Diabetes is the cause of the most common peripheral neuropathies.  In all forms of neuropathy there is an abnormal stimulation of the nerves due to damage that results in pain.  Peripheral nerves are sensitive conduits that carry impulses from extremities back to the central nervous system (i.e. the brain and spinal cord).  Impulses are transmitted along nerves by changes in the electrical charge of the cell membrane caused by movement of ions such as sodium, potassium and calcium.  Impulses are transmitted between nerves by neurotransmitters such as acetylcholine and substance P, which is responsible for transmitting pain impulses.  For protection, most nerves are covered with a thin sheath called myelin, which is made from choline and lipids.  The myelin functions like the rubber wrapping around an electrical cord and it insulates the nerve fibres and prevents abnormal transmissions.

Depending on the nature of the specific neuropathy, some part of this system breaks down.  In diabetic neuropathy, for example, there is a change in the micro vascular network that supplies the nerve with nutrients.  This lack of blood supply causes the nerve to function abnormally.  Diabetic neuropathy tends to occur in more than one nerve area (this condition is called polyneuropathy) and may cause loss of sensation and pain that typically worsens at night.  In severe cases, diabetics can suffer from a kind of neuropathy called autonomic neuropathy.  In this case, the autonomic nervous system, which controls automatic body functions, is affected with possibly serious consequences, including gastrointestinal problems, bladder emptying problems, abnormal heart rhythms and even sudden death.

Pain associated with neuropathy can be very intense and may be described as cutting, stabbing, crushing, burning, shooting, gnawing or grinding.  In some cases, a minimal stimulus such as a light touch can trigger severe pain, or pain may be felt even in the absence of any stimulus.  If a problem with a motor nerve has continued over a length of time, muscle shrinkage (atrophy) or lack of muscle tome, may be noticeable.

Unfortunately, conventional treatment options for most neuropathies are less than ideal.  The following are some of the common strategies.  For diabetic neuropathy, blood glucose control is essential because high glucose levels cause oxidative stress throughout the body.  Animal studies have shown antioxidant therapy, with glutathione and other antioxidants, has been shown to help prevent neuropathy.  Non steroidal anti-inflammatory are most commonly used to control the pain although long term use of paracetamol is not recommended because of the risk of serious liver and kidney toxicity.  For more serious neuropathies other prescription medications may be used such as gabapentin, carbamazepine and pregabalin.  These drugs were originally developed to treat epilepsy but they also work to reduce the pain associated with neuropathy.  Their main side effect is dizziness.  In one study the combination of gabapentin and B vitamins was shown to effectively and significantly reduce pain and improve quality of life. 

Drugs the treat peripheral vascular disease, such as pentoxifylline have also been used to correct nerve conduction deficit.  Another drug, cytomel, used to treat hyperthyroidism is also effective at regenerating damaged peripheral nerves.

Natural & Holistic Approaches to Treatment

The natural neuropathy treatments with the most published success include primrose oil, lipoic acid, capsicum, biotin, vitamin B12 and vitamin B6 and very recently vitamin D has joined the list too.  Natural neuropathy relief is backed by science.  In a double blind, placebo controlled trial using 4-6 grams of primrose oil per day, diabetics with peripheral neuropathy experienced significant pain relief after 6-12 months.  Another study showed that alpha-lipoic acid taken both intravenously and orally for three weeks in 600-milligram daily doses was significantly more effective than placebo in relieving symptoms of diabetic neuropathy.  Research has also shown that a topical cream containing 0.075% capsaicum (an active ingredient of pepper) cut diabetic neuropathy pain in half for 50% of the patients using it (capsaicum can cause burning initially but it usually subsides with persistent use).

Other reports (not double blind, placebo controlled studies) have shown diabetic neuropathy relief from injections of biotin and vitamin B12 and oral vitamin B6.  These can be combined in a single injection, the combination of which is typically 10 milligrams of biotin, 1000 microgram’s of vitamin B12 and 50 milligrams of vitamin B6.  As injections are not the most pleasant way of administering a substance into the body I would suggest first using the oral route.  If this does not work it maybe that poor absorption by the gut is a factor.  This can be treated using holistic approaches, one of which I use is homeopathic vitamins which increase the absorption of the actual vitamin via the gut.  If this does not work then a combination of oral ingestion and vitamin injections can be used.  Oral vitamin D supplementation has shown to decrease pain by 40-50%.  Researchers have reported that 100% of type 2 diabetics they examined with peripheral neuropathy have low serum 25-hydroxyvitamin D levels.  They concluded, “vitamin D insufficiency is under recognised and may be a significant contributor to neuropathic pain in type 2 diabetes.  Vitamin D supplementation may be and effective ‘analgesic’ in relieving neuropathic pain.

By trying one or all of the supplements listed above you may need to give it anywhere from three weeks to a year to determine how well each one may work for you.  This would need considerable patience.  But remember you don’t have to take a ‘stab in the dark’ with supplementation.  BioScan testing is by far the best way to accurately and precisely determines the exact match for you based on analysis of hair or blood.  This is a simple procedure using highly sophisticated instrumentation, which computes your exact nutritional requirements.  This scan can be fine tuned to ascertain which particular preparation of a vitamin is the best one for you to take.  This can have an effect on the way your body absorbs the supplement; a consideration most people neglect.  It is always best to work with your GP or consultant to get your diabetes under the best possible control you can.  This will also help with the pain of the neuropathy and will very likely slow its progression considerably.