Foot neuropathy and Dr. Bernstein

[PaulWright]

I’m sure this is a regular topic, but as a sufferer of very uncomfortable feet caused by type 2 diabetes I’m intrigued by some of Dr. Bernstein’s opinions. It was sore feet that first alerted me to a problem nearly 4 years ago, but thanks to a LCHF diet I got my BS down to non-diabetic levels within months. My foot neuropathy, however, stayed pretty static and slightly more manageable towards the end of last year. Things started to worsen at the beginning of this year, but I have steadfastly kept to a strict diet (my GP is happy with an HbA1c of 39 but thinks I’m too hard on myself) in the hope that the extra pain was only temporary. Turning to the well known Dr Bernstein, his thoughts and video are often quoted in relation to improving diabetic peripheral neuropathy symptoms. He strongly refutes mainstream medical opinion that damaged nerves cannot repair themselves, claiming that healing can occur over a number of years if healthy blood sugar levels are maintained.

I know I’m probably wasting my time even dreaming that you can dramatically improve neuropathy (and I’ve tried r-ALA, B12 etc supplements), but I wonder if there’s anyone who can actually backup Dr Bernstein’s claims? He seems to think that nerve repair is accompanied by major increases in pain, but the end result is worth it. Again, has anyone ever actually experienced the process that he describes? I’m not thinking so much of those people fortunate enough to find major improvements within months, but those like me who have endured this condition for a few years. Personally, I’ve become pretty pessimistic about a positive outcome, and suspect Dr Bernstein is offering false hope.

 

[AloeSvea]

I've had nerve damage in my feet for nearly 40 years! Since I was a teenager. Not in the nerves close to the surface, but more interior nerves, so a very thorough podiatrist told me. I have no idea how it happened - either a dramatic B12 deficiency, which is quite possible, or exposure to toxins - just as possible. But no, I have lived with it since. When I had uncontrolled diabetes (when I didn't know I had it) with blood glucose at a very high level it was excrutiating. Much better since finding out that the 'burning feet' and 'overheated feet' I had thought it was all those years was actually misfiring nerve messages. R-LA does in fact offer me considerable relief. As well as the well-controlled diabetes. But permanent? Yes.

So my guess would be - permanency is a 'on a case by case' basis. No real help to you, I am sure. But a good podiatrist - and ask around (I have had two and they were hugely different) will be able to really help you with such a prognosis.

 

[Mbaker]

Do you walk. In my early stages of diagnosis I noticed that as I increased walking both hand a feet tingerling went away, permanently. I did walk and exercise alot, so it may have something to do with increased circulation.

 

[Crocodile]

@PaulWright I have neuropathy in my feet. It has improved over time but very slowly. I did not experience an increase in pain before it improved. In my case it was never causing me a great deal of pain or discomfort, just an odd sensation of numbness and a bit of a burning or tingling feeling. Over the last couple of years of having good control of my BG it has got to the point where I get a small amount of numbness but no pain. I tried r-ALA and I have to say it appeared to work at first but as the condition improved it's effect became less. I no longer take it and rely solely on good BG control. To answer your question, in my specific case, it did not follow Dr Bernstein's path of increased pain before repair. That doesn't mean that others may have a different outcome. As it stands today, if it stays if it stays where it is now I won't be complaining. I really only notice it when I think about it or take my shoes off. I will soon be trying a TENS device as soon as I finish a bit of research.
Have fun,
Glenn

 

[PaulWright]

I've had nerve damage in my feet for nearly 40 years! Since I was a teenager. Not in the nerves close to the surface, but more interior nerves, so a very thorough podiatrist told me. I have no idea how it happened - either a dramatic B12 deficiency, which is quite possible, or exposure to toxins - just as possible. But no, I have lived with it since. When I had uncontrolled diabetes (when I didn't know I had it) with blood glucose at a very high level it was excrutiating. Much better since finding out that the 'burning feet' and 'overheated feet' I had thought it was all those years was actually misfiring nerve messages. R-LA does in fact offer me considerable relief. As well as the well-controlled diabetes. But permanent? Yes.

So my guess would be - permanency is a 'on a case by case' basis. No real help to you, I am sure. But a good podiatrist - and ask around (I have had two and they were hugely different) will be able to really help you with such a prognosis.

I've had nerve damage in my feet for nearly 40 years! Since I was a teenager. Not in the nerves close to the surface, but more interior nerves, so a very thorough podiatrist told me. I have no idea how it happened - either a dramatic B12 deficiency, which is quite possible, or exposure to toxins - just as possible. But no, I have lived with it since. When I had uncontrolled diabetes (when I didn't know I had it) with blood glucose at a very high level it was excrutiating. Much better since finding out that the 'burning feet' and 'overheated feet' I had thought it was all those years was actually misfiring nerve messages. R-LA does in fact offer me considerable relief. As well as the well-controlled diabetes. But permanent? Yes.

So my guess would be - permanency is a 'on a case by case' basis. No real help to you, I am sure. But a good podiatrist - and ask around (I have had two and they were hugely different) will be able to really help you with such a prognosis.

Thanks for your thoughts. I agree every case is different, which is why outcomes are so frustratingly difficult to predict. I saw a podiatrist back in 2015, but if things don’t improve I’ll give it another try. Along with perhaps acupuncture, you get to the point of trying anything. Probably no point in hanging onto Dr Bernstein’s optimism!

 

[PaulWright]

Do you walk. In my early stages of diagnosis I noticed that as I increased walking both hand a feet tingerling went away, permanently. I did walk and exercise alot, so it may have something to do with increased circulation.

I used to love walking and hugely miss the painless pleasure it used to be. I’ve tried walking more to see each time if it could help, but it always results in worse pain that night and sometimes for days afterwards. Some months ago I walked 5 miles one morning, way more than I’ve done since my neuropathy started, and paid the price within a day or two. Unfortunately, I found my toes became redder and more wrinkled later that week and I would not repeat the experience. So disappointing given that every GP I’ve spoken to recommends exercise and claim it will not cause further nerve damage. I’d try to endure the pain if Dr Bernstein’s views are truly achievable.

 

[Indy51]

Are you taking metformin? Have you ever been tested for Vitamin B12 deficiency? If not, you should be:

https://www.medscape.com/viewarticle/719043_1

Metformin can cause B12 depletion and that causes symptoms similar to neuropathy.

 

[PaulWright]

Are you taking metformin? Have you ever been tested for Vitamin B12 deficiency? If not, you should be:

https://www.medscape.com/viewarticle/719043_1

Metformin can cause B12 depletion and that causes symptoms similar to neuropathy.

I was on a low dose of metformin until mid-2016, but have been medication-free ever since. My diet is rich in foods containing B12, and this year I’ve been taking a daily B12 supplement. Although my GP doesn’t think this is a factor, I will ask for my next blood test to check it out. Thanks for your input.

 

[Alison54321]

I have had type 1 diabetes, and not had any problems with my feet yet, which I consider to be lucky. However, despite my lack of experience, I completely believe Dr Bernstein, that symptoms can improve with better control, because I want to believe it.

I do think, however, that it's a good thing to give your body as much help as you can. There is evidence that bioactive compounds in fruit and veg are neuroprotective, so increasing the amount in your diet might help speed up the process.

I think this because, if you want your body to heal itself, then give it the tools to do it, and as nutrient rich a diet as you can manage will help, subject, of course, to keeping blood glucose under control.

This article is a bit hard work to wade through, but the conclusion at the end is that the bioactive compounds discussed have potential as therapeutic alternatives.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997385/

 

[PaulWright]

I have had type 1 diabetes, and not had any problems with my feet yet, which I consider to be lucky. However, despite my lack of experience, I completely believe Dr Bernstein, that symptoms can improve with better control, because I want to believe it.

I do think, however, that it's a good thing to give your body as much help as you can. There is evidence that bioactive compounds in fruit and veg are neuroprotective, so increasing the amount in your diet might help speed up the process.

I think this because, if you want your body to heal itself, then give it the tools to do it, and as nutrient rich a diet as you can manage will help, subject, of course, to keeping blood glucose under control.

This article is a bit hard work to wade through, but the conclusion at the end is that the bioactive compounds discussed have potential as therapeutic alternatives.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997385/

I, too, am a great believer in the body’s ability to heal itself if given the right nutrition and healthy lifestyle. That in part is why I still haven’t quite given up the idea that nerve regeneration is possible. I certainly try to eat plenty of vegetables every day as I enjoy them, and find that even large amounts have little impact on my post-meal BS levels. The article you mention is certainly very ‘technical’, but it bears out how much we still have to learn about Nature’s natural remedies. Many thanks for your insight to this issue.

 

[Brunneria]

I think the key factor with Bernstein’s opinion, is that he expects his patients to keep their blood glucose really low.
From memory, i think his goal is an average of 4.7mmol/l

That is a heck of a lot lower than most of us achieve. And it equates to an HbA1c of around 27, I think.


Certainly it is lower than your 37.
So maybe he would say that your bg simply isn’t low enough to heal the damage.
Depressing, isn’t it?
My own HbA1c is around the same as yours, and I am on a zero carb way of eating, so I have no realistic way of lowering my score more without drugs.
Presumably this is why Bernstein prescribes insulin to his T2 patients - to get their bg down to what he considers normal.

 

[PaulWright]

I think the key factor with Bernstein’s opinion, is that he expects his patients to keep their blood glucose really low.
From memory, i think his goal is an average of 4.7mmol/l

That is a heck of a lot lower than most of us achieve. And it equates to an HbA1c of around 27, I think.
View attachment 28807

Certainly it is lower than your 37.
So maybe he would say that your bg simply isn’t low enough to heal the damage.
Depressing, isn’t it?
My own HbA1c is around the same as yours, and I am on a zero carb way of eating, so I have no realistic way of lowering my score more without drugs.
Presumably this is why Bernstein prescribes insulin to his T2 patients - to get their bg down to what he considers normal.

Thanks Brunneria, that’s rather what I suspected Dr Bernstein was saying: you may need to achieve BS levels that for most type 2’s are simply too low to be achievable. I know my GP considers my figures to be very good and cannot see any justification for medication, let alone prescribe insulin. It makes Dr Bernstein’s strategy an unreachable goal for people like me and many others. Nevertheless, I will continue to try and get my BS levels even lower.

 

[Brunneria]

Thanks Brunneria, that’s rather what I suspected Dr Bernstein was saying: you may need to achieve BS levels that for most type 2’s are simply too low to be achievable. I know my GP considers my figures to be very good and cannot see any justification for medication, let alone prescribe insulin. It makes Dr Bernstein’s strategy an unreachable goal for people like me and many others. Nevertheless, I will continue to try and get my BS levels even lower.

I think that keeping them steady is just as important.
I'm a lot less interesting in driving them lower, than in keeping them from dipping and rising too much.
The reason for this is that a couple of years ago I went on hol and had a bit of a carb splurge. I was wearing a Freestyle Libre at the time, and noticed that my predicted average HbA1c was the same, but instead of sticking in my normal range of 6mmol/l plus or minus a bit. I spend a week fluctuating from 4-12 and back again.

And boy could I feel it.
Started to get stabbing pains in my feet, and generally felt dreadful.
That all went away and I felt like normal again, as soon as I got home and went back to my normal eating.

So I guess I am saying, don't give up hope. It may be that by keeping your bg in a v narrow range you can see some significant improvements, even if you don't hit Dr B's targets.

 

[PaulWright]

I think that keeping them steady is just as important.
I'm a lot less interesting in driving them lower, than in keeping them from dipping and rising too much.
The reason for this is that a couple of years ago I went on hol and had a bit of a carb splurge. I was wearing a Freestyle Libre at the time, and noticed that my predicted average HbA1c was the same, but instead of sticking in my normal range of 6mmol/l plus or minus a bit. I spend a week fluctuating from 4-12 and back again.

And boy could I feel it.
Started to get stabbing pains in my feet, and generally felt dreadful.
That all went away and I felt like normal again, as soon as I got home and went back to my normal eating.

So I guess I am saying, don't give up hope. It may be that by keeping your bg in a v narrow range you can see some significant improvements, even if you don't hit Dr B's targets.

Again you make a very important point, and one that I totally agree with. I usually have pre-meal BS in the 5s and post-meal (2hrs later) in the 6’s. I very rarely go just over 7, but still aim for even lower figures. I should add that even my current results have improved since early this year, following minor tweaking of my diet, and my early morning BS is now regularly in the 5’s - at last! If anything, I have to admit I’ve become obsessive about totally avoiding foods that I know will put me outside my desired levels. Managing diabetes is truly a marathon and not a sprint, which is why I’m faintly optimistic that my worsened neuropathy could yet be the prelude to improvement down the line. Encouragement and support is so welcome when coping with nerve pain that is so disruptive to everyday life. Thanks again.

 

[Kikeena_]

I found a small dose of B12 not very useful but have upped it considerably to 5 times the recommended dose. It is working very well now. There's actually no upper limit for B12.

 

[LooperCat]

@PaulWright - I recently (January) drastically reduced my carbs and therefore my HbA1c, it’s now at 40, so similar to yours. My toes had gone quite numb, which after a couple of years of stabbing pain, came as a bit of a relief, even though I knew the potential for disaster. In recent months, I’ve noticed the numbness receding, and the pain is back - I firmly believe that this is the nerves regenerating. I’m certain neuropathy can be reversed, because the trigeminal neuralgia I was days away from having pretty horrendous surgery for, has almost gone.

 

[Matteo1980]

Also suffering from neuropathy,mostly at bedtime so I cannot sleep. A question guys please: I am having also a very bad knee pain. Of course,the pain is at its highest when i go to bed! Does anyone else have knee pain with neuropathy? Or it cannot be related to neuropathy?
Thanks for any anawer!

 

[PaulWright]

@PaulWright - I recently (January) drastically reduced my carbs and therefore my HbA1c, it’s now at 40, so similar to yours. My toes had gone quite numb, which after a couple of years of stabbing pain, came as a bit of a relief, even though I knew the potential for disaster. In recent months, I’ve noticed the numbness receding, and the pain is back - I firmly believe that this is the nerves regenerating. I’m certain neuropathy can be reversed, because the trigeminal neuralgia I was days away from having pretty horrendous surgery for, has almost gone.

Thanks for your thoughts Mel. Like you I choose to remain optimistic in the face of doctors who are convinced that the best you can hope for is to stop neuropathy getting worse. Basically, learn to live with it. I know Dr Bernstein’s views on this are still dismissed by the establishment, but there’s nothing to lose by never giving up.

 

[Alison54321]

Hello @PaulWright seeing as you thread has come back to life, I'll pass on some information I found after I left my last comment.

This research shows that vitamin C supplementation can reduce complications in people with type 2 diabetes after blood sugar control is improved, in a way that just improving blood sugar doesn't.

https://www.nutritionexpress.com/article+index/health+concerns/diabetes/showarticle.aspx?id=1714

So there is probably a link between antioxidants, especially vitamins C and E, and reducing complications. I tend to prefer eating foods that contain those nutrients to supplements, but you might want to do some more googling on this.

 

[PaulWright]

Hello @PaulWright seeing as you thread has come back to life, I'll pass on some information I found after I left my last comment.

This research shows that vitamin C supplementation can reduce complications in people with type 2 diabetes after blood sugar control is improved, in a way that just improving blood sugar doesn't.

https://www.nutritionexpress.com/article+index/health+concerns/diabetes/showarticle.aspx?id=1714

So there is probably a link between antioxidants, especially vitamins C and E, and reducing complications. I tend to prefer eating foods that contain those nutrients to supplements, but you might want to do some more googling on this.