[RobbSanFrancisco]

Hi everyone. Wish I could say I was happy to make your acquaintance

I have type 2 diabetes and my glycemic control was non-existant for many years. I'd frequently have A1C levels of 11. On top of that, my alcohol consumption was quite high. I knew this was a recipe for disaster, but took no action.

About a year ago, as I turned 40, I started having constant PN symptoms in my feet. This time, I sprung to action. I lost 90 lbs and managed to stop drinking completely. Currently my A1C levels are great -- 5.6. I still have some dawn effect (levels of around 110 mg/dl in the morning and a spike after breakfast).

Sadly, despite taking action my PN still seems to be progressing. This can happen when rapid glycemic control is achieved, I guess. Or maybe my abnormal fasting levels (despite good A1C) is still causing damage. Or perhaps its just the cold weather.

The worst symptom for me so far is just the damn anxiety of not knowing if I've managed to stop the progression, if it might ever improve a little, how the gapabentin is affecting my brain, etc. Some days the anxiety just basically takes over my life.

The next worst symptom is the constant cold feet! Sometimes they feel cold when they aren't, but most of the time they are actually cold. And the "actually" cold phase usually happens just before a flare-up of extra tingling/numbness/hypersensitivety.

Question: I know for diabetic PN the vascular system is usually damaged as well. But it seems like this symptom is common for many types/causes of PN. Is there a mechanism behind this other than vascular damage? Is it a feedback loop, with the damaged nerve signals causing vasomotor disfunction and blood flow to restrict?

I get a wonderful respite each morning until about noon, and then within an hour the cold sets in and then wavers a bit for the rest of the day. I just wonder what it is my body is "running out of" that causes this transition.

Wow, that was very long winded. Thanks for reading.

[Dr. Smith]

Hi Robb, Welcome.

Are you perchance taking R-Lipoic Acid? Since taking it (and pantothenic acid—B5) my symptoms are much better, I don't need gabapentin, and I believe progression has been stopped. A little over 3 years now.

I get cold feet too, and I find it's often due to their being wet (from sweating). The dog's nose and my feet—always cold. Keeping my feet dry helps a lot. Tough to fight because feet are one of the areas we sweat though most.

Doc

[IllPn]

My feet know when it is cold outside when I am inside. That was my worse symptom besides the buzzing/vibration all day long. My feet are like blocks of ice all day long. Lately they have not been as cold -this winter-however I am getting the electric stabs and symptoms elsewhere. I do NOT have diabetes and this is spreading.

[mrsD]

All diabetics lose magnesium in the urine daily. No one knows why yet, but it has been measured in studies.

So using a good magnesium oral product and the new lotion, which is actually better than oral IMO, may help with the temperature and circulation in the feet. Magnesium dilates blood vessels, and blocks the NMDA pain receptors.

http://www.amazon.com/Morton-Epsom-L...s=Morton+epsom

Also at Walmart and Walgreen's locally...but not in all stores yet, as it is new.

A quarter's diameter dollop on each foot at bedtime may be very helpful for your cold feet.

When blood flow is constricted, things cannot reach beyond that barrier...so topical then becomes very useful.

Here is a magnesium website:
With food suggestions:
http://www.slowmag.com/

This is my magnesium thread:
http://neurotalk.psychcentral.com/thread1138.html

[RobbSanFrancisco]

I'll look into R-Lipoic Acid and magnesium, thanks much!

I've been taking Alpha lipoic acid supplments, though I don't do it reliably. I'll google the difference between a and r.

I just saw my neurologist yesterday. I started asking him more questions about circulation. For instance, are the "bad" signals from the nerves causing a restriction response. Or is it just the vascular damage from diabetes. He said its both, and gave a prescription for Trental (pentoxifylline). It may help with circulation. I'd rather not add an extra drug, but lately my PN has been keeping me out of the gym and from being active. If this helps, I'll go with it.

I'll check back in with any results. So far the side effects -- dizziness -- are annoying, but I'm already noticing warmer feet after just a day.

[mrsD]

Trental also has a bonus... It reduces fibrosis damage
in the tissues. Some of the TOS posters on
that forum have suggested it to improve
Circulation in the chest area.

Some people make fibrotic scar tissue more
than others. So this drug maybe helpful.

[Dr. Smith]

Originally Posted by RobbSanFrancisco

I've been taking Alpha lipoic acid supplments, though I don't do it reliably. I'll google the difference between a and r.

By all means; we have a thread about it here as well (searching the archives will yield more).

Alpha Lipoic vs. R-Lipoic

Doc