Diabetic Peripheral Neuropathy--Causes and Treatment

 Diabetic Peripheral Neuropathy (DPN) is often one of the most painful results of diabetes.  The Neuropathy Association reported in 2013 that neuropathy in the United States is "skyrocketing."  Between 15 and 18 million Americans have DPN.  DPN affects the nerves in the hands and feet, causing numbness, tingling and pain.  Nerve problems may also occur in the digestive tract, the heart, eyes and other organs. The pain can be a "pins and needles" feeling, a burning sensation, and/or shooting and electric shock pains.


There is often confusion in the medical profession as to how diabetes causes DPN.  Some theorize that the excess blood sugar affects the protective coating on the nerves.  Others believe decreased blood flow to the nerves can cause damage.

However, there is more evidence forming that the largest cause of DPN and even peripheral neuropathy not related to diabetes is a B-12 and/or folate deficiency.  B-12 deficiency causes demyelination of the nerves, allowing damage to the nerves and increased sensitivity.  Folate deficiency reduces the expression of Nerve Growth Factor and increases lipid peroxidation.

Symptoms and signs of B-12 deficiency can include fatigue, depression, abdominal pain, megaloblastic anemia (enlarged red blood cells), bleeding gums, weakened immunity, bruising, eczema, rapid heart beat, hair loss, muscle cramps, and tingling and numbness in the extremities (peripheral neuropathy).

Symptoms and signs of folate deficiency can include fatigue, grey hair, mouth sores, tongue swelling, growth problems, peripheral neuropathy and megaloblastic anemia causing persistent fatigue, lethargy, pale skin, irritability, and diarrhea.

Deficiencies of both B-12 and folate can cause a swollen, geographic or cracking tongue and beaded vertical ridges on the fingernails.

Causes of B-12 deficiency include low stomach acid (common in diabetes), a vegan diet, celiac disease from gluten, stomach surgery (including surgery to reduce obesity), and less common, pernicious anemia, a lack of intrinsic factor in the stomach.

A concerning cause of B-12 deficiency is the use of the most common diabetic medication Metformin (Glucophage).  Metformin in general is a good medication for diabetes, but it causes B-12 deficiency, and too many physicians are not watching the B-12 levels of their patients on Metformin.

Causes of folate deficiency include poor diet with inadequate vegetables, excessive alcohol use, medications such as birth control pills, dilantin for seizures, antibiotics with trimethoprim such as Bactrim and Septra, chemotherapy agents such as methotrexate, often used for autoimmune diseases such as rheumatoid arthritis, celiac disease, giardia infection, and low stomach acid.

More recent studies are showing the large number of diabetics with the MTHFR DNA mutation.  This mutation keeps the MTHFR enzyme from adding a methyl group (1 carbon and 3 hydrogen atoms) to B-12 and folate, considered the activated form of B-12 and folate and necessary for the cells to be able to use them.  An MTHFR mutation increases the risk of both diabetes and nervous system disorders, especially peripheral neuropathy.  (See my blog post of Feb. 20, 2015 for more information on this common mutation.)

Many studies have been done using folate and B-12 as treatment for peripheral neuropathy.  The FDA has approved a "medical food" by the name of Metanx for the treatment of DPN, which includes methylcobalamine (methyl B-12), 5-MTHF (methylfolate) and P-5-P (the activated form of B-6).  This medication has been proven to improve DPN, but it is expensive and insurance companies often don't pay for it.

SpringTree Methylation Factors contains the same ingredients plus more to improve the functioning of the activated forms of B-12, folate and B-6.  Our SuperMulti Plus also contains 1000 mcg each of the methylated forms of B-12 and folate, along with high antioxidants and glucose tolerating factors which help reduce the damage from high insulin and blood glucose.

Our treatment recommendations for DPN include:

• a high protein and fat, including red meats, high vegetable, no grain and low carbohydrate diet (see previous blogs)--diet is VERY important!
• SpringTree Glucose Balance 2 capsules with each meal to assist in balancing blood sugar and insulin levels
• SpringTree SuperMulti Plus 4 capsules/day
• SpringTree Methylation Factors--start with 1 capsule/day and increase to 3/day if there are no negative symptoms.  (If there is increased nervousness, pain, headache, etc. you could be experiencing over-methylation.  Take niacin 50-250 mg. to stop the symptoms)
• SpringTree Pain and Inflammation 3 capsules one to 3 times a day to reduce the inflammation and the pain caused by DPN
• We also highly recommend getting tested for the MTHFR DNA mutation.  If it is positive we also recommend detox protocols.

SpringTree supplements can be obtained from www.springtreehealth.com.

Until we meet again,
Dr. Judi