General Health – Page 2

Diabetic leg and foot pain can be excruciating. It is often caused by diabetic nerve damage (neuropathy). This is a type of damage that is peculiar to people with diabetes. It is one of the most common complications of diabetes. Pain in the legs can affect up to half of people with type 1 or type 2 diabetes.

This nerve damage may be mild initially, but gradually it gets worse. The pain in the feet may become so bad that it gets in the way of everyday activities.

Nerves are specialised tissues that do several things in the body.

They send information back to the brain about things going on around you through your senses like sight, smell and touch.
They transmit signals from the brain to other parts of the body. This tells them what to do, for example, to wiggle your fingers.
Through the nerves, the brain controls your body functions like your heartbeat and digestion that you can’t control directly.

What causes neuropathic pain in the legs in diabetes?

Over time, uncontrolled and persistent high blood sugar causes damage to the nerves. They malfunction and stop firing the way they should.

High blood sugar, over a long period, damages the blood vessels that feed the nerves. How do you feel when you haven’t eaten? You feel hungry, irritable and you can’t function efficiently. That is exactly what happens to your nerves. They become nutrient-deficient, hungry and irritable.

Different types of neuropathy

Peripheral neuropathy

Peripheral neuropathy usually affects the legs and feet but may also affect the hands.

It is the most common type of diabetic neuropathy. It is usually accompanied by:

sharp pains,
numbness,
tingling/burning,
electric shock sensation and
increased sensitivity to touch.

Peripheral neuropathy is usually worse at night, although it can occur at any time of day.

Autonomic neuropathy

Autonomic neuropathy affects the internal organs – the heart, stomach, intestines and sex organs. Damage to nerves in these areas can lead to:

painful swallowing,
nausea, vomiting and loss of appetite,
diarrhoea, constipation and faecal incontinence,
persistent first heartbeat (tachycardia),
dizziness and fainting when you change position/stand-up (postural hypotension) and
problems with urination.

Proximal neuropathy

Proximal neuropathy affects the nerves in the buttocks and legs. It can lead to:

severe pain,
weakness of the muscles,
shrinking of the muscles and
difficulty in rising from a sitting position.

Mono neuropathy

Mono neuropathy affects a single nerve and can occur anywhere in the body. It may manifest as:

aching behind one eye,
double vision,
paralysis of one side of the face and
weakness of the hands, which may make you drop things frequently.

Risk factors for developing pain in the legs in diabetes

Prolonged, uncontrolled high blood sugar is the biggest risk factor for developing diabetic leg and foot pain.

The longer you have diabetes, the more likely you are to develop nerve damage.

If you have kidney disease, you are at a high risk of developing neuropathy. Being overweight, drinking a lot of alcohol, or smoking puts you at a higher risk.

High blood pressure or high cholesterol increases your risk of developing diabetic nerve damage.

Complications of diabetic nerve damage

Some of the complications of diabetic nerve damage can be worse than the neuropathy itself.

These may include:

fainting and falls – sometimes these falls can lead to death,
amputation of the toes all feet from infected diabetic sores on the feet,
urinary incontinence,
urinary tract infections,
digestive problems and
sexual dysfunction, including difficulty with arousal and erectile dysfunction.

Treatment of foot pain in diabetic nerve damage

In the early stages, you can reverse diabetic nerve damage. This process is excruciatingly slow, but it is possible.

The longer you have had the neuropathy, the worse it becomes. And the harder it is to treat and reverse.

The number one way to slow down the progression of diabetic nerve damage is to bring down and regulate blood sugar.

You’ll need to avoid drastic fluctuations in your blood sugar. Your blood glucose should not be swinging up and down continuously throughout the day, which can also make the pain of nerve damage even worse.

Put some effort into treating the insulin resistance aspect of diabetes and don’t just focus on your blood sugar numbers.

You will need to change the type of food you eat and when you eat. Work on developing good exercise and sleep habits. These and other lifestyle changes will bring down your blood sugar.

Drugs for pain in the legs in diabetics due to nerve damage

Drugs used to treat depression and convulsions can also help with the pain of diabetic neuropathy:

Anti-seizure drugs – Pregabalin (Lyrica) and gabapentin (Gralise, Neurontin) are used to treat epilepsy. Side effects may include drowsiness, dizziness and swelling.
Tricyclic antidepressants – These include amitriptyline, desipramine (Norpramin) and imipramine (Tofranil). Side effects may include dry mouth and drowsines.
Serotonin and norepinephrine reuptake inhibitors (SNRIs) – Duloxetine (Cymbalta) and venlafaxine (Effexor XR) are used commonly. Possible side effects include nausea, sleepiness, dizziness, decreased appetite and constipation.

But these drugs do not actually reverse the nerve damage.

Supplements for diabetic foot pain and nerve damage

Many supplements can help with pain in the legs in diabetes. They may also create an environment that heals the nerves.

Benfotiamine

Benfotiamine is a fat-soluble version of thiamine (vitamin B1). It is better absorbed than thiamine because it is fat-soluble. Therefore, it does a better job of penetrating the fatty myelin sheath that surrounds the nerves.

What does vitamin B1 do? It helps the mitochondria clear glucose from the cell.

Vitamin B12

Vitamin B12 can also help with nerve pain and nerve damage. The methylated form of vitamin B12, known as methylcobalamin, is more effective in non-methylators. Some people cannot methylate cobalamin, so they must take methylcobalamin.

Antioxidants

Antioxidants can be very useful in managing diabetic nerve pain and damage.

Alpha-lipoic acid exists in two forms – the r-fraction is the one that is active in the body. It is a powerful antioxidant.
Pycnogenol – this helps with neuropathy but is also necessary for a healthy heart and healthy blood vessels. It is helpful for hypertension and for managing blood sugar.

Magnesium

The cells use magnesium to process glucose, which helps blood sugar control. Magnesium also helps brain and nerve function. You need it for heart function and maintaining normal blood pressure.

There are many different forms of magnesium, some of which are more effective than others. Deficiency in magnesium can worsen blood sugar control and nerve pain.

Acetyl L-carnitine

Acetyl L-carnitine is a fat-soluble nutrient, so it can pass easily into the nerves where others cannot. It helps to protect the nerves from damage and may also help to reduce pain.

All these supplements work in slightly different ways to help with diabetic nerve pain and diabetic nerve damage.

Of course, you should consult your doctor before taking any supplement, no matter how safe it claims to be.

And once again, these supplements will be most effective when you combine them with lifestyle changes that bring down your blood sugar and treat your insulin resistance.

Have you experienced diabetic nerve pain? Have you used any of the supplements I mentioned above? Let me know in the comments.

Vitamin B1 (thiamine) is an essential nutrient for all living things. The human body can’t make thiamine. You have to eat it in your diet.
Vitamin B1 is abundant in pork, fish, liver, nuts (macadamia, sesame seeds) and yeast.

Are you diabetic? You need this vitamin! Everyone with diabetes should consider taking vitamin B1. Deficiency of this vitamin is much more common if you have diabetes. These problems arise from persistent high blood sugar.

What causes vitamin B1 deficiency?

Once again, a diet high in processed food is one of the culprits. Processed food is taken from its natural form and transformed into something else, usually less healthy.
For example, take a potato that becomes a potato chip. Another example is wheat which is processed to make bread.
Often, these steps needed to transform this food remove many of the vitamins and minerals. A diet that is high in processed food can lead to many different deficiencies.

Another cause of thiamine deficiency is eating too much sugar. Yet another is drinking too much alcohol. Some medications like antibiotics and vaccines can cause vitamin B1 deficiency. Bariatric surgery which alters the stomach and intestine in various ways, can also cause vitamin B1 deficiency.

Only about 5% of the vitamin B1 you eat is absorbed, so you’re more likely to develop vitamin B1 deficiency if you’re not eating enough.

Why is vitamin B1 deficiency a problem if you have diabetes?

Like everyone else, if you have diabetes, you may develop vitamin B1 deficiency from not getting enough in your diet. But there are also additional risks:

the kidneys don’t function well in diabetes which can lead to increased loss of vitamin B1 in the urine and
there is decreased reabsorption of vitamin B1 back into the blood so more is lost in the urine.

Symptoms and signs of thiamine deficiency

In the early stages of thiamine deficiency, the signs and symptoms are very non-specific. These may include:

tiredness,
excessive sleeping,
hair loss,
health problems,
nausea and vomiting and
loss of appetite.

You may also have symptoms like:

burning pain and
a feeling of pins and needles in your hands and feet.

That is similar to what you would find in nerve damage due to diabetes. Eventually, these symptoms and signs progress to:

uncontrolled body movements
difficulty in walking
loss of memory and other mental problems.

At this stage, you cannot reverse the damage that has occurred. In diabetes, vitamin B1 deficiency can manifest as elevated blood sugar and persistent mental problems.

What does Vitamin B1 do & why is it so important in diabetes?

Under normal conditions, when glucose levels are normal and all the required nutrients like vitamins and minerals are present, sugar in the diet is converted to energy in the mitochondria.

The byproducts of this process are called Reactive Oxygen Species (ROS). These ROS are very harmful to the cell. There are mechanisms in place to handle them and ensure that they don’t cause harm to the cell.

When you have high sugar levels for long periods, the mitochondria can’t handle the load. So much ROS are produced that the cell can’t cope. The mitochondria try to protect themselves by churning out large amounts of a powerful antioxidant. In small quantities, this is great, but too much for too long is a problem.

Eventually, this leads to damage to the cells lining the blood vessels. It also causes problems with your nerves which leads eventually to the burning and tingling sensation in the hands and feet.

The cells try to find other ways to process all the sugar. These alternative pathways are not as efficient as processes that take place in the mitochondria. They produce unwanted chemicals as they’re trying to use up all the sugar. These chemicals damage the cells, especially the ones that line your small blood vessels and your nerves.

How does thiamine help in the cells?

Your body needs vitamin B1 to break down sugar efficiently. It helps other enzymes to do their work. In its absence, they cannot work efficiently. So, even if you have high blood sugar and high sugar in the cells, having enough thiamine helps limit the damage it causes and offers some protection.

In diabetes, there is a lot of sugar circulating in the blood. There is also a lot of sugar inside the cells. Your nerve cells send signals to the brain carrying information about what’s happening in your body and in your environment. There is so much sugar in the cell that it can’t be turned into fuel.

And that is the purpose of sugar. It’s supposed to turn into energy. When the sugar is too much, it gets shunted into other pathways that eventually lead to complications like burning and tingling of the hands and feet.

What vitamin B1 does is that it prevents this excess sugar from being channelled into reactions that will give rise to complications. So vitamin B1 is required to process glucose efficiently inside the cell. Unfortunately, people with diabetes tend to be deficient in thiamine when they need it so badly.

Treating thiamine deficiency

You can treat thiamine deficiency in several different ways by:

improving your diet and eating more natural food,
limiting your intake of alcohol,
limiting the amount of sugar in your diet,
supplementation (if you have a severe vitamin B1 deficiency you may not be able to get enough vitamin B1 from your diet).

What is benfotiamine?

Thiamine is a water-soluble vitamin. Only about 5% of what you take in your diet passes into the blood. However, there is another form of vitamin B1 that is better absorbed. This form is called benfotiamine. Benfotiamine is fat-soluble and is absorbed much better than regular vitamin B1. So you will achieve higher levels in the blood.

It also gets stored in the nerves because they have a high-fat content. That means that it can work better than regular vitamin B1 to relieve nerve pain and abnormal sensations that you may get from vitamin B1 deficiency.

Taking thiamine can reduce some of the complications of diabetes by up to 50%.
If you already have complications, taking benfotiamine can help to slow the progression of these complications and stop them from getting worse.

Even if you’re using benfotiamine with all its benefits, you still need to change your lifestyle by treating your high blood sugar and insulin resistance. That would include changes to your diet and managing your sleep and stress.

As always, anything you do that affect your health should be run by your doctor or healthcare provider first.

Have you used benfotiamine before? Or maybe you have been using the more popular form of vitamin B1 form, thiamine? Let me know in the comments.

Category: General Health

Pain in the legs in diabetes (diabetic nerve damage)