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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.

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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Gluten Intolerance and Peripheral Neuropathy

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Dr. Rutherford:  We’re going to share with you in this particular broadcast and will keep it relatively short. This is a topic that can really get away from us. We’re going to be talking about gluten intolerance and peripheral neuropathy. Gates and I work as some of you may know who watch these a lot with chronic pain neuropathy tends to be a significant part of our practice. There are probably about 80 different causes for peripheral neuropathy as per the neurology series that is put out by the medical profession, every what, every four years or something like that.

Dr. Gates:  Yeah, contemporary neurologists.

Male Voice:  And the contemporary neurology series, which is the Bible for the medical neurologists and their surgeons and so on and so forth, even though a lot of people have been told it’s either diabetes or your back or tarsal tunnel, or we don’t know what it is; and so that’s four. There are about 80; they are correct. We have found that, unfortunately, to be true and one of those 80 is a gluten intolerant peripheral neuropathy. It seems like gluten still gets some bad press out there. I actually saw the big boy, what’s his name? He used to be on Oprah.

Dr. Gates:  Dr. Oz.

Dr. Rutherford:  Dr. Oz had a little controversy a few weeks ago saying, “Well it’s a scam,” he said to the audience. They screamed, and then he said, “Well, well, maybe it’s not a total scam.” Well let me tell you it’s not a scam. And there is a certain percentage of you that have it and there’s a certain percentage of you that have it that don’t know you have it; and there’s a certain percentage of you that know about gluten that don’t know that gluten intolerance may not manifest as messing up your stomach and giving you symptoms there, but may mess up your nervous system, your brain and all your nerves. And there’s a certain moderate to small percentage of you in which it will have an effect or actually create your peripheral neuropathy.

Dr. Gates:  Right.

Dr. Rutherford:  So I’m going to leave it to Dr. Gates to take it from there relative to his findings and working with peripheral neuropathy patients and his research and he can share that with you so you have a better understanding of that one mechanism of what may potentially be causing your peripheral neuropathy.

Dr. Gates:  Well, it was first observed in celiac disease patients, that they had an increased risk of developing peripheral neuropathy as well as things like balance problems, termed ataxia. But the landmark study …

Dr. Rutherford:  Celiac is?

Dr. Gates:  Celiac disease is an autoimmune disease against gluten, where if you eat gluten your immune system not only attacks the gluten but attacks your intestines.

Dr. Rutherford:  Right.

Dr. Gates:  Now relative to the …

Dr. Rutherford:  They have gut problems.

Dr. Gates:  And there is only a marked study coming out of England with Dr. Hajira Sulu. I’ll pronounce his name correctly one of these years.

Male Voice:  Okay.

Dr. Gates:  But Dr. Hajira Sulu, out of the United Kingdom in the Journal of Neurology, Neurosurgery, and Psychiatry in 2006, had this amazing study where he took a bunch of patients with ‘idiopathic peripheral neuropathy, which means we don’t know the cause of their peripheral neuropathy. They don’t have diabetes, they don’t have B12 deficiency, but they have neuropathy. And he found that 34% of them had a gluten intolerance, meaning their immune system was attacking the gluten. It was in a different form than those with celiac disease, but when their immune system was attacking gluten that could be associated with peripheral neuropathy through an indirect mechanism that we don’t need to go into.

Dr. Rutherford:  Well this gentleman is the lead researcher; he is the top neurological researcher relative to gluten and its effect on the brain and nervous system in the world.

Dr. Gates:  Yes.

Dr. Rutherford:  Bar none, and he is like the word on this stuff.

Dr. Gates:  He has over 100 articles published on the matter.

Dr. Rutherford:  Yes.

Dr. Gates:  And so this has created a huge stir in the neurology community. It’s come up against a lot of resistance, but frankly Dr. Hajila Sulu has won. Now he has a chapter in the Handbook of Clinical Neurology on gluten- related disorders, meaning problems of gluten causing neurologic complications, including problems with balance, including peripheral neuropathy. We are now seeing that certain muscle diseases can be secondary to gluten problems. So those out there suffering with ‘idiopathic peripheral neuropathy’ you really need to be screened for a gluten intolerance. Also note that the lab testing is not fantastic on this matter. We did an entire broadcast, for an hour, that you can get on PowerHealthTalk.com regarding gluten and the testing problems relative to sensitivity and specificity. So just know that you have to get repeat testing for gluten antibodies and know that it could be causing your peripheral neuropathy and we’re now seeing that it can cause a significant number of idiopathic neuropathy cases.

Dr. Rutherford:  And what would be the symptoms that the viewer would expect to see in a gluten sensitive peripheral neuropathy?

Dr. Gates:  That’s really interesting, because it can manifest in any way, shape, or form of peripheral neuropathy. It can cause small fiber neuropathy characteristics, which means you have more pain, more burning pain, more autonomic features, which is where your feet will turn blue or you gain erectile dysfunction at the same time that you have this burning pain in your feet; or it can manifest with kind of the garden variety of peripheral neuropathy, termed dissymmetric neuropathy, which is basically you get numbness and tingling in your feet and you start to get a few problems with balance, but your muscle strength is good. It can manifest as a sensory neuropathy, which is also known the ganglia anopathy, just fancy terms. All you need to know is where the person can’t feel anything throughout their entire body. And Dr. Hajila Sulu showed one of his reports that upwards of half of these cases were due to gluten. I mean this is just phenomenal, because as soon as you get into the nuances of this as Dr. Rutherford said, you know, there could be 80 different causes of peripheral neuropathy past diabetes. Gluten is showing its head as a major formidable
factor relative to this entire problem of peripheral nerve disorders.

So I think that pretty well covers it. You know, in our clinic we look at factors such as gluten heavily in testing of our patients with peripheral neuropathy. And we do a unique form of peripheral nerve rehab for brain cases back of idiopathic peripheral neuropathy where we actually have patients feeling better in terms of their numbness, tingling, burning pain, lack of balance problems. And it’s very rewarding. It coupling the approach of shock in the nerves back into life and facing the underlying metabolic problems; and for those with the gluten neuropathy it’s basically getting gluten out of the diet. And studies have shown that if you eliminate gluten from the diet and you have peripheral neuropathy, secondary to a gluten [inaudible: 00:07:03] peripheral neuropathy that the nerves will actually conduct signals better. But lots of times the symptoms don’t go away. And there have also been studies done where they’ve gone and they’ve tried shocking the nerves back into life and the person will feel a little bit better for a couple of days, but then they go right back to how they were working.

And so we’re pretty excited because we’ve coupled the two approaches together and we’re seeing some neat changes. And so, again, if you have any other questions go to powerhealthtalk.com. You can forward us individual questions there as well as the fact that we have tons of other videos on gluten. We have one on small fiber neuropathy. We just did one on B12 deficient neuropathy and we’re going to do one on statin neuropathy right now. So thank you for watching, and we’ll see you soon.