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.