Monday, 1 September 2014

Fitness Tools For Neuropathy

Today's post from (see link below) talks about taking advantage of modern technical gadgets to help you improve your exercise potential and keep track of how your body is reacting. People with neuropathy do not look forward to exercising but know they have to do the best they can. It involves pain but the alternative of doing nothing is potentially much worse in the long term. Bringing a bit of fun plus useful information into the process can make exercising more attractive. This article looks at the fitness tools available. A very useful read for people with nerve damage who are resisting the need to exercise at every turn!

Fitness Tools for Every Athlete
By Peter Jaret WebMD Feature Reviewed by David T. Derrer, MD August 2014

Want to see your progress as you get fit? You could write it down, or try a device that will give you data on every step you take, the calories you burn, your heart rate, and even your movements as you sleep.

You don't need to -- what matters is that you get out there and exercise. But seeing the numbers can be motivating.

Check out these eight types of fitness tools.

1. Basic Step Counters (Pedometers)

If you need motivation to get moving, pedometers that count each step can help.

"People are often surprised when they strap on a step counter to see how inactive they are during the day," says Ruth Ann Carpenter, a wellness consultant and co-author of Active Living Every Day.

"With a step counter, you can set a goal of how many steps to take every day and track your progress," she says. "If you're falling short, you may be motivated to take a walk after dinner instead of watching TV."

Step counters are valuable for people who get their exercise by walking or running. It won't accurately register other exercise, such as bicycling or weightlifting. About 5,000 steps is the minimum you should log in a day, and 10,000 steps is ideal.

The most basic and inexpensive pedometers measure steps only when worn or held upright. More expensive models use triaxial or 3D technology to record steps no matter how they are positioned, so they tend to be easier to use and more reliable.

2. GPS-Based Fitness Monitors

GPS signals monitor your exact location. GPS-equipped devices can record how far and how fast you walk or run. You can also use them to chart a path when you're running or walking in an unfamiliar place.

GPS devices are generally more accurate than basic step counters at estimating the distance you've walked or run.

3. Calorie Counters

Some pedometers and GPS devices use your steps and speed to estimate the number of calories you burned. The most sophisticated of these programs let you enter information about your weight, which improves accuracy.

Some devices are better than others at making the calculation. "You usually get what you pay for," says Catherine G.R. Jackson, PhD, kinesiology professor at California State University, Fresno. "The more expensive units are typically more accurate."

Even the best give only an estimate.

4. Heart Rate Monitors

Your heart rate is the number of times your heart beats each minute, which goes up when you exercise. So heart rate monitors measure the intensity of your workout. Along with displaying heart rate in real time, many devices let you set a target heart rate and then alert you when you reach your target.

Heart rate monitors can help beginning exercisers tell if their workout is moderate or challenging. High-level athletes can use heart rate monitors to make sure they reach and remain in their target heart rate zone.

5. Activity Tracking

This feature lets you make notes about your workouts and other activities. If you’re a competitive athlete, an activity tracker is a great way to keep a detailed record of your training regimen. Activity trackers are also useful for setting goals and tracking progress.

Some programs let you enter information about how you feel, what you eat, and other data. They can help you spot patterns you might not otherwise notice, such as when you have the most energy during the day or when you tend to feel tired.

"Tracking programs can alert elite athletes to signs of overtraining, such as fatigue and sleep problems," says Carol Torgan, PhD, a blogger and consultant on biosensor technologies.

6. Computer Links and Social Networking

Many fitness devices let you download data to your computer into charts and graphs. You can often share that information.

Think of it as "wear, share, compare," Torgan says. "You can go for a run and then share your results, such as time and distance, with your friends."

7. Sleep Monitors

Sleep may not seem to have a lot to do with exercise. But if you're tired during the day because you didn't sleep well, your performance will be affected.

Some home-based sleep monitors record brain waves via sensors in headbands worn at night. Others measure your movements during sleep.

Few of the devices on the market have been scientifically tested for accuracy. If you often have problems falling or staying asleep, even after you make sleep a priority on your schedule, check in with your doctor.

Sunday, 31 August 2014

The Right To Do Less If You Have Chronic Pain

Today's post from (see link below) is a short article intended to make people feel less guilty about being able to do less than others with chronic pain. It quite rightly says that the psychological effects of living with chronic pain can have a severe effect on a person's mental health. They feel constantly guilty that they're not contributing as much as they should and are becoming a burden. The fact is, you can do more than you think you can but you should never do more than your body tells you is healthy. Being at peace with your limitations will help you bear them so much better.

When You're in Pain, You Have a Right to Do Less
Lead writer: Suzanne Levy Last Updated: May 08, 2008

Ironically, letting go can sometimes help you keep control of the pain.
(SUNNY S. UNAL/CORBIS) The American Chronic Pain Association has issued a list of the basic rights of a chronic pain sufferer. Perhaps one of the most important of them is the right to "do less than you are humanly capable of doing."

In a culture that celebrates efficiency, maximum productivity, and pushing limits, doing less is a radical concept. But Penney Cowan, executive director of the association, believes it is crucial.

Real Life Strategies for Coping with Chronic Pain

Patients and experts share surprising ways you can bring the joy back and lessen the pain Read more

More about coping with chronic pain
Keeping Your Marriage Healthy When You're in Pain
4 Ways to Keep Chronic Pain From Straining Your Friendships

 "People with pain tend to be overachievers who don't listen to what their body is telling them when the pain starts," says Cowan. "They push themselves until the pain is screaming, instead of stopping when the pain is whimpering."

For many, stopping an activity before it's done may result in a complete reappraisal of how they see themselves.

Andrea Kramer, a back-pain and fibromyalgia sufferer from Montgomery Village, Md., describes herself as "a doer, a pusher, a runner." But as the reality of her condition set in, she had to adjust to the fact that she "couldn't do laundry, dishes, lifting, washing a car—it depended upon the level of pain," says Kramer.

The lurking tendency to overdo it

One problem is that even if pain temporarily sidelines the superachiever, that person's underlying mindset doesn't disappear. It just lays low until pain takes a brief vacation.

Then on a good day the go-getter wants to do as much as possible. "You push, you don't pace, you overexert," says Cowan.

Dan Clauw, MD, director of the Chronic Pain and Fatigue Research Center at the University of Michigan, sees this ebb-and-flow pattern all the time and says it's not good for pain management.

"I would suggest that people do the same amount of activity every day so they can even out their peaks and valleys," says Dr. Clauw.
Too many bad days in a row can leave a lot undone, making a pain sufferer feel overwhelmed and melancholy. Cowan says chronic pain demands a clear eye for priorities, which is why she suggests that the pain patient make lists. "Set realistic goals for yourself," she says, "and narrow them down to a point where you're not going to set yourself up for failure."

Accepting your limits is critical

Judy, 49, who runs a headache support group in Nashua, N.H., has taken the "right to do less" mantra to heart. But it's not easy if the price is a less tidy home.

"I've lessened expectations on myself over the years," she explains. "If things don't get done, they don't get done. I just can't get down on myself about them, because it's a choice between trying to feel well and saying my house has to look absolutely perfect."

Amanda, 39, a migraine sufferer who attends Judy's support group, has also learned to pace herself. For example, she cleans early and often, little bits at a time. "My parents are coming in a few weeks, and I've already started cleaning because I have no idea how I'm going to feel. So I do things slowly or piecemeal here and there. I've learned to work around it.",,20189766,00.html

Saturday, 30 August 2014

Reduce Neuropathy Problems: Avoid Aspartame

Today's post from (see link below) talks about the dangers of articial sweeteners and in particular, Aspartame. There have been rumours for years on the neuropathy circuits that aspartame can be responsible for severe nerve damage. It's not just the small pills you put in your tea or coffee but is present as a sweetener in dozens of everyday prepared foods. Now. because of increasing adverse publicity, manufacturers are changing product names to mislead people into thinking they're not eating aspartame. Just why it's so dangerous is outlined in this article but as with all things like this, you really must make up your own minds as to whether you take them seriously or not. This article gives one side of the argument.

America's Deadliest Sweetener Betrays Millions, Then Hoodwinks You With Name Change 
Dr. Joseph Mercola  11/17/2011

Aspartame is the most controversial food additive in history, and its approval for use in food was the most contested in FDA history. In the end, the artificial sweetener was approved, not on scientific grounds, but rather because of strong political and financial pressure. After all, aspartame was previously listed by the Pentagon as a biochemical warfare agent!

It's hard to believe such a chemical would be allowed into the food supply, but it was, and it has been wreaking silent havoc with people's health for the past 30 years.

The truth is, it should never have been released onto the market, and allowing it to remain in the food chain is seriously hurting people -- no matter how many times you rebrand it under fancy new names.

The Deceptive Marketing of Aspartame

Sold commercially under names like NutraSweet, Canderel and now AminoSweet, aspartame can be found in more than 6,000 foods, including soft drinks, chewing gum, table-top sweeteners, diet and diabetic foods, breakfast cereals, jams, sweets, vitamins, prescription and over-the-counter drugs.

Aspartame producer Ajinomoto chose to rebrand it under the name AminoSweet, to "remind the industry that aspartame tastes just like sugar, and that it's made from amino acids -- the building blocks of protein that are abundant in our diet."

This is deception at its finest: begin with a shred of truth, and then spin it to fit your own agenda.

In this case, the agenda is to make you believe that aspartame is somehow a harmless, natural sweetener made with two amino acids that are essential for health and present in your diet already.

They want you to believe aspartame delivers all the benefits of sugar and none of its drawbacks. But nothing could be further from the truth.

How Aspartame Wreaks Havoc on Your Health

Did you know there have been more reports to the FDA for aspartame reactions than for all other food additives combined?

In fact, there are over 10,000 official complaints, but by the FDA's own admission, less than 1 percent of those who experience a reaction to a product ever report it. So in all likelihood, the toxic effects of aspartame may have affected roughly a million people already.

While a variety of symptoms have been reported, almost two-thirds of them fall into the neurological and behavioral category consisting mostly of headaches, mood alterations, and hallucinations. The remaining third is mostly gastrointestinal symptoms.

This chart will familiarize you with some of the terrifying side-effects and health problems you could encounter if you consume products containing this chemical.

Unfortunately, aspartame toxicity is not well-known by doctors, despite its frequency. Diagnosis is also hampered by the fact that it mimics several other common health conditions, such as:

How Diet Foods and Drinks CAUSE Weight Problems

In recent years, food manufacturers have increasingly focused on developing low-calorie foods and drinks to help you maintain a healthy weight and avoid obesity. Unfortunately, the science behind these products is so flawed, most of these products can actually lead to increased weight gain!

For example, researchers have discovered that drinking diet soda increases your risk of metabolic syndrome, and may double your risk of obesity -- the complete opposite of the stated intention behind these "zero calorie" drinks.

The sad truth is that diet foods and drinks ruin your body's ability to count calories, and in fact stimulate your appetite, thus boosting your inclination to overindulge.

Unfortunately, most public health agencies and nutritionists in the United States recommend these toxic artificial sweeteners as an acceptable alternative to sugar, which is at best confusing and at worst harming the health of those who take their misguided advice.

Even More Toxic Dangers of Aspartame

Truly, there is enough evidence showing the dangers of consuming artificial sweeteners to fill an entire book -- which is exactly why I wrote Sweet Deception. If you or your loved ones drink diet beverages or eat diet foods, this book will explain how you've been deceived about the truth behind artificial sweeteners like aspartame and sucralose -- for greed, for profits, and at the expense of your health.

As mentioned earlier, almost two-thirds of all documented side effects of aspartame consumption are neurological.

One of the reasons for this side effect, researchers have discovered, is because the phenylalanine in aspartame dissociates from the ester bond. While these amino acids are indeed completely natural and safe, they were never designed to be ingested as isolated amino acids in massive quantities, which in and of itself will cause complications.

Additionally this will also increase dopamine levels in your brain. This can lead to symptoms of depression because it distorts your serotonin/dopamine balance. It can also lead to migraine headaches and brain tumors through a similar mechanism.

The aspartic acid in aspartame is a well-documented excitotoxin. Excitotoxins are usually amino acids, such as glutamate and aspartate. These special amino acids cause particular brain cells to become excessively excited, to the point that they die.

Excitotoxins can also cause a loss of brain synapses and connecting fibers. A review conducted in 2008 by scientists from the University of Pretoria and the University of Limpopo found that consuming a lot of aspartame may inhibit the ability of enzymes in your brain to function normally, and may lead to neurodegeneration.

According to the researchers, consuming a lot of aspartame can disturb:
The metabolism of amino acids
Protein structure and metabolism
The integrity of nucleic acids
Neuronal function
Endocrine balances

Furthermore, the ester bond in aspartame breaks down to formaldehyde and methanol, which are also toxic in their own right. So it is not surprising that this popular artificial sweetener has also been found to cause cancer.

One truly compelling case study that shows this all too well was done by a private citizen named Victoria Inness-Brown. She decided to perform her own aspartame experiment on 108 rats over a period of 2 years and 8 months.

Daily, she fed some of the rats the equivalent (for their body weight) of two-thirds the aspartame contained in 8-oz of diet soda. Thirty-seven percent of the females fed aspartame developed tumors, some of massive size.

How to Ditch Artificial Sweeteners, and Satiate Your Sweet Tooth

If you suffer from sweet cravings, it's easy to convince yourself you're doing the right thing by opting for a zero-calorie sweetener like aspartame. Please understand that you will do more harm than good to your body this way.

First, it's important to realize that your body craves sweets when you're not giving it the proper fuel it needs.

Finding out your nutritional type will tell you exactly which foods you need to eat to feel full and satisfied. It may sound hard to believe right now, but once you start eating right for your nutritional type, your sweet cravings will significantly lessen and may even disappear.

Meanwhile, be sure you address the emotional component to your food cravings using a tool such as the Meridian Tapping Technique (MTT). More than any traditional or alternative method I have used or researched, MTT works to overcome food cravings and helps you reach dietary success.

And, if diet soda is the culprit for you, be sure to check out Turbo Tapping, which is an extremely effective and simple tool to get rid of your soda addiction in a short period of time.

Non-Acceptable Alternative Sweeteners

I have written a few articles on fructose earlier this year, and I will be writing many more, so please be aware that I am absolutely convinced that fructose ingestion is at the core of our obesity epidemic.

And I'm not only talking about high fructose corn syrup, which is virtually identical to table sugar. The only major difference between the two is HFCS is much cheaper so it has contributed to massive increase in fructose ingestion, far beyond safe or healthy.

Please understand you need to keep your fructose levels BELOW 25 grams per day. The best way to do that is to avoid these "natural" sweeteners as they are loaded with a much higher percentage of fructose than HFCS.
Fruit Juice

Please note that avoiding these beyond 25 grams per day is crucial, even if the source is fresh, raw, and organic. It just doesn't matter, fructose is fructose is fructose ...

Acceptable Alternative Sweeteners

For those times when you just want a taste of something sweet, your healthiest alternative is Stevia. It's a natural plant and, unlike aspartame and other artificial sweeteners that have been cited for dangerous toxicities, it is a safe, natural alternative that's ideal if you're watching your weight, or if you're maintaining your health by avoiding sugar.

It is hundreds of times sweeter than sugar and truly has virtually no calories.

I must tell you that I am biased; I prefer Stevia as my sweetener of choice, and I frequently use it. However, like most choices, especially sweeteners, I recommend using Stevia in moderation, just like sugar. In excess it is still far less likely to cause metabolic problems than sugar or any of the artificial sweeteners.

I want to emphasize, that if you have insulin issues, I suggest that you avoid sweeteners altogether, including Stevia, as they all can decrease your sensitivity to insulin.

Lo han is another sweetener like Stevia. It's an African sweet herb that can also be used, but it's a bit more expensive and harder to find.

So if you struggle with high blood pressure, high cholesterol, diabetes or extra weight, then you have insulin sensitivity issues and would benefit from avoiding ALL sweeteners.

But for everyone else, if you are going to sweeten your foods and beverages anyway, I strongly encourage you to consider using regular Stevia or Lo han, and toss out all artificial sweeteners and any products that contain them.

Friday, 29 August 2014

Can Schwann Cells Revive Old Peripheral Nerves?

Today's post from (see link below) looks at the role of Schwann cells in nerve regeneration. These cells play a vital role in nerve health and are thought to contain a nerve-regeneration factor which they can release to encourage nerve re-growth after damage. Perhaps not surprisingly, age is an important factor - the older we are, the less likely nerves will be able to 'self-heal' so to speak.  It sounds complex but this article explains it very simply and is an interesting read.

Can old peripheral nerves learn new tricks? Only the Schwann cells know for sure 
by Nancy Fliesler on August 25, 2014

Healing from nerve injuries gets slower as we age--here's why. About six weeks ago, a glass shattered in my hand, severing the nerve in my pinky finger. The feeling in my fingertip still hasn’t returned, and now I know why: I’m too old.

Going back to World War II, it’s been speculated that recovery of peripheral nerve injuries—like those in limbs and extremities—is influenced by age. And studies indicate that peripheral neuropathy is common in people over 65 and often unexplained.

“When you’re very young, the system is very plastic and able to regenerate,” Michio Painter told me recently. He is a graduate student in the laboratory of Clifford Woolf, PhD, director of the F.M. Kirby Neurobiology Center at Boston Children’s Hospital. “After that, there’s a gradual decline. By the age of 30, much of this plasticity is gone.”

Traditionally, this decline has been thought to reflect age-related differences in neurons’ ability to regrow, but when Painter studied neurons in a dish, he couldn’t confirm this.

“We were surprised to see that old neurons were able to grow just fine,” he says. When they looked at gene activation in injured sensory neurons, all of the right growth signals seemed to switch on.

The older the mouse, the slower sensory function (A) and motor function (B) return after nerve injury.

So why do I still have this dead spot of feeling—and weird electrical sensations in the part of my finger cut by the glass?

Painter first speculated that older people might lack nerve-rejuvenating factors in their blood. This idea of “young blood” has some precedent: Several recent studies found that exposing older mice to the blood of younger mice made them last longer on the treadmill, increased blood flow in the brain and boosted performance on learning and memory tests.

Not so for peripheral nerve injuries, however.

“What we found was that the blood had no effect,” says Painter. “We then figured there must be something in the nerve environment itself that’s modulating the ability of the nerve to regenerate.”

He and his colleagues did a series of experiments, published last month in Neuron, working with both old and young mice. An old (24-month-old) mouse with a nerve injury recovered like a young (2-month-old) mouse if young nerve tissue was grafted on. But when a young injured mouse received nerve tissue from an older mouse, regeneration was severely reduced.

Eventually, they realized the missing link: In older mice, it was glial cells that were failing, not the neurons.

In young mice (top row), the Schwann cells, outlined in green, have begun to engulf and compact myelin (shown in yellow) by day 3 after injury. In older mice, this process is delayed.

In particular, Schwann cells, a type of glial cell in the peripheral nervous system, were defective. Normally, Schwann cells do three things to encourage axon regrowth after injury. First, they clear the area of myelin, the insulating coating on axons that is thought to inhibit regeneration after injury. Second, they form tracts—similar to roadways—along which axons can regrow. Third, they secrete growth factors that stimulate regeneration.

“That entire process was not happening as efficiently in the old mice,” says Painter.

Though many dots need to be connected, the findings open a new avenue for promoting nerve regeneration—at least for peripheral nerves. Perhaps young Schwann cells could be transplanted into older patients. Or perhaps chemical factors could be introduced to kick-start Schwann cell function. Other neuroscience research is converging on the importance of glial cells and glia-derived factors.

Painter, who has left Boston Children’s to start his postdoctoral fellowship at the Harvard Stem Cell Institute, hopes to explore what is causing the age-related defects in Schwann cells and whether the same defects start to accumulate in other kinds of glial cells, like those in the brain. “That would be very important in the context of neurodegenerative disorders like Alzheimer’s disease,” he says.

If so, I’d consider donating my poorly healing pinky to science.

Thursday, 28 August 2014

Rare Neuropathies: Facebook Chat: Sept.17th

Today's post from (see link below) is a pre-announcement of a Facebook chat about the rarer forms of neuropathy on September 17th. As you probably know, there are over 100 forms of neuropathy, with over 100 different causes and that can make life extremely difficult for doctors and patients alike. Identifying and diagnosing your particular sort of neuropathy can be time consuming and frustrating but in the end, it's how the medical professionals go about treating your symptoms that is the most important. This Facebook chat could be very interesting.

The Neuropathy Association to Host a “Rare Neuropathies: Getting Diagnosed, Getting Help” Facebook Chat on September 17th

In the U.S., the Rare Disease Act of 2002 defines a rare (or orphan) disease as any disease or condition affecting less than 200,000 people (or about 1 in 1,500). Of the over 100+ different types of neuropathies impacting millions in the U.S. alone, there are several neuropathies that are considered rare diseases including hereditary neuropathies like Charcot-Marie Tooth (CMT), familial amyloidotic polyneuropathy (FAP) and familial amyloidotic cardiomyopathy (FAC), Lambert-Eaton Myasthenic Syndrome (or LEMS), sarcoidosis, Fabry’s disease, adult polyglucosan body disease (APBD), multifocal motor neuropathy (MMN) and chronic inflammatory demyelinating polyneuropathy (CIDP) among 

Facebook Chat Image - Association Logo
Related articles:
- Diagnosing neuropathy: the key to understanding the cause
- “Ask the Doctor” Column: Multifocal Motor Neuropathy
- The Link Between Neuropathy and Fabry Disease
- “Ask the Doctor” Column: Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) Diagnostics
- The Link Between Neuropathy and POEMS Syndrome
- Understanding Lambert-Eaton Myasthenic Syndrome
- The Link Between Neuropathy and Transthyretin Amyloidosis/FAP
- Clinical Trial: Study of Efficacy of ARA 290 on Corneal Nerve Fiber Density and Neuropathic Symptoms of Subjects With Sarcoidosis
- Living with CMT
- HNF founder—Allison Moore—shares her CMT story

Because these neuropathies are rare (and rarely seen), diagnosis for many can be a difficult and drawn-out experience; many who have been successfully diagnosed have had to be their own patient advocate to achieve that diagnosis. Still, a diagnosis can hold the promise for improved care and the hope of therapies already available and several more in development.

FACEBOOK CHAT: “Rare Neuropathies: Getting Diagnosed, Getting Help”
WHEN: September 17, 2014 (7-8:30 p.m. ET)
- David Epstein (Adult Polyglucosan Body Disease Foundation);
- Jack Johnson (Fabry Information & Support Group)
- Allison Moore (Hereditary Neuropathy Foundation);
- other guest hosts to be announced

While diabetic peripheral neuropathy is what primarily comes to mind for many when discussing neuropathy, there are actually over 100+ different types of neuropathies caused by a range of diseases and disorders. And approximately a third of all neuropathies are considered to be “idiopathic” or “of an unknown cause.” For people with rare neuropathies – many of which can be extremely debilitating – the path to diagnosis can be an arduous journey which may still lead to an “idiopathic” diagnosis without the help of specialists trained to recognize these rarer neuropathies which can have symptoms mimicking other diseases and disorders…or which simply don’t “fit” together. Being your own best advocate for a diagnosis becomes critical. However, diagnosis offers the opportunity for hope as some of these rarer neuropathies now have new treatments either available or on the horizon...if you have a confirmed diagnosis...

Our Facebook Chat will feature a panel of experts who are not only well-versed on the latest tests and best practices to get to diagnosis, but who also are working on bringing new care and treatment options to those with rarer neuropathies. Our panelists will cover:
Signs and symptoms associated with these rarer neuropathies and the importance of recognizing them early;
Diagnostic tests available;
The value of partnering with neurologists specializing in neuromuscular diseases as well as other types of specialists who may be involved confirming a diagnosis;
Unique co-morbidities associated with some of these neuropathies which may provide diagnostic clues;
Treatments already available to those with rare neuropathies and treatments in development;
Current clinical trials and patient assistance programs;
Ways to improve access to care and quality of life.

P.S.: If you do not use Facebook: You can still access the Chat "live" by visiting The Neuropathy Association's Facebook page, but you will not be able to join the conversation by posting comments. View the Neuropathy Association's Facebook page!

Wednesday, 27 August 2014

Cannabis Inhaler Effective For Neuropathy

Today's short post from (see link below) reinforces the widely held belief that cannabis can relieve neuropathic symptoms as effectively as almost anything else. In this case, the cannabinoids are delivered via an inhaler which removes the need to smoke joints laced with tobacco (with all its associate dangers). Whatever, your opinion of cannabis, there is little doubt regarding its medicinal qualities and if you find that pills are not really helping you in your fight against neuropathic pain, it may be worthwhile looking into this option and at least trying it out. There are many other articles here on the blog about cannabis and neuropathy (see alphabetical list to the right).

Study: Cannabis Inhaler Delivers Effective Relief To Neuropathy Patients
Thursday, 21 August 2014

Haifa, Israel: The administration of a single dose of whole-plant cannabis via a thermal-metered inhaler is effective and well tolerated among patients suffering from neuropathy (nerve pain), according to clinical trial data published online ahead of print in the Journal of Pain and Palliative Care Pharmacotherapy.

Israeli investigators assessed the efficacy of a novel, portable metered-dose cannabis inhaler in eight subjects diagnosed with chronic neuropathic pain. Researchers reported that the vaporizing device administered an efficient, consistent, and therapeutically effective dosage of cannabinoids to all participants.

They concluded, "This trial suggests the potential use of the Syqe Inhaler device as a smokeless delivery system of medicinal cannabis, producing a delta-9-THC pharmacokinetic profile with low inter-individual variation of (maximum drug/plasma concentrations), achieving pharmaceutical standards for inhaled drugs."

A series of clinical trials conducted by investigators affiliated with the Center for Medicinal Cannabis Research at the University of California, San Diego previously determined that the inhalation of whole-plant cannabis is efficacious in the treatment of various types of neuropathic pain.

For more information, please contact Paul Armentano, NORML Deputy Director, at: Full text of the study, "The pharmacokinetics, efficacy, safety, and ease of use of a novel portable metered-dose cannabis inhaler in patients with chronic neuropathic pain: A phase 1a study," will appear in the Journal of Pain and Palliative Care Pharmacotherapy.

Tuesday, 26 August 2014

Cancer Treatment And Peripheral Neuropathy: Why?

Today's post from (see link below) looks at why cancer patients and patients undergoing cancer treatment, are susceptible to neuropathy. Most of you will have heard that cancer treatment is one of the more common causes of neuropathy, even if it's not the case with yourself but not many people know why this happens. This article doesn't go into impenetrable detail but does give a good general description of what's going on. Useful for cancer patients and their friends and family and also for everyone else living with neuropathy. Unfortunately none of us are immune to cancer and it can strike at any time. Worth a read.

Peripheral neuropathy in cancer patients
By Laura Nathan-Garner on June 18, 2014 

For many of our patients, peripheral neuropathy is among the unexpected side effects of cancer treatment.

It's caused by damage to your peripheral nerves -- that is, the nerves that are farther away from your brain and spinal cord. Certain complications of cancer or cancer treatments can cause or worsen neuropathy. So can some health conditions, such as diabetes, alcoholism, AIDS, hypothyroidism, rheumatoid arthritis and carpel tunnel syndrome.

We recently spoke with Julie Walker, advanced practice nurse in Neuro-Oncology, about peripheral neuropathy. Here's what she had to say.

What causes peripheral neuropathy in cancer patients?
The nerve damage that causes peripheral neuropathy may be the result of many different factors, including some chemotherapy drugs using vinca alkaloids, platinum compounds, taxanes and thalidomide.
Tumors themselves can cause nerve damage as well if they grow close to and press on the nerve.

And, patients with cancers of the nervous system -- such as brain tumors, spine tumors and skill base tumors -- are more likely to develop peripheral neuropathy due to nerve damage resulting from the tumor.

What are common peripheral neuropathy symptoms?

Symptoms depend on the type(s) and location(s) of the damaged nerves. The most common peripheral neuropathy symptoms include:

shooting pain or burning, especially in your fingers or toes. Other peripheral neuropathy symptoms include:

loss of balance, difficulty walking or frequent falls
difficulty picking up objects or buttoning your clothes
facial pain
hearing loss
loss of sensitivity to hot and cold
stomach pain

What can cancer patients do to relieve peripheral neuropathy?
If the neuropathy is related to something you can control, try to control the cause.

If your neuropathy is chemo-related, your oncologist can decide whether it's beneficial to reduce your chemotherapy dosage or switch to a different treatment regimen.

If it's related to diabetes, you can often slow down or stop the progression of peripheral neuropathy with better blood sugar control.

Beyond that, physical activity can help by keeping blood flowing in the affected areas. Some people also try acupuncture.

Over-the-counter pain relievers and prescription medications like carbamazepine and Lyrica may help in some cases. Non-prescription-type treatments -- such as acetyl l-carnitine, alpha lipoic acid, glutamin, calcium and magnesium -- may help, too. But more research is needed to better gauge their effectiveness. Be sure to speak with your health care provider before trying any of these.

What can cancer patients do to lower their chances of developing peripheral neuropathy?
If you have other health conditions, such as diabetes, that can make the neuropathy worse, manage them appropriately. Limit alcohol use. Maintain a well-balanced diet. And, discuss your neuropathy risks with your health care provider.

How long do peripheral neuropathy symptoms last?

Every case is different. Because neuropathy is caused by nerve damage, it depends largely on how well your nerves recover. And, that depends on the length of your treatment, extent of the damage and, in the case of chemotherapy-induced neuropathy, dosage intensity.

It's usually possible to manage peripheral neuropathy up to a certain point, but for many people, it never goes away.

As the nerves heal, some people may actually experience more tingling in the affected area. Speak with your health care provider to find out if a prescription might help relieve symptoms during this time.

People with peripheral neuropathy lose the ability to feel pain or extreme temperatures in the affected areas.

What can cancer patients with peripheral neuropathy do to avoid burning or injuring themselves?

Always wear shoes to protect your feet from an injury. Also, make sure you examine your feet every day to look for any wounds or sores that aren't healing.

Be careful when using sharp utensils or avoid them altogether. Likewise, since neuropathy typically inhibits your fine motor movements, be cautious around or avoid dangerous machinery.

Before touching water with your hands or feet, feel the water with a part of your body -- such as the underside of your forearm -- that can sense how warm it is. And, avoid using heating pads and hot water bottles.

Any other advice for cancer patients who are experiencing neuropathy?
People with neuropathy are more prone to falls because they struggle to feel the ground beneath them, especially in the dark or an enclosed space. So:

use a nightlight
keep clutter and throw rugs off the floor
use handrails when taking the stairs
put handrails in the shower
use skid-free shower and bath mats

Neuropathy also makes the body more prone to infection since circulation is decreased and wounds don't heal as well. So it's a good idea to keep your skin moist to prevent cracking and, in turn, infection.

The most important thing you can do, though, is to speak with your health care provider as soon as you start to experience neuropathy symptoms. Together, you can hopefully find ways to manage your symptoms.

Monday, 25 August 2014

New FDA Rules For Gluten Free Labelling

Today's post from (see link below) is another article looking at gluten free diets and what this exactly entails. The American FDA has done us a favour by stepping in to regulate the gluten 'industry' so that the term 'gluten free' genuinely means what it says. This of course doesn't mean that all countries are as well-regulated but it's a guide and when the FDA decides to act, the rest of the world generally follows soon after. That said, the hype that gluten-free is beneficial for the nervous system and neuropathy problems is exactly that - hype and nothing has been proved. There is no doubt however, that many people claim to have benefited from changing to gluten-free. It's not easy and can lead to a 'boring' diet but it may be worth doing the research and consulting your doctor to see if it's an option for you.

What The FDA's New "Gluten-Free" Label Really Means 
By Robin Hilmantel for Women's Health Published August 2014,

If you've been buying foods labeled "gluten-free," we have some good news and some bad news for you. The bad news: Nothing you've bought up until this point has had to adhere to a uniform standard of what it actually means to be "gluten-free." The good news? As of August 2, there's finally a definition to go along with the label.

MORE: Are Gluten-Free Diets Healthy?

Late last week, the FDA published a new regulation defining the term. To be considered "gluten-free," a product now must contain less than 20 parts per million of gluten. Products bearing the labels "free of gluten," "no gluten," and "without gluten" are also now required to meet this standard.

“Adherence to a gluten-free diet is the key to treating celiac disease, which can be very disruptive to everyday life,” FDA Commissioner Margaret A. Hamburg, M.D., said in a press release. “The FDA’s new ‘gluten-free’ definition will help people with this condition make food choices with confidence and allow them to better manage their health.”

MORE: Gluten-Free Foods That Make You Gain Weight

One word of warning: Food manufacturers have until August 2, 2015, to bring their products into compliance with this new criteria. Granted, some products on the market may already meet this standard (and items that have less than 20 parts per million of gluten aren't required to be listed as "gluten-free;" it's a voluntary label).

Even after companies are required to comply with the new ruling, they can still use the terms "made with no gluten-containing ingredients" or "not made with gluten-containing ingredients" on products that don't fit the definition of "gluten-free" (provided these other labels are true). The bottom line? Even with the new regulation, it's still a good idea to reach out to the company or restaurant making a food if you have any questions about how much gluten it might contain.

Sunday, 24 August 2014

Understanding Crohn's, Fibromyalgia, Neuropathy And Cluster Headaches (Vid)

Today's post and videos from (see link below) are a very useful description of what happens with certain serious neurological conditions. Crohn's disease, cluster headaches, neuropathy and Fibromyalgia can make people's lives a misery and most people have heard of them or know someone with one or more of these problems but understanding what's behind them is another matter. These videos explain what people go through if they are afflicted. They're easy to relate to and not difficult to follow and certainly worth a view.

Helping others understand your Crohn's, Fibromyalgia, Peripheral Neuropathy or Cluster Headache- 
videos to share and educate by Ken McKim 07/08/2014

Thanks to Ken McKim for these awesome videos

We've all been there. Maybe some of us still are there. We have illnesses that change our bodies and our lives. And the people who should support us the most - our friends and family - just don't get it! They can't understand what we are going through. They have expectations, judgments, advice and comments that sometimes hurt us more than help us.

Ken McKim has been creating a series of short videos to help us teach our loved ones about what we are going through. His videos are brief and powerful, with a touch of humor, and will really help others "get it!"

More videos about other chronic conditions are forthcoming! We look forward to those, and appreciate being able to share Ken's enlightening series!

Saturday, 23 August 2014

Link Between Poor Sleep And Suicide

Today's post from (see link below) looks at the serious problem of sleep-deprivation and the effect it can have on your mental health. People living with neuropathy very often have disturbed sleep patterns. For some reason that nobody seems to be sure of, neuropathy symptoms can flare up during the night and pains in legs and feet can seriously affect your quality of life. It's logical really that prolonged lack of quality sleep will leave you drained during the day. Over a period of time that lack of energy and constant tiredness can lead to depression. If this is the case with you and you feel yourself being impacted by this, don't hesitate to contact your doctor and get help and advice but remember, sleeping tablets may not be the answer because the symptoms will continue despite being masked by the drugs. One thing is sure, don't ignore it and hope it will go away; make sure your medical professionals are aware of the problem.

Study Hints at Link Between Poor Sleep, Suicide Risk
By Tara Haelle HealthDay Reporter
WEDNESDAY, Aug. 13, 2014 (HealthDay News) 

Sleeping difficulties may increase the risk of suicide in older adults even when other symptoms of depression aren't present, a new study suggests.

The study focused on adults 65 and older, and poor sleep included difficulty falling or staying asleep, waking up early in the morning, experiencing daytime sleepiness and not feeling fully rested after a night's sleep.

"These findings suggest that sleep disturbances stand alone as a valid risk factor -- independent of depressed mood -- and worthy of focus as a potential [suicide] risk factor, screening and intervention tool," said lead researcher Rebecca Bernert, an instructor of psychiatry at Stanford University School of Medicine. "Compared to many other known suicide risk factors, sleep disturbances are arguably less stigmatizing and may be undone, and are highly treatable."

Among the 20 study participants who died by suicide, 19 were men. The researchers randomly matched these 20 people to 400 living participants based on shared age, sex and location, and then compared their sleep quality and depression scores.

The study couldn't prove that sleeping problems cause suicidal thoughts or attempts, nor could it explain why the link may exist. But, Bernert said, it's likely that poor sleep affects the ability to regulate moods.

"The idea is simple: when we sleep poorly, it impacts how we feel and the way in which we manage our emotions, as well as decision-making," Bernert said. Past research has shown that fragmented sleep can result in more intense negative emotions, impaired judgment and difficulty managing fear or anger.

Those who reported having poor sleep quality at the start of the study had 40 percent greater odds of dying by suicide during the next 10 years before depression symptoms had been considered. Even after making calculations to remove the effects of depression symptoms, the odds of dying by suicide were 30 percent higher for those reporting poorer sleep quality, the study authors said.

Also, those who reported not feeling well-rested after sleeping had twice the odds of dying by suicide compared to those not reporting sleeping problems, even after symptoms of depression had been considered. And sleep disturbances better predicted who died by suicide over a decade than depression symptoms did, the study authors reported in the Aug. 13 online edition of JAMA Psychiatry.

The researchers used two separate questionnaires, one on sleep quality and one on depression symptoms, for their calculations.

Yet William Kohler, medical director of the Florida Sleep Institute in Spring Hill, Fla., said he's skeptical about how well the researchers could completely account for depression symptoms since they are so similar to the symptoms of poor sleep.

"We have to ask what's the cart and what's the horse because it's not common to be really sleep-deprived and then be wide-eyed and bushy-tailed and positive about things," Kohler said.

"We know that sleep disturbance causes depressive symptoms, such as lack of energy, lack of interest in things one enjoys and feeling a little down the next day, so I'm not sure how they would separate that out," he added.

Separating them out is what the researchers said they attempted to do.

"Sleep disturbances and suicidal ideation are both symptoms -- among a constellation of symptoms -- of depression, which is why it is crucial to disentangle them as risk factors and the way in which they may interact to increase risk," Bernert said. "It is important to note that suicide is the tragic outcome of multiple, often interacting risk factors and medical conditions."

Approximately 12 out of every 100,000 people die by suicide each year in the United States. Individuals thinking about suicide can reach a nearby certified crisis center by calling the National Suicide Prevention Lifeline at 1-800-273-TALK.

The U.S. Substance Abuse and Mental Health Services Administration ranks sleep difficulties as one of the top 10 warning signs of suicide. Past studies have linked insomnia, nightmares and overall poor sleep quality to an increased risk of suicidal thoughts and attempted suicide. But those studies did not usually control for depression.

This new study differs from past research because of its size, length and focus on older Americans. The researchers tracked more than 14,000 adults, aged 65 and older, for 10 years. The adults assessed their sleep quality and depression symptoms six times during that decade.

Bernert said she and her colleagues are now investigating why the link between poor sleep and suicide might exist.

The U.S. Centers for Disease Control and Prevention and the U.S. National Institutes of Health contributed funding for the study.

Friday, 22 August 2014

Diet And Nutrition For Neuropathy

Today's post from (see link below) is another short article looking at the importance of what you eat for neuropathy sufferers. A well-balanced diet will include all the vitamins you need for a healthy nervous system but it is possible that you have other conditions which have resulted in deficiencies in certain vitamins and minerals (particularly the B vitamins, vitamins D and E). In that case, it may be worth supplementing even a good diet with store-bought vitamins or supplements. Take advice from your doctor or neurologist, or do your own research on the internet but first get your vitamin status established by means of a simple test your home doctor can do.

Neuropathic Nutrition and Diet
Posted by john on June 19, 2014

Get Started on a proper neuropathic nutrition and diet plan today!

One main factor in many cases of peripheral neuropathy is diet. You probably know that neuropathy is linked to diabetes and other conditions where daily intake of sugars and nutrients is important, but your diet can also influence the condition of nerves in more direct ways, such as in cases where a nutritional deficiency is causing neuropathic damage.

One of the most common links between neuropathy and nutrition is a deficiency in B vitamins, particularly vitamin B-12. Fight neuropathy by eating foods like meat, fish, and eggs that are all high in B vitamins. If you are a vegetarian or vegan, don’t worry! There are many kinds of fortified cereals that contain substantial amounts of B vitamins as well (in addition to supplements, which we’ll talk about in a moment).

The Mayo Clinic recommends a diet high in fruits and vegetables for people who suffer from neuropathy. Fruits and vegetables are high in nutrients that have been shown to be effective treating neuropathy. Additionally, if you suffer from diabetes, fresh produce can mellow your blood sugar levels. If numbness or pain in your extremities is severe, keep pre-cut fruit and vegetables at the ready, so you don’t have to worry about the stress involved with preparing them! Just be careful of too much fruit sugars. This means a serving is 1/2 apple, banana, etc. Most non-starchy vegetables like greens and asparagus especially are great for most of us.

Foods that are high in Vitamin E are also good for a neuropathic diet, according to A deficiency of Vitamin E can happen in cases where malabsorption or malnutrition are taking place, such as the case with alcoholic neuropathy. Breakfast cereals, whole grains, vegetables and nuts are all excellent sources of vitamin E.

Lean proteins are also an important part of a healthy diet for people with neuropathy. Saturated fats and fried foods increase risk of diabetes and heart disease, in addition to aggravating nerve decay from lack of nutrients. A variety of foods—skinless white-meat poultry, legumes, tofu, fish, and low-fat yogurt—are good sources of lean protein. If you suffer from diabetes, lean proteins also help to regulate blood sugar levels. Fatty fish such as salmon, tuna, mackerel, and sardines are good for maintaining levels of Omega-3 acids, healthy fats the body needs but cannot produce on its own.

For specific types of neuropathy, research shows that specific antioxidants may help slow or even reverse nerve damage that has not existed for too long a time. For HIV sensory neuropathy, Acetyl-L-Carnitine has demonstrated good results, and Alpha lipoic acid is being studied for its effects on diabetic nerve damage. Consult your NeuropathyDR® specialist for the latest research before beginning any supplementation or treatment, even with antioxidants.

Use Tools Like Journaling and Blood Sugar Monitoring Every Day…

So what are the best ways to monitor what you are eating? The easiest way is to keep a food journal. Record everything you eat at meals, for snacks, and any vitamin supplements you might be taking. Your journal will help you and your NeuropathyDR® clinician determine if your diet could be a factor in your neuropathy symptoms! As a bonus, food journaling is a great way to be accountable for your overall nutrition, as well as to help avoid dietary-related conditions other than neuropathy. If you have a goal for weight loss, weight gain, or better overall energy, those are other areas in which keeping a food journal can help! Other ways to monitor what you eat include cooking at home as opposed to going out to restaurants, keeping a shopping list instead of deciding what groceries to buy at the store, and consulting a nutritionist or qualified NeuropathyDR® clinician about the best ways to meet your specific needs.

Dietary supplements can also help manage neuropathic symptoms and nerve degeneration. Supplementing B Vitamins, particularly vitamin B-12, can help regulate your nutrient levels and prevent neuropathy symptoms. Supplementing with fish oil can help replenish Omega-3 fatty acids, which are important if you suffer from type-II diabetes. Many other types of supplements can be beneficial if you suffer from neuropathy; consult your NeuropathyDR® clinician for specific recommendations.

Contact us if you have any questions about a proper neuropathic nutrition and diet plan. We can help you find the information you need and put you in touch with a NeuropathyDR® clinician who can help you with this and other neuropathy-related questions!

Join our conversation today on Facebook by clicking HERE!

Thursday, 21 August 2014

Vitamins B12 And D3 Important For HIV And Neuropathy

Today's post from (see link below) looks at the importance of vitamins B12 and D3 for people suffering from either or both, HIV and Neuropathy. A large number of people with HIV have been found to be both B12 and vitamin D deficient and it may not be coincidental that both vitamins are also essential for nerve health. If you're not sure, your doctor can do a simple blood test to establish if you are deficient in either or both and this applies to all neuropathy patients whether or not you also have HIV in the picture. If that is the case, then supplementation is easy and relatively inexpensive and could make a great deal of difference to your symptoms. Worth a read.

Why Vitamins B12 and D3 Are Especially Important to People with HIV 
Posted by jarebe
December 8, 2013
Our friends at the Canadian AIDS Treatment Information Exchange (CATIE), a Canadian government-supported education and prevention organization, recently published an excellent guide to managing HIV medication side effects. This online guide covers the territory from body shape changes, to gastrointestinal disorders, to neurological effects, to emotional wellness, to fatigue, to sexual difficulties.

The Appendix to this guide focuses on two vitamins, both of which have been highlighted as especially important for people with HIV: B12 and D3. Deficiency of these two vitamins appears to be common among people with HIV, and supplementing to correct the deficiency can bring about major improvements in health. So it’s definitely worthwhile to check your B12 and D3 status, and, if you’re deficient, find a good supplementation strategy. Note that NYBC stocks both of these inexpensive vitamins: the methylcobalamin form of Vitamin B12 recommended below; and several strengths of Vitamin D3, including the commonly recommended D3 – 2500IU format.

Below are the CATIE recommendations:

Vitamin B12

A number of studies have shown that vitamin B12 is deficient in a large percentage of people with HIV, and the deficiency can begin early in the disease. Vitamin B12 deficiency can result in neurologic symptoms — for example, numbness, tingling and loss of dexterity — and the deterioration of mental function, which causes symptoms such as foggy thinking, memory loss, confusion, disorientation, depression, irrational anger and paranoia. Deficiency can also cause anemia. (See the section on Fatigue for more discussion of anemia.) It has also been linked to lower production of the hormone melatonin, which can affect the wake-sleep cycle.

If you have developed any of the emotional or mental symptoms mentioned above, especially combined with chronic fatigue, vitamin B12 deficiency could be contributing. This is especially true if you also have other symptoms that this deficiency can cause, including neuropathy, weakness and difficulty with balance or walking. On the other hand, these symptoms can also be associated with HIV itself, with hypothyroidism or advanced cases of syphilis called neurosyphilis. A thorough workup for all potential diagnoses is key to determining the cause.

Research at Yale University has shown that the standard blood test for vitamin B12 deficiency is not always reliable. Some people who appear to have “normal” blood levels are actually deficient, and could potentially benefit from supplementation.

The dose of vitamin B12 required varies from individual to individual and working with a doctor or naturopathic doctor to determine the correct dose is recommended. Vitamin B12 can be taken orally, by nasal gel or by injection. The best way to take it depends on the underlying cause of the deficiency, so it’s important to be properly assessed before starting supplements. For oral therapy, a typical recommendation is 1,000 to 2,000 mcg daily.

One way to know if supplementation can help you is to do a trial run of vitamin B12 supplementation for at least six to eight weeks. If you are using pills or sublingual lozenges, the most useful form of vitamin B12 is methylcobalamin. Talk to your doctor before starting any new supplement to make sure it is safe for you.

Some people will see improvements after a few days of taking vitamin B12 and may do well taking it in a tablet or lozenge that goes under the tongue. Others will need several months to see results and may need nasal gel or injections for the best improvements. For many people, supplementation has been a very important part of an approach to resolving mental and emotional problems.

Vitamin D

Some studies show that vitamin D deficiency, and often quite severe deficiency, is a common problem in people with HIV. Vitamin D is intimately linked with calcium levels, and deficiency has been linked to a number of health problems, including bone problems, depression, sleep problems, peripheral neuropathy, joint and muscle pain and muscle weakness. It is worth noting that in many of these cases there is a link between vitamin D and the health condition, but it is not certain that a lack of vitamin D causes the health problem.

A blood test can determine whether or not you are deficient in vitamin D. If you are taking vitamin D, the test will show whether you are taking a proper dose for health, while avoiding any risk of taking an amount that could be toxic (although research has shown that toxicity is highly unlikely, even in doses up to 10,000 IU daily when done under medical supervision). The cost of the test may not be covered by all provincial or territorial healthcare plans or may be covered only in certain situations. Check with your doctor for availability in your region.

The best test for vitamin D is the 25-hydroxyvitamin D blood test. There is some debate about the best levels of vitamin D, but most experts believe that the minimum value for health is between 50 and 75 nmol/l. Many people use supplements to boost their levels to more than 100 nmol/l.

While sunlight and fortified foods are two possible sources of vitamin D, the surest way to get adequate levels of this vitamin is by taking a supplement. The best dose to take depends on the person. A daily dose of 1,000 to 2,000 IU is common, but your doctor may recommend a lower or higher dose for you, depending on the level of vitamin D in your blood and any health conditions you might have. People should not take more than 4,000 IU per day without letting their doctor know. Look for the D3 form of the vitamin rather than the D2 form. Vitamin D3 is the active form of the vitamin and there is some evidence that people with HIV have difficulty converting vitamin D2 to vitamin D3. Historically, vitamin D3 supplements are less commonly associated with reports of toxicity than the D2 form.

It is best to do a baseline test so you know your initial level of vitamin D. Then, have regular follow-up tests to see if supplementation has gotten you to an optimal level and that you are not taking too much. Regular testing is the only way to be sure you attain — and then maintain — the optimal level for health.

With proper supplementation, problems caused by vitamin D deficiency can usually be efficiently reversed.

Wednesday, 20 August 2014

Peripheral Nerves, Explained

Today's post from (see link below) is a good and easy to follow description from India of the nervous system; the symptoms when there is nerve damage and the common testing process to make diagnoses. Many people with neuropathy aren't quite sure which nerves are which, what their functions are and why they go wrong - this article provides you with a simple explanation without overwhelming you with information. Definitely worth a read to top up your knowledge.

Understanding Peripheral Nerves : Types, Peripheral Neuropathy, Symptoms and Tests 
By Sobiya N. Moghul posted Aug 20th 2014 Healthy Living

The human nervous system consists of four parts: the brain, spinal cord, autonomic nervous system and peripheral nerves. Peripheral nerves are cord-like structures containing bundles of nerve fibres that transmit signals from the spinal cord to the rest of the body, or to transmit sensory information from the rest of the body to the spinal cord. Your peripheral nerves are the ones outside your brain and spinal cord. Like static on a telephone line, peripheral nerve disorders distort or interrupt the messages between the brain and the rest of the body.

The nerves in our bodies are very similar to electric cables. The brain and spinal cord send electrical signals through the nerves to different muscles. The muscles, in turn, have a specialised mechanism to properly understand the electrical signals and act accordingly, thereby moving different parts of the body.

There are three types of peripheral nerves: motor, sensory and autonomic. Some neuropathies affect all three types of nerves, while others involve only one or two.

Motor nerves send impulses from the brain and spinal cord to all of the muscles in the body. This permits people to perfom activities like walking, catching a ball, or moving the fingers to pick something up. Motor nerve damage can lead to muscle weakness, difficulty in walking or moving the arms, cramps and spasms.

Sensory nerves send messages in the other direction—from the muscles back to the spinal cord and the brain. Special sensors in the skin and deep inside the body help people identify if an object is sharp, rough, or smooth, if it's hot or cold, or if a body part is still or in motion. Sensory nerve damage often results in tingling, numbness, pain, and extreme sensitivity to touch.

Autonomic nerves control involuntary or semi-voluntary functions, such as heart rate, blood pressure, digestion, and sweating. When the autonomic nerves are damaged, a person's heart may beat faster or slower. They may get dizzy when standing up, sweat excessively, or have difficulty sweating at all.

There are various kinds of peripheral nerve disorders. They can affect one nerve( mononeuropathy) or many nerves( polyneuropathy). In some cases, like complex regional pain syndrome and brachial plexus injuries, the problem begins after an injury. Some people are born with peripheral nerve disorders.

Mononeuropathy is usually the result of damage to a single nerve or nerve group by trauma, injury, local compression, prolonged pressure, or inflammation. Examples include: Carpal tunnel syndrome (a painful wrist and hand disorder often associated with repetitive tasks), and Bell's palsy (a facial nerve disorder) .

The majority of people, however, suffer from polyneuropathy, an umbrella term for damage involving many nerves at the same time.

There are many causes of peripheral neuropathy, including diabetes, hereditary disorders, infections, inflammation, auto-immune diseases, protein abnormalities, exposure to toxic chemicals, poor nutrition, kidney failure, chronic alcoholism, and certain medications – especially those used to treat cancer and HIV/AIDS. In some cases, however, even with extensive evaluation, the cause of a person's peripheral neuropathy remains unknown – this is called idiopathic neuropathy.

The symptoms of peripheral neuropathy often include:

• A sensation of wearing an invisible "glove" or "sock"

• Burning sensation or freezing pain

• Sharp, jabbing or electric-like pain

• Extreme sensitivity to touch

• Difficulty sleeping because of feet and leg pain

• Loss of balance and coordination

• Muscle weakness

• Difficulty walking or moving the arms

• Unusual sweating

• Abnormalities in blood pressure or pulse

There are specialised nerve tests like EMG, NCV and SSEP, which are designed to diagnose any abnormality in the functioning of these nerves.

EMG, or Electromyography is a technique used for evaluating and recording the electrical activity produced by muscles. The EMG helps doctors distinguish between muscle conditions that begin in the muscle and nerve disorders that cause muscle weakness.

NCV, or Nerve Conduction Velocity, is an electrical diagnostic test that provides information about abnormal conditions in the nerves.

SSEP, or Somatosensory Evoked Potential, is a test showing the electrical signals of sensation going from the body to the brain and spinal cord. The signals show whether the nerves that connect to the spinal cord are able to send and receive sensory information like pain, temperature and touch.

Treatment aims to treat any underlying problem, reduce pain and control symptoms. Injuries to the Brain and Spinal cord have only a very limited capacity to heal, because nerve regeneration tends not to occur. In contrast, peripheral nerves have a striking capacity for regeneration. Even completely severed peripheral nerves, if repaired in a timely fashion, can regrow, allowing the patients to enjoy complete, or nearly complete recovery in many cases.

The healing process almost invariably requires an extensive amount of time to occur. It is important for patients not to lose hope during this time. It is vital that they exercise, keeping the affected muscles and joints flexible and ready to be used once again when the axons regrow into them. It is not unusual for patients to undergo a lengthy, complex, peripheral nerve reconstruction procedure, only to see no evidence of recovery for a year or more. This can be immensely frustrating for the patient. Unfortunately, currently there is nothing in medical science that can make these axons grow any faster. Perhaps it is best to think of this delay as part of the healing process, paving the road to further recovery.

*Inputs : Dr Harleen Luther – Brain , Spine; Peripheral Nerve Surgeon, Seven Hills Hospital, Mumbai.

Tuesday, 19 August 2014

Cardio Vascular Disease Associated With Neuropathy

Today's post from (see link below) looks at the connection between neuropathy and a higher risk of cardiovascular problems. It appears that people with peripheral neuropathy are more at risk anyway of cardiovascular disease. This may be a slightly slanted view in that diabetes patients are traditionally at risk of such problems and by far the greatest number of people with neuropathy also have diabetes. However, this study is the first to show that neuropathy patients have a greater risk of going on to develop cardiovascular disease and strokes, although if you don't have diabetes Type 2, your risk may be less.

Peripheral Neuropathy Associated with CV Disease and Stroke in Type 2 Diabetes Patients          

This article originally posted 15 August, 2014 and appeared in  CardiovascularType 2 DiabetesNeuropathyIssue 742

Testing for peripheral neuropathy may provide a way to identify individuals at higher risk of cardiovascular events.... 
Jack Brownrigg, a PhD student at St George's, University of London, UK, who conducted the research at St George's Vascular Institute, said, "While the risk of cardiovascular disease is known to be higher in patients with diabetes, predicting which patients may be at greatest risk is often difficult.

"We looked at data on individuals with no history of cardiovascular disease and found that those with peripheral neuropathy were more likely to develop cardiovascular disease."

Robert Hinchliffe, Senior Lecturer and Consultant in Vascular Surgery at St George's who co-led the study with Professor Kausik Ray, said: "While loss of sensation in the feet is known to be a key risk factor for foot ulcers, it may also provide additional useful information to guide patient management. This is the first study to show that it can also indicate an increased risk of cardiovascular problems like heart attacks or strokes.

"The good news is that peripheral neuropathy can be easily identified by simple tests carried out in GP surgeries. The results of the study warrant further investigation as to whether even greater control of risk factors including blood pressure and blood sugar can prevent or delay the onset of cardiovascular disease.

"There is likely an unmet potential to reduce cardiovascular disease in this group of patients through greater monitoring and simple treatments."
The researchers analyzed data from 13,000 patients diagnosed with type 2 diabetes with no history of cardiovascular diseases. They found that individuals with peripheral neuropathy were more likely to develop cardiovascular disease, noticing that patients who experienced loss of sensation in their feet also tended to have heart and circulation problems, and so, they suggested that the presence of peripheral neuropathy could be used as a simple way to indicate which high-risk patients with diabetes are in need of intensive care and monitoring.

Practice Pearls:
  • Patients with diabetes are at higher risk of developing cardiovascular disease and strokes.
  • Predicting which patients are at higher risk of developing cardiovascular disease is very difficult.
  • Patients with peripheral neuropathy are at a greater risk of developing heart and circulation problems, and therefore, peripheral neuropathy could be used as a way of identifying patients who are at high risk of cardiovascular disease.
Press Release, St. George's, University of London
Peripheral neuropathy and the risk of cardiovascular events in type 2 diabetes mellitus. Heart doi:10.1136/heartjnl-2014-305657,