Ditto what Glenn posted.

You are showing poor B12 status, and could use an aggressive change in that. B12 is not a worrisome supplement with risks.
So start that ASAP oral 5mg daily on empty stomach--methylcobalamin type-- for 3 months. And see what happens with your PN symptoms. That reactive hypoglycemia? That is a prediabetic state, and studies show prediabetes starts the PN process. You can only benefit from the B12.
Puritan's Pride and iherb.com and places like Vitacost and Swanson's--all carry it now inexpensively. Pennies a day.
This week the news has been flooded with B12 preventing cognitive problems in aging people. It was even on CNN and has been posted here on the various boards more than once.
The NIH recommends all people 50 and over (symptoms or not) to be taking a B12 supplement.

The meds you list are typical for PN. But they do not restore you or help you heal, they just cover symptoms for the most part. Some studies suggest that the nortriptyline may encourage nerve growth in the periphery, but that is still experimental and rather new.

Start modifying your diet. Get rid of sugars and starchy carbs, which stimulate the reactive hypoglycemia. Slow carbs instead will keep your blood sugars from getting low... legumes, beans, nuts, fruit with fiber like peaches/oranges/berries, veggies, etc. Avoid fruit juices. Fiber in fruit delays absorption and moderates blood sugars.
Increase protein to about 40% of calories a day and use good fats like omega-3s and olive oil to keep food in your stomach longer so the blood sugar spikes at mealtimes will be lower.

I'd get an A1C run to see where you are in that department. A higher A1C can show you have spiking after meals, with high sugars followed by low. It is a good test to reveal how your diet is working for you.

It will be a battle on the thyroid issue. In my case I had a right sided goiter with my borderline tests. The doctor ran a radioactive uptake and found my left lobe was partly dead and hence my problem was "undiagnosable" but he gave me the hormone anyway because I had signs of hypothyroidism. I settled in at 75mcg a day after the first year and have remained at this level for a while now. Signs of hypo= intolerance to cold, the PN (I had carpal tunnel in my hands severely too), edema of the hands, face. And orange tinted palms and feet...this sign is very typical of hypo people...because the betacarotene in vegetables we eat is converted in the liver to Vit A...using thyroid. I had the orange tinting of the skin very obviously... along with brittle nails, etc, and he used that finding along with the radio uptake to decide to put me on hormone which actually SAVED me!

But unless you see a holistic doctor who does bioidentical hormone treatments, you will have a battle with many endos to get treated with your test results.

Mrsd and others,

Here is a list of my meds and supplements that I am planning on using for my PN, please keep in mind I am not a pill taker at all and this is so hard for me, I suffer From OCD and one of my triggers are medications and illness, now I have to face both very frightening! Here goes, Juice Plus, Omega3 fish Oil twice a day, 1 multivitamin once a day, Protandium, 5 mg. b-12 once a day, R-Lioc Acid 100mg once a day, Acetyl Carnate 500mg twice a day, Pantothenic Acid500mg twice a day, 80mg. Baby aspirin, Nortryptlyne 10mg. 3 times a day,Gabapentin 300mg 3 times a day. Xanax as needed. This seems like so many things to be taking will I be alright with all of this, I also suffer heart palps, will any of supplements make this condition worse, I am going to my family Doc today I will also show him this list, but I trust you all on here also so any comments so appreciated, I don't know if it would be good to add all of this at once or just do one at a time over a particular time. Thanks so much. Jan

If you have unusual heart beats.... you should get a screening EKG before using the Nortriptyline. This drug prolongs the QT segment of each heart beat and can affect the heart.
In the low 10 mg dose,it is not so much of an issue as when the dose is much higher. But it is good to get that done anyway.

I have no experience with Protandim. However, it is an herbal product and as such, you should be careful with it IMO.

I would not use this now, but wait until you do the other supplements first. YOu may find you don't need Protandim at all.

I am leary of herbal products, especially mixing them with RX drugs.

I saw my Primary Doc today, he is re testing my Vit. B12 He said you are probably right my Vit. B12 should be higher especially with my symptoms, I am hoping this could be my problem, wouldn't it be great if it's that easy!

He also is retesting my thyroid at my request, so today was a good appt. Also I have had an EKG in the hospital last week it was normal. Today he also did a Vitamin D test as well. When the results come in I will post them. I do believe the Lord is going to reveal my problem to my Doctors, and I also want to thank you for all of your suggestions they have been so helpful and I am grateful that I have a Doctor who is open to these suggestions. Jan

Just got test results back from blood test taken yesterday, again Doctor says my B12 levels are normal, he left that message on my answering machine did not tell me what levels were, but I will get them and post them here, also numbness is moving into my face now, so I am numb from toes to head now, this is all happening so fast and my Neuro Doc does not want to see me for another month, I guess he feels he has done all he can, I just feel lost and overwhelmed, I am going to try supplements as suggested on here, where can I buy these supplements, did I hear someone say Puritans pride? Again can someone tell me what I should start taking, I'm sorry to ask this question again, I'm just so depressed right now and don't know if you have already told me this. Sometimes it's just so hard with this disease to move on, but I will I have no other choice. Thanks, Jan

In your previous post, you listed Protandim... I'd stop that for now. Also are you taking that Nortriptyline 3 times a day? It will be quite sedating if so in the beginning.
You really need that Vit D tested. Without a test to guide you dose wise, you can start now at 2000IU of D3. This is inexpensive and readily available in stores or you can order when you get the B12 for now. There are beginning studies showing low D3 can impact diabetic neuropathy.
Your reactive hypoglycemia qualifies for a diabetic PN label.

Make sure you take the B12 on an empty stomach.
Supplements take a bit of time to get working. They are not fast like drugs. In a week or so you should see some improvements.
Puritan's Pride, iherb.com and swanson's all have quality brands at reasonable prices.

MrsD,

Thanks for all your help, yes Doc did do Vit D test he does not have it back yet I will post results when I get them, I also will not take protandim yet. The nortryp I am only taking once per day I'm sorry I did post 3 times a day, correction only once per day at bedtime.I have another question for you, I have fake nails, they are acrylic, I have had them for years with no apparent problem, could this be an issue now, I don't believe so but could use others opinion.Jan

VitD 25 Hydroxy 30NG/ML VitD25-oH D 2<4 Reference range() Flag:N

Vit3 25-OHD3: 30NG/ML Ref range() Flag N Methymalonic Acid Serum<0.10 RefRange<0.40 Flag Normal. Don't know what this all means but Doc says is normal. Thanks MrsD. Jan

30ng of D3 is the lower end of the "normal range" currently used in medical testing in US. If you follow the new D information, 30 is too low to accomplish further benefits which only show up at higher serum levels.

Here is my D thread with a medical video explaining:
http://neurotalk.psychcentral.com/thread85103.html

It is up to you if you want to explore further D options.

MMA is another B12 test. It shows if you have enough B12 to metabolize MMA properly. It is a good test, but some people just need more than others. Without a serum test as well, you won't know where you are exactly.
Here is the link to Dr. Snow's medical article on B12.
http://neurotalk.psychcentral.com/post698522-70.html

He believes there is a small subset of people with fairly normal blood readings who still suffer from neurological symptoms. For those people he suggests using B12 anyway, since it is non-toxic and inexpensive.