I talked about in those studies have found that peripheral neuropathy is later to onset. They’ve done the studies, “let’s stimulate the nerves of the diabetic”. We see that the diabetic calmingly, with peripheral neuropathy will have more sensation in their feet. Their balance may improve and things of that nature. They’re also short-lived and that’s why your medical doctor is telling you that nothing can be done. What we’ve done is we’re melding the two disciplines. We’re really trying to control the person’s blood sugar tightly largely through dietary interventions and other techniques of manipulating the gastrointestinal tract. You’re probably saying, “What!” Go back and watch our hangout on powerhealthtalk.com about metabolic syndrome, diabetes, and the gut.

It’s a fantastic broadcast where we talk about the new data on bacterial populations and problems with insulin. With that being said, just know that we’re not seeing there’d be cure for everybody but we’re seeing cases where we take patients with diabetes, change their diet significantly, do things to get rid of these bad bacteria in their guts, see changes in their blood sugar in a positive direction while simultaneously stimulating their nerves. Frequently, by the end of our program, we accept patients who not diabetic. Most commonly, they’re more in a pre-diabetic range. They have far more sensation feeling in their feet and lack of weird nerve-signals in their feet as well as burning, things of that nature.

So that’s what we have to say about diabetes. I have few other things actually.

Dr. Martin Rutherford: No, go ahead.

Dr. Randall Gates: You may be taking alpha-lipoic acid. Dr. Dyck came out and he did a study where he gave diabetic neuropathy patients if I remember correctly 600 mg of alpha-lipoic three times a day and he showed that basically the nerve degeneration slowed down, which is a good thing. That’s something that you probably want to have out there if you have diabetic neuropathy. There are things like that out there. There are also these things called aldose reductase inhibitors, which in essence, decrease the amount of water going to your nerves via an indirect mechanism that I can talk to you about first thing if you want to. Basically those are things that have been experimented with but as you will know, medically and this is not integration [SP] to the medical system. Just note, this is not integration to your medical doctor, your medical neurologist. They’re doing everything they can to help you within the system that will allow them to help you, but know that there really is nothing medically as you’ve been told that we know to help peripheral neuropathy, but lots of times, we have patients coming to us searching for other modalities that may help them and as we’ve discussed in this broadcast, it’s pretty exciting. Anything else you want to say?

Dr. Martin Rutherford: Yeah. The couple of patients that have come in who are on medication and they’re controlling their diabetes, I might want to define that a little better. If you’re on two blood sugar medications and you think that you’re at 116 and you’re controlling your diabetes and you still have peripheral neuropathy symptoms, you’re not controlling your diabetes. If you have to take two or three blood pressure medications, a lot of the things that Dr. Gates was just talking about and much more are involved. A lot of times, we’re going to find that you’ll have the small intestinal bacteria overgrowth that he talks about and you don’t even have to have symptoms of it. You can have it. You might have a thyroid problem that’s been undiagnosed. If you’re taking two or three medications and you’re tightly controlling your blood sugar, you’re not tightly controlling your blood sugar.

If you’re taking two or three medications and you are tightly controlling your blood sugar and it’s in the ’90s and you still have peripheral neuropathy, you’re still having other problems. Those other problems are what is causing you from not having a resolution of the burning of the feet and the sensations that Dr. Gates talked about. There’s also patients that come in here who have brought their blood sugar down with diet and exercise and still have peripheral neuropathy. I think the point that Dr. Gates made which I want to clarify this is your nerves are starting to die down there essentially in English. Your nerves are starting to die. As Dr. Gates uses the example to the patient, you can bring those nerves back kind of like extremely weak muscle or like the defibrillation, shocking back to life and so you can shock them back to life and it’s a 2-way. But as he stated, it’s a combination of two. You can shock them back to life.

But if there are other things that are there in addition to your blood sugar that are perpetuating back, then it’s going to stop you there. I can’t speak for all functional medicines or all functional neurology but we do have a pretty tight program relative to screening patients for that. Just surely I want to tell on our practice has developed into chronic pain practice and of significant percentage of it is peripheral neuropathy, so we’re speaking from experience here and a lot of trial and error and a lot of sleepless nights figuring this out. When Dr. Gates says that our results are pretty significant, they are pretty significant. So what we’re saying is we’re talking from that experience and experimentation that this is what you need to look at it. You need to go way beyond. The stimulation doesn’t work and it’s temporary way beyond the okay. I got to tightly control my blood sugar and if I control it and if I control them and it’s still there, I got to live with it.

Dr. Randall Gates: Exactly and one last thing I’ll close on is you also have to look for other confounding variables relative to peripheral neuropathy, like we know that Metformin, a medication, the one we use to treat diabetes can cause B12 deficiencies, which is associated with peripheral neuropathy. Lots of times, we find our diabetics may have problems with certain foods, thyroid disorders, etc. We have many more talks on peripheral neuropathy and other topics as I alluded to. You definitely should watch the broadcast on metabolic syndrome, diabetes and the gut.

Dr. Martin Rutherford: It’s a pretty comprehensive broadcast on this topic.

Dr. Randall Gates: It’s on powerhealthtalk.com. You can ask questions there, as well as on our Power Health Facebook page.

Diabetic Neuropathy Natural Treatment

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Hello, I’m Dr. Randall Gates. I’m a chiropractor as well as being a board certified chiropractic neurologist.

We treat a lot of neuropathy in our clinic. We have a selection criteria for neuropathy patients. I say that because in our experience, not all diabetic neuropathy patients can be helped, but a certain number can in our experience. Relative to neuropathy, you likely have heard you have neuropathy, and if you’re watching this video you likely have diabetes, you or a loved one, and you know the suffering that goes along with it.

Lots of times people can’t feel their feet. They may have burning or tingling sensations associated with it. Maybe you can’t feel your hands and your balance is going downhill. These can have some major predictors for significant problems like hip fractures going forward. With that being said, you’ve likely been told that you have diabetic neuropathy, there’s nothing that can be done for it, go home and take your diabetes medications and we’ll give you some other medications that help with the pain or the tingling.

The current data is showing that nerves can be rehabilitated, even in diabetic populations, where they can shock nerves and force the nerves to work better. However, those results are short lived. They’ve also done studies where they’ll tightly control blood sugar, very tightly, maybe even using insulin to do so. That can decrease the inflammation in nerves, but it’s really not enough to help a person with diabetic neuropathy. They’ll use things called aldose reductase inhibitors which basically get sugar out of nerves.

Many times, by the point that somebody walks in with diabetic neuropathy, their nerves are dying or dead, there are some current changes in the nerves. Now those with diabetes, if you have Type I diabetes, correct me if I’m wrong, I’m studying the Rochester diabetic study that was conducted by Dr. Dyck. He’s out of the Mayo Clinic in Rochester, Minnesota. He showed that upwards of 66% of Type I diabetics will develop peripheral neuropathy, and I believe it’s 59% of Type 2 diabetics will develop peripheral neuropathy. We’re talking about a pretty significant percentage of the diabetic population.

We’re seeing that when someone has diabetes, the reason why the nerves start to die is that as sugar elevates and you can’t control it, because you can’t make enough insulin or your pancreas is completely dead as in Type 1 diabetes, then as a result with the sugar elevation, the sugar attracts water into nerves. Commonly, as we talked about in our other videos on pre-diabetic peripheral neuropathy, the nerves encoding pain and temperature start to be sacrificed first because they don’t have a lot of insulation around them. They’re termed small fiber nerves. Then, later on the large diameter nerves encoding things like vibration and where your toes are at and things like reflexes, they start to go as well.

That’s part of what’s termed the distal symmetric diabetic polyneuropathy, which is diabetic polyneuropathy, which is where all the nerves start to die because of these blood sugar elevations. Not only is it the swelling of the nerves that cause the nerves to die, but also when sugar goes into the outer portion of the nerve there’s a lot of inflammation in there. That inflammation can attract the immune system, and that can be part of either the nerve itself dying or the insulation around the nerve starting to be sacrificed as well.

We work with patients heavily, heavily, heavily through diet and lifestyle. You can find on our website powerhealthtalk.com a lot of videos of us discussing the relationship of our gut, believe it or not, and the bacteria in our gut in regards to obesity, in regards to blood sugar regulation like pre-diabetes and diabetes.

Basically, we’re finding that a lot of diabetics have problems with obesity, especially those that are Type 2. Those Type 2 diabetics can modulate their obesity or get rid of their obesity through changing their diet, but it’s more than just calories. It’s way beyond calories. Calories, in our opinion, are a thing of the past. It’s really about what types of food you’re eating, because the foods that we eat feed the bacteria in our intestines, and parts of those bacteria breaking up and going into our bloodstream are now being associated with diabetes.

Yes, I just said that. Watch our videos on I think it was metabolic syndrome, diabetes, and the gut. It’s on powerhealthtalk.com.

The problem for you is that now you have diabetes. You’re probably taking Metformin. You may be taking Glyburide. You may be taking even some insulin because you can’t control your blood sugar. Know that there are some things that possibly can be done to control your blood sugar better. Even by losing, let’s say, 5% or 10% of your excessive body mass can really do wonders to regulate your blood sugar.

Diabetes used to be thought of, and actually it’s still termed this, as a lifelong condition, you’re just going to have to learn to live with it. You know what? If you keep eating the standard American diet, and you keep eating what you want, and you don’t exercise, then, yeah, it’s probably going to be something that you have to live with.

You can blame your genetics on it. There are genetic components. But, know that new research is showing that it is a modifiable illness. It really is.

That’s what we see clinically in those patients that we select who we feel that we can help. Then, we couple our modalities nutritionally, and through lifestyle, and through some supplementation with peripheral nerve rehab to get the nerves working better, and in the properly selected patients, we see some pretty profound changes in some of our diabetic peripheral neuropathy patients.

That’s kind of the skinny on natural treatments for diabetic neuropathy. I feel that we hit the major points as well as need to be hit in a 5-minute little broadcast.

You can go, again, to our website, powerhealthtalk.com, for further data on other conditions, further data on diabetes, further information on peripheral neuropathy, and you can send us any of your questions. All right. Thank you for watching.

Fibromyalgia Small Fiber Neuropathy

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Dr. Martin Rutherford: Hi. Good to see you again. We are going to do kind of an interesting topic today. We’re doing it because there seems to be people that are on the web searching for it. It”s fibromyalgia and small fiber peripheral neuropathy.

This is kind of a new development in both of those fields. A new understanding is evolving relative to fibromyalgia which we might even discuss is a term that probably needs to be abandoned. You heard it here first. Indeed, it’s something that people are starting to look for on the web.

We, Dr. Gates and I, run a largely chronic pain practice of which fibromyalgia and peripheral neuropathy are a significant percentage of the people that we treat. I would say for years, we have noticed that fibromyalgia patients will come in. Your particular aspect of the exam, doing the nervous system, will almost more often than not produce the understanding that they have peripheral neuropathy also. I don’t know if we see it as much the opposite way around where somebody would come in with peripheral neuropathy and have fibromyalgia.

Dr. Randall Gates: Not as often.

Dr. Martin Rutherford: We see it, but nowhere near as often as that. We see it both ways. Now, one of Dr. Gates’ hobbies is to spend two or three hours a night researching everything in the world about what we do. I’m very grateful for that, because I don’t do that.

There is some new data that’s coming out there. It’s very interesting. It’s correlating with what we’re seeing, so we thought it would be interesting if Dr. Gates shared some of his findings with you and maybe even why I just stated that. We said for a long time fibromyalgia is a dumb term. It means you have pain in your muscle fibers, and it really isn’t even that.

Dr. Randall Gates: Not at all.

Dr. Martin Rutherford: It’s an even dumber term based on the fact that it doesn’t tell you anything about what’s wrong with you, but based on the fact that it isn’t really pain in your muscle fibers. I will turn this over to Dr. Gates at the moment, and he can show you some of the exciting new stuff that has been helping us to understand better what we’re doing and has helped us to go forward with maybe advancing our treatment in this area.

Dr. Randall Gates: Yeah. As you alluded to, the first understanding of fibromyalgia was that this person, or you out there watching, or a loved one, has severe pain throughout the entire body. We thought that the pain was in the muscles, because that’s where it felt as though the pain was.

Dr. Martin Rutherford: Right.

Dr. Randall Gates: Then, as time went on and studies evolved, we learned that there really was nothing wrong with the muscles. And instead, there were problems with the spinal cord and the brain and how the body was interpreting this pain. We really locked onto, I say we, the scientific community locked onto…

Dr. Martin Rutherford: Stress.

Dr. Randall Gates: …stress as a major provocative factor for triggering the spinal cord to not be able to shut off pain as well as inflammation throughout the system. We even quoted articles from earlier this year really sending the association between Hashimoto’s thyroiditis, which is an immune condition against the thyroid, and fibromyalgia. However, ‘The Journal of Pain,’ I swear I thought it was June of last year, but I do know there was also an article in November of last year where they really started talking about small fiber peripheral neuropathy and fibromyalgia.

Dr. Martin Rutherford: Right.

Dr. Randall Gates: First of all, we need to explain peripheral neuropathy. Peripheral neuropathy is where the peripheral nerves start to dysfunction. We have a central nervous system and nerves that go out to our arms, our hands, and our feet. Diabetics commonly have peripheral neuropathy, and it accounts for 50% of the peripheral neuropathy cases in our country.

That being said, neuropathy basically involves the nerves out here in your arms, your hands, or your legs dying or dysfunctioning. Usually there’s an underlying metabolic cause like diabetes, like an auto-immune problem that causes those nerves to die.

There are many different types of nerves. Some are big. Some are little. The little ones are called small fiber neuropathies, and the little ones encode pain. That’s what you need to get, pain. This ‘Journal of Pain’ in November of 2013 demonstrated that upwards of 41% of fibromyalgia patients have small fiber neuropathy. This was…

Dr. Martin Rutherford: And the point being patients come to our office, I have fibromyalgia. Other patients come to the office, we have peripheral neuropathy.

Dr. Randall Gates: Right.

Dr. Martin Rutherford: A lot of people don’t know that they have kind of both. Again, usually it will come out in the exam, and it was kind of something that’s been interesting. That’s why this is kind of an exciting breakthrough for us to understand better what’s going on.

Dr. Randall Gates: Exactly, because we were seeing it clinically…

Dr. Martin Rutherford: Yeah.

Dr. Randall Gates: …before it came out in these studies.

Dr. Martin Rutherford: Before it came out in the studies.

Dr. Randall Gates: In essence, in the study they went and they took a little piece of skin out. They can look at it under a microscope how many small fiber nerves…

Dr. Martin Rutherford: Right.

Dr. Randall Gates: …are there, and they see fewer of them in fibro patients versus control patients. This is a really novel finding, as Dr. Rutherford said, because it’s changing our understanding on fibromyalgia. And now we do have what’s termed a peripheral mechanism for fibromyalgia.

We’ve known for the last 20 years, there’s no inflammation in the muscles. We’ve known that the problem was largely in the spinal cord or in the brain. Now, we’re starting to see there can be a problem in the small fiber nerves out here, in the extremities most commonly. Just know that is the skinny on fibromyalgia and small fiber neuropathy.

We’ve gotten feedback that many of you are on fibromyalgia message boards, and this has been talked about. We wanted to do this little exposé so that you can get a better understanding of really the nuances of what’s happening.

If you have any more questions you can go to powerhealthtalk.com. We have more broadcasts there. We have full hour long presentations on fibro.

Was there anything else you wanted to…

Dr. Martin Rutherford: And peripheral neuropathy.

Dr. Randall Gates: And peripheral neuropathy.

Dr. Martin Rutherford: And peripheral neuropathy.

Dr. Randall Gates: Is there…

Dr. Martin Rutherford: And now it’s probably going to come together that they’re basically…

Dr. Randall Gates: The same thing.

Dr. Martin Rutherford: …the same thing and they just are manifesting for some reason in some people. I have both, by the way.

Dr. Randall Gates: Yes you do.

Dr. Martin Rutherford: I’ve had both, okay. It’s part of how I got into this. For some people ,it’s going to manifest in the fibromyalgia, the super sensitivity. Some people it’s going to manifest in you having pain, numbness, tingling, burning in your feet. In some people, it’s going to manifest in both.

I think where it’s going it sounds like it’s the same thing. When we do this, frankly, it’s like it’s a little bit formal, but this is kind of how we talk. Off hand, I was going to say frankly we’re getting close to where it’s almost the same treatment in a sense…

Dr. Randall Gates: Right.

Dr. Martin Rutherford: …that you might even do the same thing for peripheral neuropathy patients relative to the fibro patients relative to the stimulations that we do in the feet, that we do for the peripheral neuropathy patients. It’s kind of logical to do it if a person has foot pain, and it might be kind of counterintuitive to do electrical stimulations to the feet for somebody where comes in with this sensitivity all over the place, but it does sound like it’s going into the same place…

Dr. Randall Gates: Exactly.

Dr. Martin Rutherford: …which simplifies things for us a lot. Okay, I think that’s it.

Dr. Randall Gates: Okay, perfect. Well, thank you for watching.

Dr. Martin Rutherford: I got my 2 cents in.

Dr. Randall Gates: Again, if you have any other questions go to powerhealthtalk.com.

Dr. Martin Rutherford: Okay.

Pre-Diabetic Autonomic Neuropathy

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Hello. I’m Dr. Randall Gates; I’m a chiropractor as well as being a board-certified chiropractic neurologist. So, we work with a variety of neurologic conditions here, and pre-diabetic autonomic neuropathy is one of them. We basically have a large neuropathy practice. We have many other conditions which are fibromyalgia and chronic pain syndromes and balance disorders, but neuropathy is a big part of our practice, and many times, patients with pre-diabetes will have a painful small fiber and autonomic neuropathy. Now, today we’re talking about autonomic neuropathy so we’re going to go with that. We’ve already done one on pre-diabetic neuropathy. I recommend you watch it. Now, what is autonomic neuropathy?

With peripheral neuropathy, commonly a person will have numbness, tingling, and/or burning in their feet, and maybe their hands. There are many other types of neuropathies; we’re not going to get into the nuisances of those. With autonomic neuropathy, basically the nerves that control autonomic functions or automatic functions, like your pupils dilating or constricting, like you salivating, like your heart speeding up when you’re exercising, like you digesting your food, like you having an erection or you going into reproductive function, or you getting blood flow to your feet, all those things are controlled by these nerves that control automatic responses, and they’re termed the autonomic nerves. And, there’re two sides.

There’s the fight, fight response that repairs you to fight a bear that comes from your brain and sends signals throughout your body to do one thing versus rest and digest responses. Think of the lion sleeping under the tree for 20 hours after they make their kill. And so, what happens with pre-diabetes is that we get blood sugar elevations some of the time. Not all of the time as we commonly see in an unmanaged case of diabetes. But, if you have pre-diabetes, lots of times patients may be getting a little larger in the waist, maybe their blood pressure’s going up, maybe your cholesterol’s a little bit up, and your doctor runs an HBA1C, which is a 3-month measure of blood sugar, and says, ‘Hey, Joe,’ or ‘Hey, Sharon, your sugar’s starting to go up. You’re not diabetic yet but you’re moving that direction.’

And what that really means is that, when you eat a carbohydrate dense meal like a feast of pasta or a box of donuts, you can’t make enough insulin to get all that sugar back into yourselves. Insulin takes sugar from our blood stream, puts it into our cell. You can’t make enough insulin to do that. So as a result of that, your sugar keeps climbing, climbing, climbing, and in those instances, the sugar draws water into three primary tissues; the retina, the kidneys, and nerves. And because the autonomic nerves, as well as the small fiber nerves, because the autonomic nerves don’t have a lot of insulation around them, they can take on water really easily and swell, and therefore start to dysfunction pretty quickly.

And, just a little nerve physiology, we have big nerves and nerves like the sciatic nerve, those encode which direction your toes are going, small nerves encode pain and texture, autonomic nerves tend to encode exactly what I was talking about, blood flow parameters. It really depends on where the nerve is going, but definitely blood flow into the feet. So that’s why a lot of those with autonomic neuropathy may have blood flow issues into their feet. Maybe your feet turn red, maybe your feet turn purple, maybe they turn blue. But, oftentimes when someone develops autonomic neuropathy, they can have a host of complications throughout their body, like their heart rate may not change the way it’s supposed to when they’re under stress. Or, maybe they develop an arrhythmia.

There’s a possibility you may not be digesting your food as well as you should be. Maybe now if you’re a male, you’ve developed erectile dysfunction and you don’t know why. You’re taking Cialis. Well, oftentimes in a pre-diabetic state, it can be due to pre-diabetic autonomic neuropathy. And, I have a list of articles here, we’ll be happy to send them to you. Go to powerhealthtalk.com to request them. powerhealthtalk.com is really the best place to get them from. We’re not going to post them, that’s why I hesitated. Anyways, one of the articles talks about how in pre-diabetics, the pupil area response actually changes. So, if you shine a light into the eye, the pupil should constrict and it will dilate. And they’re showing that in pre-diabetics, that response will change because of pre-diabetic autonomic neuropathy.

So, I bring that up because that’s a far-reaching implication away from the feet, which a lot of people who are searching this are going to be concerned about. Know that there are ways to control pre-diabetes. Pre-diabetes is a problem of lifestyle as well as diet, and that is not a degenerative way of saying that at all. We have so many videos on powerhealthtalk.com really discussing the underlying roots of diabetes and blood sugar dysregulation. Now, a lot of it has eventually come from the gut, and there’s certain things in your diet that you may think are healthy that are not, that are actually provoking your pre-diabetes to continue or get worse. So, know that you can control your pre-diabetes and there’s a lot of research showing that, especially small fiber neuropathies, secondary to pre-diabetes, these changes can be reversed and you can be improved.

We also talked about in the small fiber pre-diabetic video, about how new studies are showing that nerves can be rehabilitated. We can actually shock nerves with certain types of electric stimulation and cause them to improve in their function for a short period of time. And we’re seeing clinically in the right selected patient that you can basically shock the nerve, and if you couple that with the metabolic intervention, this case corrective of pre-diabetes, we’re seeing some pretty neat results. So, for any other questions, contact us at powerhealthtalk.com. We have a lot of other videos on our website, and we’ll go from there. Thank you for watching.

Pre-Diabetic Peripheral Neuropathy

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Hello, I am Dr. Randall Gates. I am a chiropractor, as well as being a board certified chiropractic neurologist.

We work with patients who have have peripheral neuropathy on a very common basis. It’s actually the majority of our case load. What we are seeing is that, in our clinical practice certain neuropathy patients can be helped.

So lets pause there. You are watching this because you likely know something about pre-diabetes and peripheral neuropathy. You may know more than what your doctors know about this condition. I’m not saying that in a denigration fashion. It’s just that this is a relatively new finding and we will get to that.

So what is peripheral neuropathy? Peripheral neuropathy is basically where patients commonly have numbness, tingling and or burning in their feet, maybe spreading up to their knees and maybe involving their hands. Yes, there are many other kinds of peripheral neuropathy but they’re not what we are commonly talking about here.

So for those with blood sugar disorders, we’ve known for a long period of time that diabetes causes peripheral neuropathy. The current statistics estimate that for those withperipheral neuropathy, diabetes counts for half of that. In our clinical experience many types of patients with peripheral neuropathy are told it’s your diabetes half the time or we don’t know the cause the other half of the time. We can run lots of lab tests but we are not going to figure it out. You just have to go home and live with it because there is really nothing we can do for you anyway.

Those are commonly the accounts patients get from their medical peripheral neuropathy or their medical general practitioner. While that may have been true some time ago, a new research is coming out that patients with peripheral neuropathy can be helped. So I’m just going to stop there.

So now lets go into pre-diabetes. The literature started coming out late 1990s early 2000s. This pre-diabetic peripheral neuropathy has really been discovered by two gentlemen out of the Universtiy of Utah, Dr. Gordon Smith and Dr. Robinson Singleton. These are two neurologists from the University of Utah, which is a specialty center, where they started showing that pre-diabetes can cause peripheral problems.

We thought diabetes counts for half of peripheral neuropathy patients in America. They are now showing that pre-diabetes can account for a significant percentage. This statistic varies from 10% but I’ve seen it as high as 30%, which I think is a little too high. Ore-diabetes can account for a significant percentage of those cases of idopathic peripheral neuropathy or cryptogenic peripheral neuropathies, which basically means we don’t know the cause of it. So we are now seeing that pre-diabetes can cause peripheral neuropathy.

How does it do that? Well, when someone has pre-diabetes, in essence what happens is that they have periods where their blood sugar goes too high. It is not too high all the time as is commonly the case in an unmanaged case of diabetes. So let’s say you go have your feast of pasta and bread, you go to a nice Italian dinner, and if you are moving into a pre-diabetic state there is a possibility that you just cant make enough insulin to get that sugar into yourself. So insulin takes sugar from our blood stream and puts it into our muscle cells or our fat cells.

So in essence, in pre-diabetes you eat that high carbohydrate meal and sugar goes a little too high. When that sugar goes a little too high, there are three tissues in the body that can’t get sugar out of them. The retina, the kidney and peripheral nerves and nerve tissue basically. If you can’t get sugar out, the problem is that sugar gets converted into a substance that attracts water. So now those with pre-diabetes, we are seeing that they can pull water into the nerves. That can cause the nerves to start to dysfunction.

They are also seing in cases of pre-diabetic peripheral neuropathy. The nerves aren’t actually dying or dead as they see in diabetic peripheral neuropathy, it’s just that the nerves are just kind of swollen. Unfortunately with those with pre-diabetes as you probably well know, commonly they suffer with painful burning sensations and stabbing pains and things of that nature.

It’s not the garden variety typical numbness and tingling sort of neuropathy that in other peripheral neuropathies. It is a painful neuropathy and that is why it is terms a small fiber neuropathy. There are many types of big nerves, like the sciatic nerve.

Some are larger in diameter, some are smaller in diameter. Those that are larger in diameter sense things like which direction your toes are going. Those that are small in diameter encode things like pain temperature, and autonomic function. We’re going to do something autonomic neuropathy coming up.

Those three things. Autonomic function basically involves blood flow to your feet. Are your feet blue? Are your feet red? Do they turn cherry red when your feet are burning? That’s all really important because what is happening there in pre-diabetic peripheral neuropathy is, we are seeing t sugar is going into those nerve tissues, especially the small fiber nerves and they swell more for a reason we won’t get into. Basically they don’t have as much coating around them.

Then because they are swelling the nerves discharge and because they encode pain, now you are getting an abundance of pain signals being sent to your spine your feet most commonly and now your feet are burning. You may be taking Gabapentin, Lyrica, other forms of medications that calm down the pain, because this can be one of the most miserable forms of peripheral neuropathy.

I want to say that we are writing a book right now called “Peripheral neuropathy successes stories,” Dr. Rutherford and I. In this book I site studies where they are now showing that you can actually go on and shock these nerves back into life. You can shock these nerves and make them work better, which is really interesting. However, those results are short lived. Mayber a couple of days, and then the nerves go back to their old pattern.

They’ve done studies, Dr. Singleton and Smith citing that if you control your diabetes through diet and excercise, there’s a possibility that your pre-diabetic peripheral neuropathy may go away. That’s interesting in and on itself.

What we see is a complement of those two factors together between peripheral neurostimulation and addressing the underlying medical cause and we properly selected a patient … I’m not saying this is a cure for everybody, but we have a selection process. If we do that effectively, we see that their peripheral neuropathy symtpoms can often abate or go away.

So what does this mean for you? What this means is that … One other thing. You need to know that commonly medical doctors are not aware that pre-diabetes can cause peripheral neuropathy. We’re even treating a medical doctor right now who came to us and said “I went to UC Davis, I don’t have pre-diabetes, and they said pre-diabetes can’t cause peripheral neuropathy.”

Well the fact of the matter is … maybe we can attach this clip word of article somehow to our website, on pre-diabetes and peripheral neuropathy. That would be awesome, just because I’ve attached like 30 references regarding Dr. Smith’s work, Dr. Robinson Singleton’s work about this subject. Because it’s irrefutable now.

Or if we can’t attach it on the website, you can chime in to our website powerhealthtalk.com and we’ll get back to you, we’ll send you the link. Bottom line is, even though your medical doctor may not be … or even your neurologist may not even know that pre-diabetes can cause peripheral neuropathy. This is world found entity, it’s irrefutable now. It needs to be paid attention to.

So for any other questions on this subject, go to powehealthtalk.com. We have an hour long broadcasts on a variety of subjects that you can find interesting. You can also direct questions to our Facebook page For Power Health, and we’ll go from there. Thank you for watching and please send us any questions. Thank you.

 

Statin Induced Neuropathy

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Dr. Gates:  Hello. I’m Dr. Gates. I’m a board-certified chiropractic neurologist. This is Dr. Rutherford. He is a certified functional medicine practitioner. Today, we’re talking about statin-induced peripheral neuropathy.

Dr. Rutherford:  We just decided that 30 seconds ago.

Dr. Gates:  No, we’ve been planning for this. This is an exciting subject. I’m going to let Dr. Rutherford speak for a little while because you
usually do the initial consultations. You encounter a lot of patients with peripheral neuropathy, who come in here and have questions about statins relative to the issue itself.

Dr. Rutherford:  This has been a topic for us forever. The statin drugs are quite controversial right now, in our opinion, quite justifiably so. I just heard this morning on the news where the FDA came out and said, “Maybe it’s not a good idea to take aspirin every day.” Immediately, there was a retort from the AMA saying, “Don’t stop taking the aspirin. Ask you doctor first,” and so on and so forth. This is because the side effects of taking an aspirin every day are significant. We’ll do another five minutes or 10 minutes on that at some point in time.

The statins are at least that controversial, if not 100 times more. It’s getting out into the media and onto the internet that statins can
cause peripheral neuropathy. There is controversy over that. Well, there should be no controversy over it. Statin drugs damage cell walls of the muscles. It kills CoQ10. There are a lot of things that statin drugs do. One of the things that can happen is you can get peripheral neuropathy. One of the strikes of success of treatment of peripheral neuropathy is to figure out which one of the 80 different things, and there are 80 according to the “Neurological Contemporary Series” that’s put out by the AMA every four years for their neurologists and for their neurosurgeons. They list 80 different problems. Statin drugs, whether it’s listed in there or not, I can’t remember, but statin drugs is definitely one of them, and doctors have become fairly aware of that.

In our interviews with patients, we try to determine first of all, “Is this a good selected patient for the types of procedures that we use?” One of the things is for us to do a very thorough history. In that history, if I see a statin drug written down, the next question is always, “When did
you start taking it?” “Uh, two years ago.” The next question is, “When did you get the peripheral neuropathy?” “Well, you know, right after that.” Ding. You know. Now, they might say, “Ten years ago,” and now it kind of goes down on the list as a potential. It’s not always going to cause peripheral neuropathy. But I’m going to let Dr. Gates get into that. So statins clearly can be involved in creating and causing your peripheral neuropathy a certain percentage of the time. I’ll let you take it from there. Dr. Gates:  Absolutely, it’s a very interesting topic. The statistics vary, but the landmark study came from a gentleman by the name of Gaist. He published in the “Journal of Neurology” in 2002, where he looked at the prevalence of peripheral neuropathy and the prevalence of people taking statins and the odds, so to speak, of them developing a peripheral neuropathy secondary to a statin. He came up with some staggering numbers. Basically, there’s a four times to 14 times increased chance of developing peripheral neuropathy when taking a statin. Keep in mind, that’s a 400 to 1400 percent increased chance, which, lots of times when we look at smoking relative to cancer, these are maybe a 1.3 or 3 times increased chance. Fourteen times increased chance of developing peripheral neuropathy is just amazing in terms of a predictor.

The original studies were regarding Lipitor and they have seen that if you switch from Lipitor to another statin medication, it really doesn’t
help. Lots of times, if you catch this early, you can go off the statin medication and the side effects will lots of times go away. But, if you
don’t catch it early and you stay on the statin medication, you don’t only have peripheral neuropathy, it can be harder to regain that function, and more importantly for you, get rid of your symptoms. They are saying that the statins pose such a problem to peripheral neuropathy patients because it depletes the nerves of CoQ10, which is an important factor, as well as some other substrates that are needed for the insulation around the nerves to work well. Also, know that the statistics vary in terms of how prevalent the statin-induced neuropathies are. Some say 10 per 10,000. Others say 60 per 10,000, which you may not think is that high. So, 60 people taking statins out of 10,000 taking statins will develop peripheral neuropathy. You may say, “Well, that’s not that much.” But as Dr. Rutherford was alluding to, it’s now becoming a recommendation that everybody be on a statin. In essence, they’re now going away from cholesterol numbers being
the high value. Then you give a person statins, more if you have all the risk factors of being obese and you eat the standard American diet and the history of high cholesterol. Well, we’re just going to give you a statin no matter what your [inaudible 05:32].

Dr. Rutherford:  I think it’s a problem because, relative to those numbers. . . When I got out of school, which was in the late 70’s, high cholesterol was considered to be 275. Those of you who may be conversive with cholesterol numbers, which seems to be everybody who walks in here, people would rather know what their cholesterol number is than their blood sugar. We’re so sensitized to it. Now it’s 200. Now we’ve seen labs where it’s 175 and I’ve seen suggestions where they want to consider high cholesterol over 150. That’s insanity. I don’t mean to be controversial. I’m just telling you that biochemically, you can’t make hormones with a lack of cholesterol. Cholesterol makes your hormones. Cholesterol makes those cell walls that are being damages around the nerves. Cholesterol is 50% of what makes your brain work. It helps the nerves to conduct, and so on and so forth. What the point is, is there’s a lot more statins being taken out there. It’s still a standard recommendation. Certainly, if you’ve had any type of a coronary issue, it’s a standard recommendation. I don’t know what the percentage of our patients coming in that are taking statins are, but it’s high.

Dr. Gates:  It is high and that’s where the rubber meets the road. Basically, as I mentioned, the prevalence regarding how many people taking
statins develop peripheral neuropathy vary. A lot of  these articles I have here will site that there’s a lot of push back from doctors to even want to acknowledge this because the overwhelming effects and positive effects of statins greatly outweigh the side effects of developing something like peripheral neuropathy.

Dr. Rutherford:  However, clinically we see the relationship occur very commonly. So, medication-induced peripheral neuropathies are quoted at two to four percent as being the cause of peripheral neuropathy out of the 80 different caused. But we see this pretty commonly. We reference that “Journal of Neurology” 2002 by the author Gaist. If you have any questions, you can look that up or contact us. It’s an issue that needs to be addressed, especially if you have idiopathic peripheral neuropathy, where you don’t know what the cause is.

Dr. Gates:  Especially if you started taking a statin drug and your peripheral neuropathy showed up shortly afterward, shortly being anywhere from a couple of days to a couple of months afterward.

Dr. Rutherford:  Exactly.

Dr. Gates:  You can forget the two to four percentages. There’s a good chance that it’s causing your peripheral neuropathy.

Dr. Rutherford:  Or a large factor associated with it.

Dr. Gates:  Or an average factor.

Dr. Rutherford:  Three other factors that can be contributing as well.

Dr. Gates:  So, if you have any other questions, go to powerhealthtalk.com. We have many other videos on neuropathy and gluten and other health conditions there. Also, know that when we address a patient with statin neuropathy, we look at, “Okay, can we get the person off a statin?” We work with their medical doctor. I’ve worked with a number of cardiologists on this issue. As well as working with them to stimulate the nerves. We try and shock the nerves back into life. If we can eliminate the cause, in this case the statin, and shock the nerves back into life, and replace the factors that were missing in the nerves because of the statins, we see a wonderful union where lots of times patients can get better when they thought they couldn’t.

Dr. Rutherford:  So, the takeaway from that comment is, “You may get off the statin and your peripheral neuropathy may not go away.” That doesn’t mean it didn’t cause it. It means that there are other factors or those nerves may need to be stimulated back to life, if you will. I think that pretty much covers it.

Dr. Gates:  I think that’s pretty conclusive. Thank you for watching. Again, go to powerhealthtalk.com for any other questions.

B12 Deficiency Neuropathy

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Dr. Rutherford:  OK so we’re going to talk about B12 induced neuropathy. We’re going to try and keep this relatively short. B12 has been … a lot of times patients come in Doc Gates and I do a lot of neuropathy it’s a pretty significant part of our chronic pain practice. So there’s a lot of different things that can cause neuropathy according to the research or within that research serious put out by the medical profession. The

Neurology Research Series. What about the black book that we beat up.

Dr. Gates:   Oh, OK the Contemporary Neurology Series.

Dr. Rutherford:   Okay so according to this Contemporary Neurology Series which is kind of the bible for the medical neurology field. They list approximately 80 difference reasons that a person can get neuropathy. So a lot of folks come in and have done their research and have come up well if I take Alapha Lipoic Acid or if I take B12 or if I take this and I took it and it didn’t work or I took it and it work. So we’re going to discuss that one mechanism of how that could potentially be involved or not be involved relative to who you are in neuropathy. With that I’m actually going to refer over to Dr. Gates on this. He’s done most of the research he works most directly with our neuropathy patients and I’m going to let him share his findings with you.

Dr. Gates:  And so I’m just going to say it anyways I’m a Board Certified Chiropractic Neurologist. Dr. Rutherford is a Certified Functional Medicine Practitioner. We look at nutrition heavily in our trim base and peripheral nerve cases. Now that being said, almost every patient of neuropathy come in invariabley taking B12. Now you need to know B12 deficiency neuropathy the prevalence or the agreed upon statistics on how may neuropathy patients have B12 deficient neuropathy varies. Some say 3% some say 7% but it’s pretty low overall. And so first of all you need to know that. Now let’s say you do actually have a B12 deficient neuropathy. We have to ask the question why do you have a B1 deficiency. Are you a vegetarian, are you a vegan. We have seen those cases, we have seen those cases and the critical factor was taking B12 and lots of time they may not absorb this. So they’ve had to get injections. We had to refer the patient for an injection.

Dr. Rutherford : And odds because.

Dr. Gates:  And that’s where I’m going next. And so commonly B12 can be deficient term initial pernema which is where the amount system attacks the factor that finds the B12. So let’s say you eat a big steak, that steak has B12 in it. That steak goes into your stomach. You stomach has to be acidic to break down the steak to get the B12 out. If your stomach is not acidic because you’re aging, because you’re on Prilosec. Prilosec the favorite purple pill.

Dr,. Rutherford: If you had acid indigestion which most of the time folks is caused by a lack of hydrochloric acid and you’re taking the purple
pill to destroy what little acid you have left which will then not break things down so that you can absorb your B12.

Dr. Gates:   Exactly. And so now…

Dr. Rutherford:  You could be having B12 prophylactic.

Dr. Gates:  Right. And so now if you’re not breaking down the B12 out of the fluids that you’re eating. You’re not going to be able to get it out of those foods and that’s one circumstance. Where I was going before relative to promisioin anemia is that the immune system can actually start to kill the factor that is secreted further down in our def intestinal track in terms of trim factor that finds the B12 and gets it into your blood stream. Also ,other confounding variables can be hypothyroidism which will not allow you to make enough hydrochloric acid in your stomach. So you can see immediately that it gets pretty complex, pretty quickly. And so any clinician looking at a case of B12 deficient neuropathy has to consider all those other factors int terms of why the person is not getting B12 from their dietary needs. And then figure out a strategy to get that B12 into the system. The studies are pretty good in showing that if someone has a B12 deficient neuropathy and they haven’t had it for a while and if you give them B12 in conjunction with some other techniques. They can start to feel a little bit better. Now B12 deficiency neuropathy can also go hand in hand with something termed sub acute combined degeneration of the spinal cord. Which is where because the body lacks B12 the spinal cords actually starts to degenerate as well. And it can be confusing for a neurologist to
really figure out is that going on with neuropathy or it just the spinal cord problem or just the neuropathy. There is some overlay there as well. So that’s what I would say relative to B12.

Dr. Rutherford:   And what symptoms might they look for in B12-neuropathy deficiency?

Dr. Gates:  B12 deficiency neuropathy patients commonly will have numbness in their feet commonly they’ll have some unsteadiness with their balance. Reason being is that the B12 tends to affect the pathways and the peripheral nerves as well as the spinal cord that involve things like sensing where your toes are at, which are critically important in balance. And commonly when we exam these patients they can’t feel vibration in their feet. They can’t tell which direction we’re taking their toe up or down so on and so forth. Now, the interesting thing we see clinically relative to working with  B12 deficient patients who have neuropathy is that if we figure out the underlying cause as to why they lack the B12 and fix that and then.

Dr. Rutherford:   Detect the B12.

Dr. Gates:  Maybe we need to take the B12, maybe you’re just a vegetarian you’re not getting B12. And then we couple that with some rehabilitation exercises that we use in our office to basically shock the nerves back into life. We’ve seen just some striking and dramatic improvements in B12 deficiency neuropathy cases. And it’s really gratifying because a lot of those who are suffer B12 as a mentioned, B12 deficiency, have problems with balance. And balance can be a major factor in leading to someone falling and fracturing a hip and it can be a disastrous event, let’s just say it that way.

Dr. Rutherford:    So if you have B12 deficiency OK. It’s a small percentage of neuropathy patients who have it. But 4 to 7% that’ significant, you know. And if it’s somehow determined that B12 deficiency just understand you need to check these other things out. You’re taking Prilosec and now you’re taking B12 and it isn’t working guess what, that might be the reason. OK, if you have hypothyroid you’re taking B12 it’s not working it may not be that you have a B12 deficiency it maybe that your thyroid needs to fixed. And I think that’s really the take away point for this because that’s generally what I hear when patients come in. Well, you know I took B12 it didn’t work. And then it turns out they have B12 deficiency but their trans fat is bad, their thyroids bad, their gut it bad so on and so forth. I think that’s a pretty good suppose. And think those are the important points for those of you who are researching or investigating of you have a B12 deficiency should …. I think those are the take away points. And it think that should be very helpful. Thank you for watching and if there are any other questions you can go to powerhealthtalk.com.

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