Diabetic neuropathy or something else?
 

Hey all I have posted some of this in a previous thread about my general health but this question is more direct.

I am a type 1 diabetic and have been for the last 18 years. I am 29 now. slightly overweight in the last few years (about a stone over ideal weight for about 3 or 4 years) my hba1c has always been between 7 and 7.5 over the last 10 years. While my blood control is not perfect I I would not describe it as terrible.

About 6 months ago I started to feel tingling in my hands and feet along with general numbness in my arms and legs when I lie or sit in my hands and feet. This all came along very suddenly in a few days.

Went to Diabetic doctor and they noticed my thyroid was swollen and all my glands were also up. They reckoned it was due to a virus that I had these symptoms come on so suddenly and said it should pass.

Sure enough 2 or 3 weeks later the neuropathy symptoms all stopped and I felt fine again. Thyroid stayed swollen DCT says I have a small multi-nodular goitre but it is common. Thyroid function was fine.

2 or 3 weeks ago I noticed my glands were again swollen (very large one under arm). The tingling came back although now it is in arms as well as hands (and still feet). I also have the numbness again in my arms or legs when I sit down. Along with this I now have pain in my joints particularly wrist and elbow.

This comes and goes at the moment on a day today basis... Yesterday it was very uncomfortable today it is barely noticeable.

I have spoken to the Doctors who still think it is probably a virus due to the speed everything has come about (symptoms possibly made worse by the fact I am a diabetic and therefore may have a small amount of neuropathology anyway) and the timing with the swollen glands.

I have been checked for lots of things and had lots of scans and blood tests so far all have come up normal.

Next thing the doctor wants to check me for is Lyme diesease.

anyone have any experience with Neuropathy and its advancement?

Do these symptoms sound typical of diabetic neuropathy or atypical

My diabetes control has actually been a lot tighter in the last month or so and hope to get my hba1c into the 6s next time I go to the Doctors.

Obviously I would rather it be a virus or illness that can be cured but if it is diabetes related I need to know.

many thanks

Welcome Y3Mbailey. :Tip-Hat:

Someone will be along to help.

Hi Y3mbailey,

:ROTFLMAO:

Pardon my guffaw, but I think we all have some experience with neuropathy or we wouldn't be here. :wink:

With over 100 known causes/types of PN (and no-one knows how many aren't known yet), combined with the diversity (everyone being different) of cases here, the symptoms you describe definitely fall within the scope of typical for many possible causes, including (and besides) diabetic neuropathy.

In fact, I think everything you've mentioned (virus, diabetes, thyroid, Lyme Disease) are possibilities, and some others may be suggested as well.

Everyone who comes here needs/wants to know their cause. Some are fortunate and know—or find out (not that it always makes a difference, but sometimes it does), but many experience the frustration (and possibly resignation) of never finding out. Somewhere around 40-50% (depending on the source) of PN cases are deemed "idiopathic"—i.e. of unknown cause.

Ultimately, only time will tell—with possible help from test results, some detective work, and trial & error.

However, there is much information, experience, and wisdom to be gleened from this site and its denizens. :cool2: Particularly in the PN Tips, Resources, Supplements & Other Treatments Sub-Forum and in the archives.

B12 is important. Here's The Vitamin B12 Thread: Other supplements are discussed in the ~~SUPPLEMENTS~~~ for Peripheral Neuropathy: thread.

Because of the likelihood of your PN being diabetes-related, I would also start taking stabilized R-Lipoic Acid. There are several tons (threads) of information on this supplement available through the Archives/Search Facility.

Others here know more about thyroid, Lyme Disease, and virus-related PN. I'm sure some will chime in shortly.

Doc

Many thanks for your detailed reply I will check out the info regarding supplements.

Interesting you say thyroid. I have recently also been diagnosed with a multi nodular goitre although my thyroid tests all came back fine. I have not seen any info regarding PN caused by thyroid issues do you have any resources on this?

kind regards and many thanks

Matt

I actually have been diagnosed with a multinodular goitre so the fact you mention thyroid issues is an interesting one?

All my thyroid functions were normal at my last test.

so appreciative of your help will look into supplements today

Hi Matt,

I only mentioned it because you did in your O.P. At least one source (below) lists it as one of the most common treatable causes.

There's quite a bit, so it might be easier for you to cross-search the archives. (Links to specific searches don't seem to work here).

I'd start by Search Titles Only for thread titles containing thyroid here in the Peripheral Neuropathy forum, and similarly, Search Titles Only for thread titles containing neuropathy in the Autoimmune Diseases forum (where thyroid issues are discussed).

You can also find info on the web:
Can hypothyroidism cause peripheral neuropathy and, if so, how is it treated?
Polyneuropathy in hypothyroidism: clinical, electrophysiological and morphological findings in four cases
Peripheral Neuropathy: Differential Diagnosis and Management

peripheral neuropathy thyroid (goggle)
and
peripheral neuropathy thyroid (goggle scholar)

As mentioned previously, there are many possible causes of PN. Another that shows up here fairly often is PN caused by certain medications.
~MEDICATIONS~~ That May Cause Peripheral Neuropathy

Doc

Dear Doc,

What an excellent response. I had wanted to comment but you not only covered it all, but did so in such a great manner. (as you always do)

Thanks

Thanks Dr Smith I intend to read these tomorrow in detail and discuss with my diabetic team on my next visit in 2 weeks time.

I thought I would mention the rest of my medical history (which pretty much all started about 6 months ago to see if there is anything else relevant I have missed.)

Ongoing issues/ possible symptoms
Recurring Sweat Rash during summer months (Usually treated with Canestan Hydrocortisone cream +anti-fungal)
**** abscess. Recurring for many years. Comes maybe a few times a year and then goes of its own accord. Never been big enough to lance.
Hair loss (although I suspect/worry this may be to do with ageing rather than a syptom)
Occasional heartburn symptoms

2012 – Lump found in my right chest area. Mammogram done found to be a fatty lump. Doctor predicted quite correctly I had been in a car accident a few month previous and this lump was likely caused by the seat belt.

November 2013 – had pain in left testicle, urinary tract and possibly kidneys.
urine test showed no signs of anything.
Full STD test was clear (chlamydia, gonorrhoea, syphilis, HIV, hepatitis).
Testicles ultra-sounded and diagnosed as a spermal granuloma. This occasionally causes testicular pain every few months and is still occurring. Doctor said there was no real treatment that may not cause further issues and problems. any bladder/kidney pain during this time has never returned.
Kidney function normal

Also during these investigations I was told I might have the starting of a small hernia but at this point there was no need to do anything.

Ultrasound of abdomen done. Nothing abnormal. small cyst in spleen nothing of issue.

January 2014 – Sudden onset of feeling very unwell, full limbs tingling and limb numbness. Went to see diabetic doctor assuming it was diabetic related. She noticed thyroid was enlarged. Though general wellness may be due to a virus.

Thyroid function was normal

Vitamin D level was low started taking vitamin D, multivitamins and omega 3 capsule daily.

Multinodular goitre diagnosed ultrasound completed. Nothing noticeable small multinodular goitre cause unknown.

February 2014 - Neuropathy symptoms completely subside

March 2014 – Recurring nightly chest pain for several days went to A&E when it was particularly bad they performed an ECG and said everything was normal and it was most probably heartburn. Got month long medicine for this which has general cause heartburn to go away.
Now occurs very infrequently.

May 2014 – Ingrowing infected toenail. Received antibiotics from walk in centre and was seen by a podiatrist who removed and treated it. Lasted about 2 – 3 weeks.

July 2014 - glands swollen (very large one under arm) but swollen all over (including groin, armpits, neck. The tingling and pain came back (and still feet). I also have the numbness again in my arms or legs when I sit down.

Sore throats occurring at this time.

Along with this I now have pain in my joints particularly wrist and elbow and knuckles.

General feeling of unwell (as my wife says I look a bit pale).

I appreciate this reiterates something I have already said but as everyone has been so helpful I wanted to make sure there was nothing here that I have not mentioned that could be important.

Have you been tested for mono? Sore throat and swollen
glands are typical with it.

What antibiotics have you taken recently ? Fluoroquinolones like
Cipro and levaquin can cause PN.

I'd investigate olive leaf extract for your chronic virus issue.
It is very helpful for some . There is a good post currently on
MS forum with information and links .. I am on an iPhone and
cannot get that link for you now . Use our search function
To find it. OLE is very helpful for some chronic problems.

reply
 

Just wanted to say I have thyroid nodules in 3 places and multiple ones on my thyroid. Nodules can run in families. They are common. My sister had her thyroid out due to her goiter. I have a friend who has these as well. Her sister had her thyroid out too. So there you go. I actually had one of mine aspirated and need to do follow-up ultrasounds. Ask if you can have a copy of your scan.
I have so they say idiopathic neuropathy. I think it is due to my spinal issues but who knows. I don't think drs for me did that much testing.
I assume you are in England or the UK since you mentioned a "stone" gain. Where are you located?
I can share some info with you if you want to PM me I listened to hrs of a thyroid seminar that was suggested on this website back in June I think. It was very good with many hrs of talking to drs each nite.

Hi Matt,

Here's the link to the "Olive Leaf Extract" thread from MS Forum that mrsD mentioned in her post to you.

Olive Leaf Extract

Check that your vitamin D is D3 and not D2. D2 is (IMO) virtually worthless. ;)

d2 vs d3

Doc

I will check that the supplements I am taking do not seem to mention which D it is.... I will buy better brand supplements :)

I did actually tested positive for antibodies for Epstein Barr (Mono/glandular fever) but it was a historic infection I have had in the past and was not active so the Dr ruled it out as a cause.

Antibiotics I have taken recently are...

Metronidazole (a few months ago for my ingrown toenail) and Clarithromycin (last week or so for **** abscess flare up)

Looking through all of the posts so far I am so grateul how helpful everyone is.

I will also look into olive leaf extract.

I will list the supplements I take later and see if there is anything noteworthy there.

Matt

Metronidazole is a known trigger for peripheral
Nerve damage.

Hopefully with time you will recover. Some do and
Some don 't.

Drug induced or toxin induced PN often responds
To acetyl carnitine. 500mg to start and work up
to 2000mg a day in divided doses. This helps the
damged mitochondria use fatty acids for
Energy instead of glucose. This may be
Helpful for your diabetes too.

Thank you , Lara for helping out.

OLE is very good for viral problems.
I had mono over about 50 yrs ago and still
Get swollen glands. The OLE takes them down
Within 3 days!

Epstein Barr stays with you for life (like Herpes Zoster--
Shingles) and I personally believe it reactivates.
It is thought to be the trigger for lymphoma
Later in life.

If you do the OLE drink lots of water
And start slowly at one a day with food.
If you have a large viral load you may get a
Detox reaction.. Called Herx. The water helps
Flush the toxins out faster.
The detox varies from person to person and
After it you will be astonished at how
Much better you'll feel. OLE is quite amazing.

D2 is ergo calciferol --avoid this one

D3 is cholecalciferol and this is the one you
Want. 1000iu per each 10 points you need
To raise.. based on your test results.

Yep.

epstein-barr reactivation

It got me pretty good with Chronic (more than 15 days/month) Tension-Type Headache/Migraine Complex (Sudden Onset) for over a decade now. They're not technically "chronic" anymore, but that's of little comfort/import when one comes on... :icon_cry:

Doc

This is really intersting as both bouts of neuropathy symptoms in the last year have been accompanied by swollen glands and aching joints.

I think this could be a strong possibility

In terms of my current vitamin regime I take:

25mcg Vitamin D (just ordered D3 to replace this with)
Vitamin B Complex
2000mg Cod Liver Oil
14mg Iron
360 mg of vitamin C
200mcg selenium
150mcg iodine

Have also just ordered RLA and OLE

Did your doctor tell you to take iron?
Was this based on testing?

Males should not use iron unless they are told to
And supervised by a doctor.

Cod liver oil is high in retinol... Too much
of this can be toxic and affect the pressures in
the brain. Use fish oil or krill oil for your
Omega-3s.

And test your blood sugar on the OLE.
Type 2 diabetics may see a better
Response to insulin resistance but you
Are using insulin now... Correct?
It may over time with the OLE improve your
Insulin response and you may need adjustments
In dose of the insulin. But I really think not
In your case.

Chronic infections tend to raise blood sugars
So as those recede your blood sugars may
Fall a little for that reason.

While not anaemic I was on the low end of normal for iron. Dr suggested I take some iron. I am getting retested in a few weeks and will stop if those are normal.

I did not realise there was much difference in the way you got omega 3. Up until recently I used Flaxseed Oil for omega 3 so may go back to that.

Yes I am type1 but I am hoping the OLE will help with the chronic infections I have been having that ahve been playing havoc with blood sugars....

and the weirdest thing.... after a day of feeling like my feet and hands were on fire on Saturday it subsided yesterday and now I feel ok..... No pain and not really any tingling....

god my health is all odd atm..

I almost seem to have 1 symptom at a time..... currently I have indigestion.... Also I am sure someone will know does taking several vitamin tablets have a negative effect on your stomach?

Flaxseed provides alpha linolenic acid
which is an essential omega-3.
This enters a complex biochemical pathway,
To the long chain fatty acids EPA and DHA
Which are used in fixing nerves.

However there exits a gender gap with it. Males do not
convert flax in high amounts. I have read estimates that
only about 4% gets converted. Females who carry
Developing fetuses convert in the low 20% range
Because a developing brain before birth
Requires huge amounts of DHA and EPA.

So males should take fish oil or krill oil
To get the benefits that flax alone cannot
Provide enough of.

Upping doses of cod liver oil is a common
Mistake that health food store personnel mistakenly
Advise customers. There is too much vit A
And not enough DHA in it.

I was going to make the same observations about iron.

I don't know how mcg. relates to D3. Mine is rated at 5000 IU.

360 mg of C seems light to me. I usually take 500-1000 mg/day. Ascorbic acid exacerbates my IBS (causes bleeding), so I take a calcium-based ester C.

I'm allergic to cod liver oil. :rolleyes:

I should have mentioned before that RLA can lower blood sugar, so just be aware of that. Some sources question whether RLA taken orally is effective (it's used intravenously in Germany). I can attest that it's very effective for me. It stopped the burning pain completely.

It can, but I spoze it depends on the individual, the vitamins, and whether or not you take them with food. Methylcobalamin (B12) should be taken on an empty stomach, but with others it doesn't matter. That info should be in the supplements threads.

Doc

Based on your suggestions I have increased my intake of vitamin C and am still awaiting my delivery of RLA.

I have also been taking 160mg of Oleurpeln in Olive Leaf Extract spread out over the day to see if it helps with whatever virus this is. Only a day in (and no Herx reaction) so we'll see where this goes. Last night I felt really wierd like I was having a kind of spacey out of body experience. Although I was sober not on drugs and my Blood Sugar was fine.

Oddly after my symptoms appearing last Thursday and disappearing on Sunday they have returned slightly this evening (Wednesday). Both times they have reappeared seem to be following exercise.

Has anyone heard about neuropathy flaring up due to exercise?

Finally I am being tested for Lyme Disease, Cat Scratch Fever and Toxoplasmosis on Friday in the next round of what the crap is wrong with me to cause swollen glands for 6 months and neuropathy symptoms that may or may not be diabetes related. Although my Diabetic Care Team is still convinced this is pathogenic and not Diabetes.

Thanks for all the help so far I am super appreciative.

It comes up from time to time... To exercise to improve circulation/blood flow to nerves and risk exacerbation/flares, or not?

Check the archives for threads with exercise in their titles, e.g.
Does exercise bother you?
There are ~16 such threads.

Doc

Had a sudden moment of inspiration last night

I think a good candidate for what I might have is candida overgrowth.

I have had sweat rash (same fungus) on and off for months.

I also had several antibiotics right before all of this started 6 months ago for a variety of things

This would also explain all of my symptoms including the heartburn and stomach discomfort which could not be explained by any other ideas.

Going to see the doctor next week and get them to test for it.

So grateful to everyone who has posted here been a real comfort will let everyone know how the results come out.