A diagnosis of type 2 diabetes should always be taken seriously. In fact, 23.6 million Americans, or 8% of the population, have diabetes. An estimated 60-70% of diabetics suffer from peripheral neuropathy. One of the most special concerns about a diagnosis of diabetes is that, over time, diabetic neuropathy, also called peripheral neuropathy, can set in causing debilitating diabetic leg and foot pain, hand pain, weakness and numbness.
What is Peripheral Neuropathy?
Peripheral neuropathy is a serious disease of the blood vessels that supply the nerves as well as the nerves themselves. Peripheral neuropathy is usually described as a tingling or burning in the legs, feet and/or hands as well as loss of sensation or numbness.
Diabetic Neuropathy Facts
- Estimates suggest that more than 20 million people in the USA suffer from some form of peripheral neuropathy. In fact, this figure could be significantly higher since not all people with neuropathy symptoms are actually tested for the disease and the current tests don’t look for all forms of neuropathy.
- At least 60-70 percent of diabetics have neuropathy. Peripheral neuropathy is diagnosed in 23-29 percent of all diabetics, and in older diabetics around 65 percent.
- Research from the National Institute of Diabetes and Digestive and Kidney Diseases indicates that bringing your blood sugar levels down to a healthy range may reduce the risk of diabetic nerve damage by 60 percent.
- Those diagnosed with type 2 diabetes are more likely to develop diabetic neuropathy and pain more than type 1 diabetics. Painful neuropathy symptoms seem to be twice as frequent in type 2 versus type 1 diabetic patients even after tweaking for differences in age.
- Women are more likely to have pain due to nerve damage and loss of function than men. In fact, women have a 50 percent increased risk of neuropathy pain symptoms compared with men.
- Close to one-third of diabetics report no noticeable symptoms of diabetic neuropathy. However, 40 percent of all patients without noticeable signs of neuropathy present with mild nerve damage caused by diabetes.
- Being overweight increases your risk of diabetes and diabetic neuropathy. Research indicates that a body mass index greater than 24 places you at a higher risk for diabetes complications in general.
- The longer you experience diabetes, the higher your risk for neuropathy. The highest risks are among those who have had diabetes for 20–25 years plus.
- A very common complication of diabetic neuropathy is amputation. Over 60 percent of all nontraumatic lower-limb amputations in the USA happen in those with diabetes.
- 71,000 nontraumatic amputations are performed yearly in people with diabetes in the USA alone. However, researchers believe that making healthy adjustments to lifestyle as well as treating neuropathy with medications before it progresses can lower these numbers by 45 percent to 85 percent.
Symptoms of Peripheral Neuropathy
Even though peripheral neuropathy is the most experienced type of diabetic neuropathy, other types can also develop, including the following.
- Autonomic neuropathy affects nerves in the digestive system, sexual organs and sweating. Autonomic neuropathy is extremely dangerous because of its ability to mask hypoglycemia signs, thus leaving people unaware of when they experience low blood sugar.
- Heart and blood vessels nerve damage.
- Proximal neuropathy generates pain in the thighs, hips or buttocks.
- Focal neuropathy generates muscle weakness or pain throughout the entire body.
Prevalent signs and neuropathy symptoms include the following.
- Cramps, pain, tingling and numbness in the toes, hands, feet, legs.
- Hypoglycemia (low blood sugar) symptoms, including shakiness, sweating and a fast heartbeat.
- Muscle wasting/sarcopenia.
- Sensitivity to touch on the skin.
- Digestive issues, including bouts of constipation and diarrhea, nausea, vomiting, bloated stomach, and loss of appetite.
- Low blood pressure, especially when quickly standing up.
- Loss of balance, dizziness and fainting.
- Sexual dysfunction, erectile dysfunction in men, and issues with vaginal lubrication and arousal in women.
- Changes in perspiration, heavy night sweating, the inability to regulate internal temperature or complete lack of perspiration (anhidrosis)
- Kidney damage.
- Damage to the nerves in the bladder and urinary tract, causing frequent urination.
Lyrica – Most Common Prescription Medication for Neuropathy
The most common prescription drug prescribed by doctors for those suffering with diabetic leg and foot pain is Lyrica®. Unfortunately, Lyrica® comes with a multitude of side effects and a high price to pay for many who suffer from diabetic neuropathy.
Below is a list of some of the recorded and more notable side effects of Lyrica®:
- Unexpectedly high incidence of hemangio-sarcoma (a cancer of blood vessels).
- Raises creatinine kinase (leads to kidney disease)
- Lowers platelet count
- Causes changes in the EKG that can lead to heart block
- Causes weight gain
- Causes swelling of the ankles
- Can cause life-threatening angioedema (swelling of the throat and face inhibiting breathing).
- Causes retinal atrophy as well as corneal inflammation and calcification. (meaning you can go blind from it as it progresses to macular degeneration)
- Vertigo, dizziness, unsteadiness, coordination problems, abnormal gait
- Depression, suicidal thoughts or actions
- Muscle breakdown (rhabdomyolysis), tremor
- Withdrawal symptoms, discontinuation syndrome, seizures
You may have already noticed that many of the above side effects are health concerns those with diabetes are actually trying to avoid. This particular drug tends to speed up the likelihood that one may experience the side effects much sooner. To make matters worse any improvement that one may experience from Lyrica® is usually short-lived and often wears off after a year or so.
Natural Solutions for Diabetic Leg and Foot Pain (Peripheral Neuropathy)
Fortunately, there is abundant research using non-drug solutions for peripheral neuropathy. And most, if not all, of these solutions are free of toxic/harmful side effects.
Unfortunately, it’s not often that you will hear about doctors who specialize in diabetes seek to identify the underlying cause of this disease. And that is exacte the philosophy of conventional medicine – treat the symptoms and not the actual cause — help the patient to maintain their symptoms.
Keep Blood Sugar Levels in a Healthy Range
Managing your blood sugar levels is the top priority to prevent or control diabetic neuropathy. IT is also paramount in preventing permanent damage to your nerves, blood vessels, eyes, skin and other body parts.
Studies indicate that unhealthy blood sugar levels greatly increase the risk for developing peripheral neuropathy. In fact diabetic neuropathy accounts for more frequent hospitalizations than all the other complications of diabetes. It is also the most frequent cause of non‐traumatic amputations. Frequent testing of your blood glucose levels, eating a healthy plant-based diet, daily exercise, and working with your doctor/practitioner to determine if you need diabetes medicine and/or insulin therapy — all of which are very important health solutions for diabetic neuropathy.
Consume a Healthy Diet
What you eat has a very direct impact on your blood sugar levels. Your diet focal point should be the consumption of unprocessed, whole foods and severely limiting your intake of refined carbs, added sugars and sugary drinks.
The best ways to accomplish this include the following.
- Choose water/herbal tea instead of soda, fruit juice and other sweetened drinks.
- Consume lots of healthy fats and lean proteins instead of refined carbohydrates.
- Purchase less pre-packaged foods.
- Always check food labels for added sugars or harmful ingredients.
- Manage your weight effectively and easily by preparing healthy meals at home and by using cooking techniques such as roasting, baking, steaming or broiling over frying.
Your diabetic food plan should include the following.
- Fresh organic vegetables and whole fruits which are high in antioxidants, fiber, vitamins, and essential electrolytes like minerals and potassium.
- Wild-caught fish rich in omega-3 fatty acids which benefit diabetics by lowering triglycerides and apoproteins that raise risk for diabetic complications.
- Healthy fats including coconut oil/coconut milk, olive oil, nuts, seeds and avocado.
- Lean protein foods such grass-fed and grass-finished beef, pasture-raised poultry, cage-free eggs and sprouted beans/legumes, which are high in fiber.
- Stevia is a good choice to use as a natural no-calorie sweetener, in place of refined table sugar.
More tips for managing blood sugar with diet include the following.
- Eliminate all grains.
- Limit your consumption of high-sodium foods. It’s best to keep your sodium intake to no more than 2,300 milligrams per day to help control blood pressure. Using Himalayan salt is a good choice because of the mineral content.
- Drink at least eight eight-ounce glasses of purified water each day to stay hydrated. More is better.
- Practice portion control. Measure your food for a while to learn what healthy serving sizes look like.
- Keep a food journal consisting of your daily food intake for several weeks to track your progress and to show you where you need to focus more effort.
- Keep your blood sugar levels healthy by consuming regular meals and snack times every few hours.
- Make your lunch at home to bring to work/school, and include healthy snacks.
Daily exercise is one of the easiest ways to manage your diabetes symptoms, maintain a healthy weight, control your blood sugar and any high blood pressure symptoms, increase your strength, and improve your range of motion. The Journal of Diabetes Complications published a 2012 study that indicates regular exercise causes noteworthy reductions in pain and neuropathic symptoms in diabetics and increased intraepidermal nerve fiber branching.
Try to your way up to exercising for 30–45 minutes daily. Low-impact exercise like cycling, rebounding, swimming or walking tend to be recommended the most. Daily exercise can help your body to better respond to insulin and lower blood glucose, possibly to the point where you can end-up taking less medications. Daily exercise can also help protect nerves by improving circulation especially in your arms and legs, where those with diabetes usually have the most issues and by lowering stress levels which can help with inflammation in the body.
Physical therapy can increase muscle strength, mobility and overall daily functioning. Physical therapy can help you improve your balance and coordination, both of which can be affected by peripheral neuropathy.
The objectives of physical therapy for peripheral neuropathy include the following.
- Maintaining and improve functions via a range of motion – passive range of motion exercises consist of progressive stretching and self-stretches.
- Strengthening muscles – this includes exercising against increasing resistance, use of weights, and isometric exercise.
- Balance training provides stability and prevents falls.
- Physical therapists can also recommend braces and/or splints to enhance balance and posture.
Reduce Toxin Exposure
Lower your exposure to pesticide chemicals sprayed on non-organic crops, chemical household cleaners and beauty products, unnecessary prescriptions or antibiotics, and too much alcohol and cigarettes/recreation drugs. Those with neuropathy are more prone to develop kidney stone symptoms and other kidney issues, including kidney disease, which is why it’s important to take added stress off your kidneys by preventing an accumulation of toxins in the blood.
If you smoke, quit asap. Tobacco in any form can make you more likely to develop nerve damage and even have a heart attack or stroke.
Manage Your Stress Levels
Stress makes inflammation worse. Stress also raises the risk for diabetic complications of all kinds. Daily exercise, meditating, praying, spending more time with a hobby or walking in nature, and being around family and friends are all natural stress relievers that can help with pain.
Lower Pain Naturally
If you’ve already developed neuropathy and are looking for ways to lower diabetic nerve pain and improve daily functions, you’ll be happy to know that a combination of natural remedies can help. Studies have shown that several natural anti-inflammatories and antioxidants help stop nerve damage from progression and lower pain. These include:
- Alpha lipoic acid acts as a natural anti-inflammatory and can improve insulin sensitivity and work against neuropathy. 300–1,200 milligrams daily is usually recommended.
- Evening primrose oil acts as a natural anti-inflammatory to lower neuropathy numbness, tingling and burning and has other positive effects. 360 milligrams daily is usually recommended.
- Chromium picolinate can help to improve insulin sensitivity. 600 micrograms daily is usually recommended.
- Magnesium. There is relatively little research on the impact of this essential mineral for easing nerve pain due to damaged peripheral nerves. A few small studies have shown benefit (Journal of Family Practice, Aug. 2015). An animal model suggests that magnesium supplementation may reduce pain from diabetic neuropathy and restore sensation (Journal of Physiology, Nov. 1, 2010). While studies are limited concerning magnesium for peripheral neuropathy pain, most people are magnesium deficient and don’t know it. I suggest researching magnesium orotate.
- Cinnamon is known to help stabilize blood sugar, add one to two teaspoons to meal daily. Ceylon cinnamon is recommended.
- Omega-3 fish oil is known to help lower inflammation. 1,000 milligrams daily is usually recommended.
- Vitamin B12 is a B vitamin in which many diabetics are usually low. Low Vitamin B12 levels can actually worsen nerve damage.
- Essential oils may help to lower pain and inflammation. Try peppermint, lavender and frankincense.
- Acupuncture is a beneficial treatment that not only can help lower stress and pain, but also can ease symptoms of neuropathy with very few, if any, side effects.
Take a glance at the medical references listed below in the References & Resources Section. These references indicate there are nutrients that have actually helped to reverse diabetic neuropathy. These natural remedies include acetyl-L-carnitine, alpha lipoic acid, Full Spectrum vitamin E, Biotin, turmeric, benfotiamine, B6, etc. Considering these medical studies are from the very journals of diabetic specialists, why would a doctor prescribe Lyrica as a first-line of treatment of leg pain when they have not first tried ALC (acetyl-L-carnitine) for nerve regeneration?
NOTE: It might take some time to see improvements, so be patient and try different combinations until you find relief. Be sure to check with your healthcare practitioner before and during the use of any natural remedies.
Take Care of Your Feet, Legs, Hands, Skin
Take care of your feet, legs, hands and skin. Inspect them daily for injuries, blisters, or sores, and wash them carefully. Wash your skin and feet/toenails carefully daily, especially in skin folds where bacteria and moisture can build up and cause infections. Wear shoes, slippers and socks to protect your feet when at home; many insurance programs, including Medicare, can help cover the costs of therapeutic shoes. If you need help with your care, see a podiatrist, or foot doctor, for advice and treatment.
Wear clean clothing everyday. Keep toenails trimmed and file any corns. See your healthcare practitioner as soon as possible if you notice redness, swelling or any infection forming. Studies find that skin creams containing capsaicin from cayenne pepper can help reduce pain sensations in some people with diabetes. Use these creams carefully because they may cause burning and skin irritations in some people. Be sure to check the ingredient list for toxic ingredients.
Diabetic peripheral neuropathy can often lead to the loss of reflexes, especially at the ankle, and cause changes to the way that you walk. Foot deformities, like hammertoe and midfoot collapse, can also occur, and blisters and sores may develop in areas of the foot that are numb to the pressure or injury. Foot injuries, if not properly treated, can cause infection deep into the bone and result in amputation but, when minor problems are addressed, this drastic course of action is usually not necessary.
Sometimes the answer to diabetic neuropathy might be as simple as correcting a vitamin B1 or B6 deficiency. It all depends on each person’s symptoms as well as other health concerns they may have in addition to diabetic neuropathy. In other words, it’s far better to look for the underlying cause instead of putting a band-aide on a symptom that in the long run may actually cause other health issues.
Certainly those with hard-to-treat diabetic leg and foot pain can do well while using Lyrica® and may suffer few or no side effects. But some people just don’t get much benefit and do end up with short and long-term side effects. For them, Lyrica® may not be the panacea described in TV commercials. Even more concerning is that many do not realize or understand the long-term health concerns that can arise from the use of Lyrica®. This is why it is very important to do your own research. And as always, before implementing any of my suggestions, please talk about your particular symptoms with a trusted healthcare professional who knows your health history.
References & Resources
Sima AA, et al, Acetyl-L-Carnitine Study Group, Acetyl-L-carnitine improves pain, nerve regeneration, and vibratory perception in patients with chronic diabetic neuropathy: an analysis of two randomized placebo-controlled trials, Diabetes Care 28; 1:89-94, Jan 2005.
Quatraro A, et al, Acetyl L-carnitine for symptomatic diabetic neuropathy, Diabetologia 38:123, 1995.
Scarpini E, et al, Effect of acetyl-L-carnitine in the treatment of painful peripheral neuropathy is in HIV-positive patients, J Peripher Nern Syst 2: 250-2, 1997.
Zeigler D, et al, Alpha-lipoic acid in the treatment of diabetic peripheral and cardiac autonomic neuropathy, Diabetes 46 suppl. 2: s 62-6, 1997.
Nakamura J, et al, Polyol pathway hyperactivity is closely related to carnitine deficiency in the pathogenesis of diabetic neuropathy of streptozotocin-diabetic rats. J Pharmacol Exp Ther, 287:897-902, 1998.
Tutuncu NB, et al, Reversal of defective nerve condition with vitamin E supplementation in type 2 diabetes. Diabetes Care 21:1915-18, 1998.
Fedele D, et al, Peripheral diabetic neuropathy. Current recommendations and future prospects for its prevention and management, Drugs 54:414-21. 1997.
Ido Y, et al, Neural dysfunction and metabolic imbalances in diabetic rats. Prevention by acetyl-L-carnitine. Diabetes 43:1469-77, 1994.
Onofrij M, et al, Acetyl-L-carnitine as a new therapeutic approach for peripheral neuropathies with pain, Mt J Clin Pharmacol Res 15:9-15, 1995.
Lowitt S, et al, Acetyl-L-carnitine corrects the altered peripheral nerve function of experimental diabetes, Metab 44:677-80, 1995.
DeGrandis D, et al, Acetyl-L-carnitine in the treatment of diabetic neuropathy. A long-term randomized, double-blind placebo-controlled study, Drugs R D, 3: 223-31, 2002.
Abbas ZG, et al, Evaluation of the efficacy of thiamine and pyridoxine in the treatment of symptomatic diabetic peripheral neuropathy, East African Med J, 74:803-8, 1997.
Koutsikos D, et al, Biotin for diabetic peripheral neuropathy. Biotin may also reduce pain, Rimed Pharmacother 44:511-4, 1990.
Miranda-Massari JR, Gonzalez MJ, Jimenez FJ, Allende-Vigo MZ, Duconge J. Metabolic correction in the management of diabetic peripheral neuropathy: improving clinical results beyond symptom control. Curr Clin Pharmacol. 2011 Nov;6(4):260-73.
Balakumar P, Rohilla A, Krishan P, Solairaj P, Thangathirupathi A. The multifaceted therapeutic potential of benfotiamine. Pharmacol Res. 2010 Jun;61(6):482-8. doi: 10.1016/j.phrs.2010.02.008. Epub 2010 Feb 25.
A study of 551 patients indicating the clinical success of the ReBuilder® Electrical System in treating peripheral neuropathy. Dynamic Health and Wellness Center, Illinois USA. http://www.rebuildermedical.com/studies/study-551.php
Grisanti, Dr. Ron. The Answer to Diabetic Leg Pain? http://www.yourmedicaldetective.com/public/1140.cfm