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Old 10-07-2007, 10:09 AM #21
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Lightbulb Jason...

If you are relatively young.... doctors do this. They tend to do it for everyone,
but basically they form opinions about you within 10 secs. How you sit, how you present, your face eyes (may show puffiness etc), whether you fidget, all sorts of things.

Right now my son is going gluten free (he has tried it on and off) because he
feels strange, cold and numb when he eats gluten. He went to a GP in Sept and had testing, basic stuff, and all was normal. He was told to keep a food diary with symptoms's occurance for 2 months, and to return. It is difficult to be young and active socially and stay gluten free, so he has slips now and then.
The longer he follows the diet, the more obvious the symptoms when he slips.

I suggest you go to the Gluten forum here and read Megan's question, and also read the responses. She is beginning as well to investigate this.

If your GTT was only elevated one or 2 pts and you weigh alot, are very tall, etc or overweight, that is sometimes considered normal. If you were taking Risperdal when you had the test or just stopped it recently, your blood sugar can be off from that. Risperdal and other drugs of its type cause diabetes in some patients.

There may be ways for you to improve, that do not require a doctor at all.
But you have to tell us here some details about yourself in order for us to
suggest nutritional supports.
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Old 10-07-2007, 10:12 AM #22
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Hi. First welcome and sorry for your struggles. I can relate to this. The doc I saw last week here was similar. I have learned and I know its so stressful to start over but in the long run will make things better. I wasted time by giving chances when I knew in my heart they sucked. You need someone to listen and when results of blood or other tests are confusing to look outside th box for just maybes even. Your not making this up and I hear how your frustrated. I often wonder if docs turn it on us when they are frustrated and were not an easy fix. Hang in there.
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Old 10-07-2007, 11:13 AM #23
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Originally Posted by mrsd View Post
Welcome to our board.
Hi mrsd. Thank you!

Quote:
After reading your first post, I have some questions.

Did you have that glucose tolerance test at the same time you were on the Risperdal treatment?
I had the test a month after finishing withdrawing from Risperdal. I went down from 4mg to 1mg of Risperdal the last 1.5 years with no withdrawal. At the end of June I went off the 1mg for 4 days and got a little anxious then read about safety issues with going off without tapering then went back on .5mg and tapered off that the next 6 weeks.

Quote:
How old are you?
32

Quote:
How long were you on Risperdal? Long term use of Risperdal has been shown to cause pituitary tumors and increases in prolactin which is a hormone.
12 years. It also factors in diabetes.

Quote:
Are you overweight with abdominal fat? Risperdal causes weight gain.
I am normal weight. 5'11" 175 pounds. In twelve years I got up to 215 pounds a couple times.

Quote:
When you had that GTT, you had both insulin and glucose run with eachblood draw?
Yes to glucose, and insulin just the last three. Here are the results:

At beginning glucose was 90, insulin wasn't shown
First hour glucose was 206, insulin was 108.0
Second hour glucose was 156, insulin was 121.0
Third hour glucose was 82, insulin was 25.2

The test says insulin is normal below 29.2 for each one.

Quote:
Do you rest on that elbow alot due to life style habits? Work tasks?
Prior to the ulnar injury for a few weeks I was wresting on my elbows, which I normally didn't do. I also slept with my elbows bent and was doing maybe improper dumbbell exercises last year. The injury came when I was sleeping with the elbow bent. Now I am not leaning on it and am sleeping with Velcro splints loosely on both arms to remind myself not to bend them.

Quote:
Do you eat whole foods, and tend to be careful to keep healthy food habits?
I am careful about that. I'm eating mostly fish, vegetables, goats milk yogurt, a little amount of fruit, and a lot of water. A couple months ago I was eating/drinking less healthy including a large Pepsi a day and a lot of fruit, bananas, skim milk, whole grain cereal, and salted almonds. Before that I ate processed food and whole food and a couple time periods having sugar drinks. Before that it was mostly processed food.

Quote:
What you do, what you eat, and what drugs you take or have recently taken, can impact alot on the nervous system.
Thanks mrsd, I appreciate the help.

Last edited by Jason; 10-07-2007 at 10:07 PM.
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Old 10-07-2007, 12:08 PM #24
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Lightbulb Ok,

Only burning feet, no numbness, no cold sensations?

Your fasting glucose was fairly normal. The response to the glucose solution
was high. This is called post-prandial elevation, and occurs in many so called normal people. You can control this with diet, by avoiding high glycemic carbs, and eating wisely like you are doing.

I haven't seen many studies to show how after discontinuing Risperdal/Zyprexa if the diabetes risk goes away...whether it is permanent or not.

Another thing you can do is take thiamine 200mg/day in divided doses. Thiamine helps metabolize carbohydrate and also helps reduce burning pain. This may work for you.

Do you know your B12 actual test number? If it is below 550...I think you should do the B12 we all use here... 1mg methylcobalamin by Jarrow. We get it on line at www.iherb.com or other discount vit places like Vitacost.

Fish oil also helps with neuropathy and helps keep the nerve myelin sheaths, intact and healthy. Not all fish are equal in fatty acid content.

These are beginning ideas that may increase your health, and may reduce some burning. If you were elevated glucose for many years and did not know it, it could have led to your being more prone to diabetic neuropathy.

If I were you I'd start here. If you are on other drugs now, you can PM me with those, because some drugs do deplete nutrients and have a negative impact on health. I'll look them up for you.
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Old 10-07-2007, 12:37 PM #25
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Originally Posted by Brian View Post
I also had a hell of a time convincing doctors that i had real problems, i went to 6 GP's none of them had a clue, one rheumie, that couldn't find anything wrong and one Professor of Neurology, who done a Nerve Conduction test and said, " i showed no signs of PN,[ nerve conduction only tests for large nerve damage] another idiot that actually said to me " i don't think you have burning feet, the test [NC test] proves that , it was the Internet that helped me find out what was wrong, in particular the PN forum i stumbled across in my desperate search for answers, the experts here pointed me in the right direction, thank god, so i insisted that my local GP send me to a PN expert which i eventually got to see [ after a battle with him ]and he diagnosed "Prediabetes" as the cause after a 3 hour Glucose tolerance test,
& i was running real low on B12 as well.
The reason why your feet are burning is that the small nerve's are damaged and are sending confused signals, your small nerve job is to sense heat, cold & pain, a clear indiction was when you felt that neuro's tool feel differant above your knee, he should have picked that up and sent you for a QS test.
Thanks again Brian and everyone.

Brian, I brought my GTT test, blood, and urine tests to the neuro. He said the tests didn't show anything related to the neuropathies. My family doctor said a few weeks ago that the GTT test shows that I likely have Pre-diabetes and that might have to do with the neuropathies. I had to ask my family doctor a couple times before he got me the GTT test. He didn't seem to know Pre-diabetes doesn't have to show up in a regular blood test. Since I was on Risperdal so long I wanted that test for Pre-diabetes. I'm glad that your PN expert diagnosed Pre-diabetes as your cause based on your GTT test. Was that all he needed to make the diagnosis?
Quote:
I have to get going , pretty busy day today, but others will explain more.
Brian
Hope you got to relax a bit. Take care.

Last edited by Jason; 10-07-2007 at 01:10 PM.
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Old 10-07-2007, 01:16 PM #26
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Don't blame you a bit. I am furious for you!
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Old 10-07-2007, 02:31 PM #27
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Originally Posted by mrsd View Post
Only burning feet, no numbness, no cold sensations?
Only mildly burning feet. Right big toe is mildly numb sometimes. Fourth and fifth left digits are mildly numb always. No cold sensation. A little burning in mouse using fingers sometimes. One other thing burns a little sometimes.

Quote:
Your fasting glucose was fairly normal. The response to the glucose solution
was high. This is called post-prandial elevation, and occurs in many so called normal people. You can control this with diet, by avoiding high glycemic carbs, and eating wisely like you are doing.

I haven't seen many studies to show how after discontinuing Risperdal/Zyprexa if the diabetes risk goes away...whether it is permanent or not.
OK, thanks.

Quote:
Another thing you can do is take thiamine 200mg/day in divided doses. Thiamine helps metabolize carbohydrate and also helps reduce burning pain. This may work for you.
OK, I will.

Quote:
Do you know your B12 actual test number? If it is below 550...I think you should do the B12 we all use here... 1mg methylcobalamin by Jarrow. We get it on line at www.iherb.com or other discount vit places like Vitacost.
Thanks, it is 432. I will take it.

Quote:
Fish oil also helps with neuropathy and helps keep the nerve myelin sheaths, intact and healthy. Not all fish are equal in fatty acid content.
Good idea. LOL

Quote:
These are beginning ideas that may increase your health, and may reduce some burning. If you were elevated glucose for many years and did not know it, it could have led to your being more prone to diabetic neuropathy.

If I were you I'd start here. If you are on other drugs now, you can PM me with those, because some drugs do deplete nutrients and have a negative impact on health. I'll look them up for you.
I'm not on any other drugs other than supplements.
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Old 10-07-2007, 08:23 PM #28
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Brian wrote you a great post on diabetes, and gives good advice. My take is that you need someone excellent to handle the diabetes (prediabetes is a silly concept) and get that under control. The ulnar neuropathy needs to be explained. Where is it from? The wrist? The elbow? It is NOT typical of small fiber neuropathy to get a neuropathy of a single LARGE nerve like this. That's more typical of compression. It's not even something that looks like it's from a spinal disk. So I'd want to know why the ulnar neuropathy.

In terms of the burning feet...You probably have your cause right in front of you, in terms of the diabetes, but if you want a better workup, it looks like you need another neurologist.

Many doctors are threatened by patients on the internet; others just don't realize that an intelligent person can distill out the good information from the worthless. If he hasn't looked at the net from a patient's perspective, he doesn't know. He doesn't sound like someone to have an ongoing relationship. Depending on where you live, you might a very good general neurologist (many of them are excellent), or another neuro who calls himself a neuropathy specialist. Or, I might be safe to just get the diabetes under control---as long as you have someone good and caring taking care of you---you can always go for more tests if it goes in the wrong direction after taking care of the sugars/insulin.

But I'm not sure that whatever explains the feet explains the ulnar symptoms.

It's possible to have termites AND ants, my own neurologist told me.
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Old 10-07-2007, 09:49 PM #29
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Originally Posted by LizaJane View Post
Brian wrote you a great post on diabetes, and gives good advice. My take is that you need someone excellent to handle the diabetes (prediabetes is a silly concept) and get that under control. The ulnar neuropathy needs to be explained. Where is it from? The wrist? The elbow? It is NOT typical of small fiber neuropathy to get a neuropathy of a single LARGE nerve like this. That's more typical of compression. It's not even something that looks like it's from a spinal disk. So I'd want to know why the ulnar neuropathy.

In terms of the burning feet...You probably have your cause right in front of you, in terms of the diabetes, but if you want a better workup, it looks like you need another neurologist.

Many doctors are threatened by patients on the internet; others just don't realize that an intelligent person can distill out the good information from the worthless. If he hasn't looked at the net from a patient's perspective, he doesn't know. He doesn't sound like someone to have an ongoing relationship. Depending on where you live, you might a very good general neurologist (many of them are excellent), or another neuro who calls himself a neuropathy specialist. Or, I might be safe to just get the diabetes under control---as long as you have someone good and caring taking care of you---you can always go for more tests if it goes in the wrong direction after taking care of the sugars/insulin.

But I'm not sure that whatever explains the feet explains the ulnar symptoms.

It's possible to have termites AND ants, my own neurologist told me.
LizaJane, I read that cubital tunnel compression is common to people with diabetes. I didn't think they were related for a while until I read that. The orthopedic surgeon said the EMGs show the problem mostly at the elbow and lesser somewhere above it which is double crush. My posture in the shoulder area is less than ideal. I am fixing my posture with exercises and ergonomics. I don't know yet what causes neuropathies in people with pre-diabetes and diabetes. If pre-diabetes is my cause for sure it wouldn't be sugar level because mine are close to normal after drinking that sugar drink they give you for the test.
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Old 10-08-2007, 12:42 AM #30
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Default An interesting link...

......outcomes of which I'm sure we are all aware of, but often do not necessarily take seriously - soft drink consumption!

http://www.medscape.com/viewarticle/560344

Jason your question: ‘Also why do people with pre-diabetes get PN when people with long standing diabetes don't get it’, has me totally puzzled too. It just doesn’t make a lot of sense. I wonder if there are other as yet undiscovered comorbid conditions related to this! I went to a diabetologist/endocrinologist a couple of weeks ago and he totally denied that there was a connection BUT that is NOT what the published literature that I have been reading, is saying.

Also from Jason’s post: ‘Brian, thanks for the info. That site says that QST uses temperature to test the small fibers and vibration to test the large fibers. He didn't use QST but he used hand held tools to test temperature and vibration and asked me for feedback’. That is the same with the neurologist I went to. Only used some ‘tools’ on hand – nothing computerised to test sensations and proprioception. Do neurologists usually have this equipment in their rooms or do you have to get QST done as a separate test in a specialised lab?
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