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Nerve Pain

Discussion in 'Reactive Hypoglycemia' started by jeffreyman777, Nov 10, 2018.

  1. jeffreyman777

    jeffreyman777 · Member

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    Hey Folks,

    Hope you are well.

    I have been diagnosed with Reactive Hypoglycemia in 2010, i have managed to control this eating more protein and fibre meals, cutting out alot of sugars. In 2010 i had bad burning and tingling in my arms and legs, i had alot of investigations including MRIs and blood tests with no abnormality found, this settled down on its own.

    This has reoccurred again, a few months ago, further tests did not show any abnormality. It is either a small fibre neuropathy or functional sensory neurological symptoms, with the cause being unknown. Does anyone kindly know if Reactive Hypoglycemia could have caused this and does anyone please know any herbal supplements or vitamins that may help? My GP has prescribed me Amitriptyline but this causes awful fatigue and only works for a short period of time.

    Thank you so much for any advice you can give, i appreciate your time and your support. Thanks again.

    Best Wishes,

    Jeffrey
     
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  2. Guzzler

    Guzzler Type 2 · Expert

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    Hello and welcome to the forum. I am sorry that I can't help with your problem as I do not have RH but may I suggest you request that a moderator move your post to the RH section of the forum where you may get more views and possibly some advice?

    To highlight your request just select a mod by putting an @ in front of their name in a comment here and they will answer any query.

    Best of luck.
     
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  3. alanj

    alanj Type 2 · Newbie

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  4. jeffreyman777

    jeffreyman777 · Member

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    Thank you for getting back to me.

    I am sorry i appear to have posted in the wrong thread, i do hope the moderators will kindly help move this thread and see if i can get any advice on this matter. Thank you again for your help.

    @Lamont D @Brunneria @Administrator @DCUKMod
     
  5. Brunneria

    Brunneria Other · Moderator
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    Hi and welcome @jeffreyman777

    I will move your thread to the RH section, and hope it gets more attention. :D
     
  6. Guzzler

    Guzzler Type 2 · Expert

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    Hi, it isn't the wrong place at all, don't worry. It is just that it isn't in a place as heavily frequented as others. Good luck.
     
  7. Brunneria

    Brunneria Other · Moderator
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    Hi again @jeffreyman777 :)

    With regard to your question, yes, people with RH can get neuropathy, most likely because of the rapid blood glucose highs and lows. Even pre-diabetics can experience it, and they probably don’t have the glucose rollercoaster we do.

    I am sorry to say that i have to log off in about 2 mins (its a school night ;) ) but if I can just give you a v abbrieviated version of what I would normally say:

    • The key to avoiding further neuropthy damage is almost certainly keeping blood glucose low and steady.
    • For RHers this usually means a low carb diet.
    • Each of us needs to work out how low is low, to suit our bodies, so get thee a blood testing meter.
    • Dr Bernstein (expert diabetes specialist in America) says that if we normalise bg and keep it low, then nerves DO heal, although progress may be frustratingly slow. His patients show that this works.
    • Have a google and a forum search (search box top right of forum) for discussions on R ALA also known as alpha-lipoic acid it is a supplement that seems to help reduce/heal/slow down neuropathy, and is prescribed as such in enlightened germany, but not in the UK. However easily sourced from Amazon.
    • Also have a read of the neuropathy section of the www.bloodsugar101.com website. It is aimed at type 2 diabetics, but much of the info will be helpful to you
    Hope that helps!
    Will check in again tomorrow if anything else springs to mind. :D
     
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  8. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    Oh yeah, I do occasionally get the tingling burning itching, always only upper arms, it can be so awful. Sometimes it's like my upper arm bones are on fire, and so itchy!
    Hi and welcome to our forum, it's good to know you have good control of your RH!
    And the dietary changes have worked.
    As far as I'm aware, there is no reason for this itchy burning as far as my GP and endo are aware. I was prescribed antihistamines to ward off the worst of the burning itch, also when it's really bad, frozen peas from the freezer will help.
    I usually get my itching, burning in the evening, so you can get piriton, to help you become drowsy, but don't take these during the day if you are working or driving.

    I'm being nosey, can you tell us how you got diagnosed and the journey to getting your diagnosis? What symptoms and advice from doctors, endocrinologist, dsns?
    I'm really interested in the difference in RH ers and how they control it, and to see if you are aware of how and why. And what you've been advised.

    Best wishes, Jeffrey.

    Welcome to our forum, it's a really good knowledgeable read, about those who have similar conditions.
     
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  9. DaveXF

    DaveXF · Well-Known Member

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    Sounds ruddy awful..
    I was wondering what you meant by the am' only working for a short time?
    Am I right in thinking your discomfort comes back a few hours after taking it?
     
  10. jeffreyman777

    jeffreyman777 · Member

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    Many thanks for all your replies, they are all very helpful.

    Yes DaveXF, it is ruddy awful, that is how i would explain it. The Amitriptyline works for a few hours, but then the pain returns.

    I got diagnosed after having numerous attacks of feeling weak, faint and lightheaded after eating. I then went to an Endocrinologist who diagnosed the condition, i have been advised to eat small meals with complex carbohydrate and protein on a regular basis. It is interesting pre-diabetics can experience these neuropathy symptoms also, they are very uncomfortable.

    I will try the R ALA thanks Brunneria for the great advice, is there anything else i can try please, i am already watching my diet. I do not really want to rely heavily on the GP medication, would a good multi vitamin help address any other nutrients i am missing from my diet?
     
  11. Brunneria

    Brunneria Other · Moderator
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    :)

    Well, I don't know if you have been reading the RH section of the forum, at all? But most people are told to base their way of eating around complex carbs, with meals every few hours - and then feel pretty rough.

    On the other hand, those of us who cut our carbs severely, and go much lower carb, maybe even down to ketogenic levels, get much better blood glucose control and feel sooooo much better. I obviously don't want to speak for anyone else, but in my case, the lower carb I go, the more excellent I feel. :D

    Have a read round, and you will find I am not the only one.

    It is basically because eating carbs triggers insulin, and for we RHers, the problem is that our insulin overshoots and sends us into the hypo. But if you avoid foods that trigger insulin, then no over shoot, and no hypo. We can easily get all our nutrition from low carb foods (there is no dietary requirement for carbs at all). In fact, once you eliminate all the rice, bread, pasta, potato, other grains, and starchy veg, then there is plenty of room left on the plate for much more nutritious foods like veg, salads and a huge variety of meat, fish, eggs, cheese and healthy (unprocessed) fats like butter and olive oil.

    When I drastically cut my carbs I also improved my diet dramatically, mainly because I wasnt' filling myself up with pointless starchy bulk.

    As for a good quality supplement... well it certainly won't do any harm. :)
    Sometimes people add some supplements such as magnesium and potassium when they go v low carb, and I myself take those and several others, following some (non-RH and non-Diabetes related) digestive upset in the last year. But it really is a matter of personal choice. You could have a look at Chromium because it has a reputation for helping glucose regulation, but it has never made a blind bit of difference to me. On the other hand, for me, adding in Vitamins D3 and K2 made a noticeable difference to my overall wellbeing. But I don't think they made any difference to my glucose regulation.

    :)
     
  12. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    Hi again, unfortunately complex carbs are as bad as high GI carbs, because as @Brunneria has said the carbs are too high and will trigger the overshoot.
    We RH ers have a problem with carbs that turn to glucose, it is an intolerance, that intolerance will always effect your blood glucose levels.
    We cannot cope, if you are like me more than a low percentage of any carbs, under 5%, will trigger a spike, then a low, the best way to control is to not spike.
    We have a carb intolerance. It sounds daft, it defies logic and medical advice, it also goes against every dietary advice you would have heard, but it does work.
    My logic is why eat something that makes you ill?
    And if you avoid them, you are healthier?

    It will take time to get good control, but because dietary lifestyle is the only treatment, you should be eating the foods that don't have an effect on your health.

    I don't take supplements or extra vitamins, because once I got control, I found my health changed for the better and it just wasn't necessary.
    I am of the opinion, that unless you have a deficiency in the vitamins you are supposed to have by tests done, you shouldn't need them.
    Just my opinion.

    If you are having trouble getting your head around it all, keep asking, no questions are stupid, knowledge is key in understanding how and why you are getting these symptoms.

    Best wishes
     
  13. SimonCrox

    SimonCrox · Well-Known Member

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    I would get my vitamin D level measured as well as vitamin B12 and thyroid function (I was low on Vit D (as are most UK residents) and B12); if you have seen an endocrinologist, they have probably already measured these. It is just a long shot, but sometimes neuropathy is attributed to the glucose problem but there is another contributory problem. And the vitamin replacement is easy.
    There are other drugs than amitriptylline such as duloxetine, pregabalin and gabapentin; but the side effects are annoying so it is a case of starting at a very low dose and working up slowly.
    Best wishes
     
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  14. Winnie53

    Winnie53 Type 2 · Well-Known Member

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    @jeffreyman777 I came here to grab a link to share with an acquaintance who has been diagnosed with hypoglycemia. Saw your question and agree with everyone's responses whole heartedly.

    When members of our diabetes group come to us with diabetic complications, I immediately encourage them to get started on a good quality B-complex and 600 mg alpha lipoic acid daily initially.

    Once they're better they can then switch to a good quality multi-vitamin with minerals supplement, D3, K2 (MK-7), and minerals as needed. Magnesium is probably the most important (because its required for almost 300 different processes in the body and I believe 75% of adults are deficient). If they have a thyroid condition, 200 mg selenium is often helpful. Zinc is another mineral that I personally choose to take because it's helpful fighting off viruses. There are other minerals too. One member of our group benefits from taking potassium but I can't remember why. Sorry.

    If diabetic complications return, I'd resume taking the B-complex and alpha lipoic acid. If inflammation is an issue, I suggest adding a good quality turmeric (curcumin) supplement.

    This is all done of course with a healthy low carb diet, regular exercise, quality and adequate sleep, and stress management. It takes time to build all these healthy routines into our lives, how long varies. Be kind to yourself.

    I'm going to speculate that the reason some with mild glucose issues develop complications while others who have moderate to severe glucose levels don't develop complications, at least for a while, is due to nutritional deficiencies.

    The brain and nervous system are happiest with daily intake of healthy fats. Cod liver oil is a good source of vitamin A, fish oil is a good source omega-3 fatty acids, DHA, and EPA. Green olives, avocado, coconut, and their oils, are good sources of healthy fats, as is fat from animals, poultry, fish, and seafood fed their natural diet. Do not eat farmed fish. Raw nuts such as almonds, walnuts, pecans, and a few other nuts are a good source of omega-6 fatty acids, fiber, and nutrients.

    Before I go... I'm a bit perplexed by the itchiness of the the arms and legs. If the above does not help, I'd definitely learn more about autoimmune disease and how to do an elimination diet. Sometimes gluten found in wheat, rye, and barley, and "hidden gluten" found in quite a few processed foods IS THE PROBLEM.

    I believe it's estimated that 1 in 15 people have non-celiac gluten sensitivity (NCGS). Symptoms can occur anywhere the nervous system travels, in other words, anywhere in the body. And symptoms vary greatly. More than 300 symptoms of Celiac and NCGS have been documented. With the elimination diet, all potentially offending foods are removed from the diet, then added back, one at a time. If symptoms go away on the elimination diet, then return when a specific food is re-introduced within days to a few weeks, bingo, you've identified a food your immune system is reacting to and attacking, damaging surrounding tissue in the process (which causes symptoms).

    Some, myself included, who have NCGS have given up eating wheat, rye, and barley, and also greatly limit or have eliminated all other grains from their diet.

    But again, only 1 in 15 have this problem, so the odds are in your favor. Hopefully the combination of lifestyle changes and specific supplements will restore your health.

    I had hypoglycemia throughout my 20's and early 30's. It was miserable at times. Hope you're feeling a lot better soon.
     
  15. Winnie53

    Winnie53 Type 2 · Well-Known Member

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    Here's a something I wrote a while back that might be helpful...

    In this study, “Treatment with α-Lipoic Acid over 16 Weeks in Type 2 Diabetic Patients with Symptomatic Polyneuropathy Who Responded to Initial 4-Week High-Dose Loading” (2015), they used a loading dose of 600 mg of alpha lipoic acid three times a day, 30 minutes after each main meal for one week, then reduced the dosage to 600 mg once a day with good results...

    https://www.hindawi.com/journals/jdr/2015/189857/

    And here's another study, this one from 2017...

    https://www.omicsonline.org/open-ac...tic-polyneuro-2161-1459-1000241.php?aid=91836
     
  16. jeffreyman777

    jeffreyman777 · Member

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    Thank you everyone for getting back to me your responses have been so useful.

    Winnie i will get checked for non-celiac gluten sensitivity, thank you for that. Regarding the auto immune diseases can these be checked on a blood test with my GP, as i have heard of auto immune diseases which are rare attacking just the small fiber nerves?The symptoms seemed to occur after bad attacks of low blood sugar and when i did not have good control over my diet, which makes my think this is why these symptoms have started.

    I am losing weight due to restricting my carbs and wondered if i could add some virgin coconut oil with meals, or if anyone else has any ideas please to try get my weight back to normal again? Regarding my diet, i have enclosed a sample plan for one day below, if anyone could recommend some changes or replacements i would be so thankful. Thank you for all your help everyone.

    Breakfast 08:00am - Low carb toast, peanut butter and marmite, with spring water 500ml
    Snack 12:00pm - Small portion of cheese
    Lunch 2.00pm - Cornish pasty with a selection of fruit, with spring water 500ml
    Snack 5.00pm - Plain natural protein based yoghurt
    Tea 7.00pm - Chicken breast, mixture of vegetables, potatoes, with spring water 500ml
     
  17. Brunneria

    Brunneria Other · Moderator
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    Hi again :)

    I think you need to be testing your blood glucose, before eating, at its highest, and then at its lowest.

    The menu plan you describe would definitely not suit me at all. It has FAR more carbs than works for me.
    The toast might be OK if eaten with peanut butter and butter, because that slows down the carb absorption. The pasty, the fruit and the potatoes definitely wouldn’t be. My blood glucose would be swinging about link a rollercoaster, I would feel rough, and I would get stabbing pains in my feet.

    (I get stabbing pains in my feet if I eat too many carbs for a week or so e.g. on holiday. Once I stop eating too many carbs, it then takes another week for the stabbing pains to subside again. I assume it is neuropathy. And I know that keeping my blood glucose low and steady stops the pain and prevents it from progressing.)

    From what you describe, I would not be blaming your neuropathy on the hypos.
    I would be blaming it on the repeated daily highs and lows of your blood glucose caused by 3 or more portions of starchy or sweet carbs a day.
     
  18. Winnie53

    Winnie53 Type 2 · Well-Known Member

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    Jeffrey, thank you so much for describing what you're eating - I've itallicized the good choices you're making...

    Breakfast 08:00am - Low carb toast, peanut butter and marmite, with spring water 500ml
    Snack 12:00pm - Small portion of cheese
    Lunch 2.00pm - Cornish pasty with a selection of fruit, with spring water 500ml
    Snack 5.00pm - Plain natural protein based yoghurt Not sure...compare your yogurt to FAGE 5% yogurt... https://uk.fage/yoghurts/fage-total#fage-total
    Tea 7.00pm - Chicken breast, mixture of [non-starchy] vegetables, potatoes, with spring water 500ml

    I agree with Brunneria. Trying to think of a time when I haven't [giggle]. She's incredibly knowledgeable.

    So Jeffrey, to turn your situation around, you're going to need to unlearn everything you've been taught about nutrition. And I should add here that it was very difficult for me but I did it anyway. Every time my brain yelled at me that the low carb ketogenic diet would give me a heart attack or damage my kidneys, I reminded myself again and again that if that were true then why do most people who do the diet experience dramatically improved lab test results over the first months, year, and beyond?

    I had a lot of anxiety about the diet and relied heavily on those here for guidance and reassurance. It's good that you are doing this. Keep doing it.

    There are three macronutrients: carbs, protein, fat.

    We have been taught that carbs are healthy and fat is bad.

    We need protein to build and rebuild our body, so in general, protein remains the same across most diets so we won't focus on that for now. Most people eat animal and plant based proteins. Some eat only animal, while some eat only plant based protein. I'm going to assume you eat both.

    Our body can get all the energy it needs from carbs, or fat, or both. Here's where the problem comes in. For those who have raised insulin levels - (you can ask your doctor for a fasting insulin level but I don't know what the healthy range is for the units used in the UK) - and wide ranging glucose levels, using fat for energy works better because, unlike sugars and starches, it doesn't raise insulin or glucose levels.

    1) If you choose to do the low carb ketogenic diet, I encourage you to become a member of Diet Doctor, at least for a few months, to learn everything you can there about what to eat. I assure you, it's a steep learning curve and requires commitment.

    2) You won't be hungry but you'll be battling cravings for sugar and starch the first couple of weeks. You'll also experience withdrawal symptoms because your brain likes the sugar hits and some of the microbes in your gut will be screaming at your brain via the vegas nerve to resume eating the sugars and starches immediately.

    3) To achieve satiety, you'll need to include a healthy fat, some protein, and a non-starchy vegetable for nutrition and fiber - (no grains, no starches, no sugar) - with every meal or snack.

    4) You'll need to drink lots of water as your body changes over from burning carbs (glucose) for fuel to fat (ketones) for fuel. You'll also need to supplement with salt daily (because you're no longer eating processed foods and your kidneys will begin dumping electrolytes, particularly sodium. You may wish to supplement with magnesium and potassium. I did all three: salt, magnesium, and potassium. A simple way to supplement salt is to dissolve a 1/4 teaspoon of salt in hot water and drink one or more times daily. I do this anytime I feel light headed or when I have a headache. It typically works after a couple of hours.

    5) Test glucose before each meal, and one or two hours after each meal. That's how we learn how each food affects our blood sugar. How well you tolerate a specific food may evolve over time. I initially ate 1/4 of a carrot on my salad. Now I eat one whole carrot every day. Also, test when you're having symptoms. It helps to keep a food, symptom, and glucose log.

    6) Learn how to make a "One-Minute Keto Mug Bread" but use butter instead of olive oil... https://www.forkly.com/recipes/one-minute-keto-mug-bread/

    Here's a list of good and bad fats to help you navigate the new world of eating fats and oils to get you started... http://drcate.com/list-of-good-fats-and-oils-versus-bad/

    Here's more from Catherine Shanahan, M.D.... http://drcate.com/video/the-real-skinny-on-fat-documentary-episode-1-the-beginning-of-the-end/ and

    I have listened to these presentations three to six times in the last week.

    There are also many sources of whole food fats which I encourage you explore... Plant based ones are green olives, coconut, avocados, RAW nuts such as almonds and walnuts, macadamia nuts, I like pecans too. Animal based ones are animal fat, full fat cream, cream cheese, yogurt, butter, and cheese. Learn to cook meat with bones in. Cook chicken with bones in, skin on. Bacon adds flavor to meals. A favorite go to food for me when I first started the diet was a slice of ham, a chunk of cream cheese, and sliced dill pickles rolled. Today, if I have a sugar craving, I eat a pat of butter or a spoon of peanut butter - (the kind you have to stir and refrigerate). Actually, I eat almond butter now.

    For breakfast, I have two eggs, butter, onions, cauliflower, broccoli, mushrooms, and gouda cheese.

    For lunch, I have a leafy green salad topped with meat, nuts, raw vegetables, cheese, and a vinaigrette made with extra vigin olive oil, vinegar or lemon juice, and spices.

    For dinner, meat and vegetables with one or more fats such as a healthy oil, butter, or coconut oil. Sometimes I'll add a tablespoon of yam sliced to my steamed or sauted vegetables.

    I didn't eat low carb berries, lemon and lime initially, but you can in small amounts.

    Once I became fat adapted, I stopped snacking and stopped eating 3 hours before bed time. That is a step that may take time for you because of the hypoglycemia.

    A popular quote that helps me is... "Nothing tastes as good as healthy feels."

    I'm sure I'm forgetting something, but the Diet Doctor site should fill in any details I left out. Best of luck to you. :)
     
    #18 Winnie53, Nov 26, 2018 at 1:16 AM
    Last edited: Nov 26, 2018
  19. Winnie53

    Winnie53 Type 2 · Well-Known Member

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    Here's another thought... Instead of trying to change your diet all at once, which is more my style, why not start by changing just one of your three meals a day, and ease into it? I think it's harder that way because it will drag out changing from sugar and starch burner to fat burner, but we each have to find our own path. It's your life. You can jump in with both feet, or wade in. :)

    Oh, and I forgot to mention this. When your body begins burning fat, look out. You'll likely have more energy than you've had in years!
     
  20. jeffreyman777

    jeffreyman777 · Member

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    Thank you very much for getting back to me regarding the issues i have been making with my diet.

    It sounds like you are correct Brunneria, the constant high and low blood sugars have caused this neuropathy pain. To try and resolve the nerve pain, would a low carb diet be enough, for instance switching out the Cornish pasty and potatoes for something much lower in carbs? Further or would i need to realistically go onto the low carb ketogenic diet please?

    If anyone could give me a few examples for breakfast, lunch and dinner i would be grateful. I am very thankful Winnie for the examples you have provided. So realistically would i need eggs every morning, is there any other alternatives please, as i am used to having low carb toast and low carb cereal in a morning, this would be a drastic change for myself?

    Thank you again for all your support and hopefully if i see through these changes hopefully i can maybe get my life back again.
     
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