[Richie Rich]

Hi Everyone,

I am a 40 year old male in general good health, Problem started a year and half ago with sensitive skin on lower legs and feet then numbness in big toe and ajascent toe in morning time and cramping burning pain in lower right calf after walking a distance also tingling and numbness in feet and hands at night, after months of this I went to my doctor who did blood testing, everything came back OK except for my A1C which was 6.0 He said this could possibly be the cause and told me what to not eat and what not to eat to get my blood sugar down to normal. I totaly changed my diet to low carbs and got my A1C down to 5.4 after a few months but symtoms persist, I did notice at that time the tingling and numbness at night was alot less. In the middle of this I hurt my back and did physical therapy but still had back pain, I was then sent to a back neurosurgon who said I had a bulging disc at L4-L5 and this could cause problems in the legs so I ended up having a microdiscetomy and after four months my back felt better but it did not help my legs at all. I am now seeing a regular neurologist who says he would have not sent me for back surgery because when he looked at my MRI it was not that bad. After he did an exam and blood test he did not think I had a neuropathy because I did not have any weakness and I did not have any stabbing pains and he did not agree whith my primary doc that said my prediabetes could be the cause, he thinks I have some carpel tunnel syndrom in my hands and feet but still put me on gabapentin and suggested tonic water for the cramping pain.

I have had an EMG NCS and lyme test, heavy metal test and autoimune blood test all OK except for some nerve conduction velocity slowing in my legs the worst was my right peroneal that was 31 ms others where at 38 ms just below the bottom of the normal 41 ms, the Dr doing the test said these slightly low velocities where most likely because of my 6' 3" height and my leg temperature was cool being at 30.0 celcius.

I am concerned now because I am noticing these symptoms in my upper legs and I don't know if this is part of the healing or if it is getting worse. After 8 months of control over my blood glucose I only notice my toes are not as numb as before glucose control and much less of the tingling and numbness at night which I always thought was because of sleeping in a bad position.

Does this sound like prediabetic neuropathy or something else?


Supplements I am Taking.

GLA 160 mg X 6
Vitamin C 500 mg X 6
Acetyl-L-Carnitine 500 mg X 4
CoQ10 100mg
Inositol 650 mg X 2
R-Lipoic Acid 300 mg
Benfotiamine 150 mg
Ginko Bilboa 120 mg
Vitamin E 400 mg

[mrsD]

Welcome to NeuroTalk:

It is difficult to say regarding the pre-diabetes. You'd have to have a 3 or 4 hr glucose tolerance test and A1C levels to see if there are hints of reactive low blood sugar after the 2 hr mark.
You can also have a fasting INSULIN done which if elevated suggests insulin resistance. A1C is a general marker showing over time, glucose stability. Usually it is the spikes after eating that raise it. But A1C does not demonstrate LOWS. Lows, also starve nerves.

Did you have thyroid testing? Some hypothyroid symptoms involve PN symptoms.

I don't believe tonic water is what you need for cramping pain.
The amount of quinine in it is very low.

You could add in a good magnesium supplement (not the OXIDE form which is not absorbed) and see if you are better.

Diabetics lose magnesium in the urine. And most people do not eat foods providing magnesium and they become low from dietary lack.

Also I don't think you need so much Vit C. More like 500mg a day would be enough. Taper off slowly if you discontinue this, because Vit C in high dose can cause a vitamin dependency and scurvy symptoms may result with sudden discontinuance.
Too much Vit C puts a strain on acid/base control of the blood.
Using Ester C is a bit milder and less acidic.
There have been suggestions for type II diabetics to not take high dose Vit C...but those are still not proven.

Check your R-lipoic...is the stabilized form? Also called:
NaRALA. The non stabilized form is thought to be less absorbable, so check your labels.. You will want to take this on an empty stomach as well.

I would get your B12 levels checked. and Vit D. Both can be low, and often doctors say "normal" when in fact the labs report lows as "normal" . Your B12 should be at a minimum 400 US units, and with PN symptoms you should strive for 1000.
Some drugs like acid blockers block B12 absorption and people can become low from them. Also metformin used for type II diabetes will lower B12.
This is my B12 thread with medical links:
http://neurotalk.psychcentral.com/thread85103.html

Also if you take statins to lower cholesterol, be aware these can cause nerve damage. Also some common antibiotics, Cipro, Levaquin and Avelox, and Flagyl. The PNs from Cipro etc are not thought to be reversible at this time.
There are threads in our subforum above on the subject of drug induced PN and also supplements.

Also some people get PN or GBS from vaccines. Some vaccine injuries are similar to PN.

The GLA may be helpful, but you may not need so much. If you don't have side effects from it, leave as is. But if you seem to be getting worse, I'd cut back to 1/2 that dose, and see if that is better. Also useful are fish oil, or krill oil. These are anti-inflammatory. If you do not eat salmon regularly you should either do that or take the supplement versions.

[daniella]

Hi welcome though sorry about this. I am not as knowledgable as many here who I think will come along to help.
Did you have any fall in the recent years,any other health issues prior,were you active,sickness,meds you were on,etc? Anything you can think of in the past that is not normal or you may have brushed off but now could be connected? Have you seen any other specialists like rheumatologist or endocronolgist?

[glenntaj]

And part of what she's implying is that the causes of neuropathy--of which there are many--can be very hard to pin down.

It HAS become increasingly evident that impaired glucose tolerance/pre-diabetes/insulin resistance CAN be a cause of neuropathy in some people, and typically the symptoms involve the small fibers that subsume the sensations of pain and temperature. (EMG/nerve conduction studies only show gross abnormalities with larger, myelinated sensory and motor nerves--though it looks like you may have some involvement of these from some cause.) A lot of doctors don't know this, though.

Take a look at my post number 12 in this thread--lots of links to articles about pre-diabetic neuropathy:

http://neurotalk.psychcentral.com/sh...1828#post21828

And, as has been mentioned, you could have multiple etiologies for your symptoms--for example, glucose dysregulation combined with compression from somewhere in your lumbar spine, and the combined symptoms may be greater than the sum of their constituent parts. There is actually a name for this--"double crush phenomenon"--in which an already compromised nerve has a second cause of compromise added, often compressive, and the symptoms then seem to increase all out of proportion to the severity of the compression.

See:

http://www.ncbi.nlm.nih.gov/pubmed/3275922

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2365954/

There's even a medical textbook about it now:

http://search.barnesandnoble.com/Dou.../9780792378051

[Richie Rich]

Thanks everyone for the resplies,

mrsD, I have had the thyroid test and that was OK and I do take a calcium magnesium supplement and do also take a 5mg sublingual methylcobalamin B12 and I do not take statins or have had any antibiotics recently.

glenntaj, I did have the back surgery 4 months ago but that did not help my legs and my neurologist looked at the MRI and said that would not cause my leg symptoms. I also told him about a bad whiplash injury I had 25 years ago but he did not think that would cause these symptoms. My primary Dr thinks this is something systemic and thinks it could be my prediabeties which my neurologist says no. I do have a glucose meter and keep my blood sugar under 140 after meal at 1 hour with my careful diet,but some times if I eat something I shouldn't like a small bowl of cheerios my sugar will go up to 160 at 1 hr but then comes down to 100 at 2 hrs so I can only imagine what my post meal blood sugar was up to prior to my lo carb diet. The wierd thing is I am not obese if anything I am slender so I hope I am not doing all this low carb diet for nothing but regardless if this is causing my leg problem my primary doc says if I don't I will be diabetic years from now.

danniella, I have been in good health except for my back problem which is ok now, I have had kidney stones and neck pains from whiplash in my past and had an incident over 20 years ago involving overexposure to a paint remover that messed with my vision and gave me pains in the chest but I recovered after being put on prednisone for two weeks so I don't think that could be efecting me 20 years later know because I stay away from chemicals now.

[mrsD]

Well, if you are feeling better on the low carb food, that is telling IMO. So keep at it.

You don't have to have had the antibiotics "recently" that I mentioned to be affected. People have been permanently damaged from fluoroquinolones and Flagyl.
You could have had them 10 yrs ago... and have PN from them.

Also exposure to solvents is problematic. That exposure could have started an assault that was joined later by other factors.

Sometimes PN is more than one trigger. Some people have several in fact...which add to each other, to damage the nerves.
Even vaccine exposures can do it.

You are 40... wait til you are 60+ . Controlling this now, will help delay later in life issues with blood sugar.

Have your neurologist read this paper:
http://www.citeulike.org/user/wrs1/article/6499468
He needs some updating.

If you use a mixture tablet for your calcium/magnesium check those ingredients carefully. Most are OXIDE and magnesium in this form is not absorbed. It is useless. A quality magnesium product that has good absorption, will help cramping tremendously.

[Richie Rich]

mrsD,

Thank You for the reply, I will stay on the low carb diet because I have also noticed other improvments in health like I used to have hazy vision after hot showers but I wasn't to concerned because it would go away after 5 minutes and also dizzy spells once in a while and tingling in hands and feet at night, all of these disappeared after getting my blood sugar down.

Know if I could only get rid of this cramping/burning feeling in my right calf and upper leg muscle and get rid of this strange sensitive feeling in both my legs, this sensitive skin thing is wierd, its not painful but if something like clothes or a hand brushs my legs its like overly sensitive. Hopefuly these are signs of healing nerves.

Thanks again, This site has a wealth of knowledge.

[Sallysblooms]

Even when A1C and fasting glucose tests are ok, you can still have problems with insulin. I am off of gluten and almost off of sugar. I take many supplements with the help of my integrative doctors. I take 600mg of the ALAMAX by Xymogen. (Alpha Lipoic Acid) I am working up to more. I want to work up to 1200, but it keeps me awake at night since I am sensitive. So I stay on 600mg.

I take Benfotiamine by Life Extension. 250mg.

I have CFS and POTS caused by Autonomic Neuropathy (Dysautonomia) so I have plenty of nerve healing to do in my body. I have improved so much with all of my supplements thankfully. The breakdown of my autonomic nervous system has been a nightmare. I went from not being able to walk from the POTS from Orthostatic Intolerance to doing great.

I am so thankful for supplements and foods that heal. No med. will heal nerves.

[daniella]

Originally Posted by Richie Rich

Thanks everyone for the resplies,

mrsD, I have had the thyroid test and that was OK and I do take a calcium magnesium supplement and do also take a 5mg sublingual methylcobalamin B12 and I do not take statins or have had any antibiotics recently.

glenntaj, I did have the back surgery 4 months ago but that did not help my legs and my neurologist looked at the MRI and said that would not cause my leg symptoms. I also told him about a bad whiplash injury I had 25 years ago but he did not think that would cause these symptoms. My primary Dr thinks this is something systemic and thinks it could be my prediabeties which my neurologist says no. I do have a glucose meter and keep my blood sugar under 140 after meal at 1 hour with my careful diet,but some times if I eat something I shouldn't like a small bowl of cheerios my sugar will go up to 160 at 1 hr but then comes down to 100 at 2 hrs so I can only imagine what my post meal blood sugar was up to prior to my lo carb diet. The wierd thing is I am not obese if anything I am slender so I hope I am not doing all this low carb diet for nothing but regardless if this is causing my leg problem my primary doc says if I don't I will be diabetic years from now.

danniella, I have been in good health except for my back problem which is ok now, I have had kidney stones and neck pains from whiplash in my past and had an incident over 20 years ago involving overexposure to a paint remover that messed with my vision and gave me pains in the chest but I recovered after being put on prednisone for two weeks so I don't think that could be efecting me 20 years later know because I stay away from chemicals now.

That is interesting your neuro felt the back would not cause the leg pain or did he mean the mri did not show anything in the back? With my leg pain the neuro did the mri of the spine even though at the time I had no back pain to see if the leg pain was coming from the spine. If you are able can you see a rheumatologist? What about another neuro opinion?

[Richie Rich]

I had microsurgery on my back and my back is fine now but it did not help my legs at all. I was prediabetic when my legs started bothering me. It started with tingling and numbness in my feet and hands at night, then numbness in right big toe and the toe next to that one then skin sensitivity in both feet and calfs that persist into daytime. I have gone low carb 8 months ago and it seems to help because I no longer have the tingling and numbness at night and my toes are only slightly numb in the morning. From what I see on this forum I think the prediabetes could have caused this even though my neuro says no. I told him my sugar spikes even doing low carb to 160 an hour after meals sometimes and he did not think that could cause this. Right know the thing that bothers me is the skin sensitivity in my legs, my skin is sensitive to any brushing like from clothes and seems not to get any better and is has gone up both legs. I also get a burning feeling in my right calf muscle and upper leg muscle. I hope continued sugar control and supplements will heal this too.