I had my annual physical yesterday, and after grilling me on what I was eating and drinking to make sure I was doing things right, my doctor had no explanation for why my A1c didn't drop. As you'd mentioned, MrsD, some diabetics I consulted with said that if I'm eating too much protein, my liver will convert excess into glucose. That's not something I'm monitoring at all, so I'll have look at how much I should be getting, and compare it to the reality. I'm definitely much heavier on the protein than I ever have been.

As I expected, there was a discussion about both my LDL and triglycerides which increased significantly from last year. The triglycerides were still within normal reference range, but I still need to try to understand why they more than doubled. I know they're very sensitive to what you've eaten in the week prior, but I don't remember eating anything hateful before this blood draw.

We had the discussion about bad LDL and benign LDL which I initiated, and she asked if I wanted to get the more refined test to check my LDL particle count to distinguish between the two. I think it will run about $100, and am still trying to decide whether I want to do that or not. I know I can bring my LDL down by just backing off on the saturated fat which would be the path of least resistance, and then just re-check the regular panel in 6 months.

She did at one point ask, "Do you want to take something to bring it down?" She knows I'm not a pill-popper and would decline, but I got the feeling she was obligated to ask. I'm sure "offered and refused" went into her notes.

I wish I had asked for her honest opinion on statins. It would have been interesting to hear her answer.

[QUOTE=janieg;1155632]I had my annual physical yesterday, and after grilling me on what I was eating and drinking to make sure I was doing things right, my doctor had no explanation for why my A1C didn't drop. As you'd mentioned, MrsD, some diabetics I consulted with said that if I'm eating too much protein, my liver will convert excess into glucose. That's not something I'm monitoring at all, so I'll have look at how much I should be getting, and compare it to the reality. I'm definitely much heavier on the protein than I ever have been.

As I expected, there was a discussion about both my LDL and triglycerides which increased significantly from last year. The triglycerides were still within normal reference range, but I still need to try to understand why they more than doubled. I know they're very sensitive to what you've eaten in the week prior, but I don't remember eating anything hateful before this blood draw.

We had the discussion about bad LDL and benign LDL which I initiated, and she asked if I wanted to get the more refined test to check my LDL particle count to distinguish between the two. I think it will run about $100, and am still trying to decide whether I want to do that or not. I know I can bring my LDL down by just backing off on the saturated fat which would be the path of least resistance, and then just re-check the regular panel in 6 months.

She did at one point ask, "Do you want to take something to bring it down?" She knows I'm not a pill-popper and would decline, but I got the feeling she was obligated to ask. I'm sure "offered and refused" went into her notes.

I wish I had asked for her honest opinion on statins. It would have been interesting to hear her answer.

Hi Jan
I hope this finds you doing "ok".. I read you have Idiopathic small fiber Neuropathy. I also suffer with I-Sfn and my first A1C was 5.7. My BS fasting average around 83. I was told I am pre-diabetic. Like you I changed my diet and eat like I am a diabetic. I eat low carb and very little red meat. I get my protein mostly from chicken, fish , vegs and legumes. Lots of avocado, peanut butter, olive oil and walnuts. My A1C did go down to 5.3.
My (2) Endo Docs do not believe my Pre-Diabetes is related to the I-SFN!. My Neurologists "thinks" there may be a correlation between the sfn and pre-diabetes. Its all so frustrating, to think these "Specialists" do not understand any of this...
I did my own research and read studies show even early stage (pre-diabetes) can cause harm to the small fibers and cause neuropathic pain! I am interested in knowing how your sfn started and what kind of "symptoms" or pain your suffern with.
I see you take mostly natural supplements. Do you take anything else for your pain? Mine all started in early 2011 with pins & needles in my calves and burning under both feet. Its been 4 years and it spread to all over my body. Mainly painful pins and needles, roaring tinnitus with surging buzzing and burning. I take 300 mgs Lyrica, and Tramadol as needed. Neither one of these meds help with this type of pain. I take Klonopin for anxiety. I dont know what else to do or who to talk too. I tried all the "first-line" meds, including Gabapentin, Cymbalta and Elavil, nothing worked. What do you take , if anything and how are you coping?
Sorry this response is not an answer to your question or concerns. I felt the need to respond to you because of your I-sfn & Pre-diabetes.
Feeling alone and isolated with pain. Any comments or suggestions would be greatly appreciated. If you like, you can private message me and we can talk further. I think that would be good..
Marie

Your increased Omega-3's should bring down the triglycerides.

Thanks.

I was really surprised my triglycerides went up at all. I need to learn more about them.

I'm thinking for my 6 month check up that I'll spring for the more advanced NMR Lipid Panel that will show LDL particle size as well. Having read what I've read, I can't believe that's not standard operating procedure now.

Hi Marie,

I've not had the blood sugar discussion with my neuro yet, but two other docs I've seen were completely non-committal on whether my mild sugar problems could be responsible for my SFN.

I did not have typical diabetic-SFN onset. I've had paresthesia in my left leg for 30 years since I was in my mid-20s. Docs could never figure out what caused it, and I was left with a diagnosis of "nerve root irritation." Whether or not that has anything at all to do with what I'm dealing with now, I doubt, but it could.

Without going into all the gory details leading up to it, on Nov. 10, 2013 I woke up feeling like I had electric current running through my body. My left leg symptoms were now in my right leg, and I felt odd things all over. They included mild paresthesia in my arms and hands, and really bizarre sensations in my temple areas. At its worst, I would feel electric current running up through my temple and down under my right eye. It was hitting whatever nerve that was. I have a really bad neck, and I somewhat suspect this SFN is "opportunistic" and wherever you have some kind of nerve insult, it magnifies it.

Also at its worst, I'd wake up feeling like my bed was vibrating, or like I was plugged into an electrical socket. My lower legs also twitched like crazy. I'd had that twitching in my left leg all along, but it was now worse, and also my right leg joined the party. (I definitely think the Mag64 I'm taking helped with the twitching.)

Other symptoms are extreme sensitivity to cold and "referred sensation." The latter seems like a unique symptom to me. No one else here has reported it. If I touch my body anywhere from my armpits on down, the constant sensation in my feet gets stronger. So if I touch my left torso anywhere, I "feel it" in my left foot. Very weird.

I don't know how old you are, but you might want to check the "Progesterone Therapy" thread here which is kind of mis-labeled at this point. I strongly suspect that there's a hormonal component to my SFN. (I'm perimenopausal.) That thread will also lead you to another thread MrsD started about neuropathy research. I think the findings out of UC Davis are very interesting. It's that research that has lead me to increase my omega 3s and ALA intake, and I'm also going to go on estradiol to see what that does. As it is right now, I'm feeling better than I have in 20 months. My symptoms are definitely dialed back, and I have no pain. The weird sensations are all still there, but no pain.

My neuro prescribed gabapentin early on, but I no longer take it (by choice). I'm not sure the dosage I was taking, 300 mg at night, was enough to help, so when facing the choice of increasing the dosage, I opted not to. I just didn't want to go down that path if I didn't have to. My discomfort wasn't horrible everyday, but my flares were pretty unpleasant. I would use lidocaine patches and epsom salt lotion to help. And just last month, I got some kratom for the really bad days, but I haven't had to use it (or anything else) in the past couple of weeks.

I'm not supplementing B12 in any form, and my B12 just came back at 835 (normal).

Have to run now. I decided to reply publicly in case it would help anyone else, but feel free to message me anytime.

Janie



[QUOTE=Marie33;1155801]

Janieg, adding to what mrsD wrote;

"When you eat less glucose the liver makes more. And the liver is not a very accurate organ for this, and tends to make more than you need."

I guess that you have Type 2 (not Type 1) diabetes.

If so, metformin is a medication which is worth considering. It stops the liver from making too much glucose.

Like all medications metformin has both potential benefits and risks - this is something that your clinical care team should be able to tell you about.

I actually don't have diabetes, but I have some level of Impaired Glucose Tolerance. Both my A1c and FBG are normal, but they won't be if I don't watch my diet. I can see my glucose spiking too high with home monitoring when I eat carbohydrates.

Hope you don't mind my asking, but something you just posted made me wonder... wouldn't that happen for everyone after high carb meal?

janieg, have you tested an hour after the carbs and again 2 hrs after the carbs? I'm curious if it settles after the 2 hr mark or stays high?

It does spike for everyone, but it's a matter of how high. Mine goes higher than normal, and stays elevated for too long. It seems to peak at the 90 minute mark or so, and it can take upwards of 5 - 6 hours to get it back down to under 100. I've seen mine spike as high as 190, and apparently a completely normal person would never go above 140 no matter what they eat.