An explanation of various treatments for neuropathy Warning! It aint gonna go viral on YouTube!

We're going to drop in on the 2006, Rare Neuroimmunologic Disorders Symposium to listen to and watch a talk given by Joanne Lynn MD. For the first two and a half minutes you may well wonder why, because the video takes some time to get to the point, or at least the points that are relevant to us. Apart from that, the good lady is not exactly the most inspiring speaker to listen to but stay with it because there is so much useful information and explanation which is specific to our problems. Apart from that, the slides that are shown, explain the difficult vocabulary that would normally go in one ear and out of the other.

You must remember that this is a medical professional talking to other medical professionals and therefore, there aren't very many fireworks to keep your attention but it's worth the effort. I've watched this three times and have learned something new and useful each time.

You can read the transcript of the video on: http://www.myelitis.org/newsletters/v7n2/newsletter7-2-02.htm
It helps!

Neuropathy Patients Hate Exercise But They Mustnt Avoid It

Today's short post from journals.lww.com (see link below) is a response from a doctor to a question most of us with neuropathy hope the answer to, will be a resounding "No". Unfortunately, the answer is yes to the question as to whether exercise helps with neuropathy. So we need to be prepared to put our bodies through yet more pain and discomfort for their benefit in the long run. The key is, making exercise something that is so obviously valuable that we can't ignore it and making it as pleasurable as possible. You can groan all you want (I do too) but the fact is that neuropathy weakens our muscles and joints to such an extent that it makes the pain considerably worse, never mind the fact that we can't do simple tasks any more. Read the article and think about your best strategy but don't overdo it and listen to your body when it tells you that you're doing just that.

Departments: Ask the Experts
You Ask. We Answer: 
Is exercise helpful for peripheral neuropathy?
Ensrud, Erik MD Neurology Now: October/November 2016 - Volume 12 - Issue 5 - p 31 doi: 10.1097/01.NNN.0000503487.82934.2d
 
Q Is exercise helpful for PERIPHERAL NEUROPATHY?

ERIK ENSRUD, MD, RESPONDS:

Answer: Yes, as long as you aren't overdoing it. The same benefits that anyone gets from exercise—improved cardiovascular function, increased mobility, a boost in mood—are realized by people with peripheral neuropathy, regardless of its cause. People with neuropathy may also experience an improvement in function and quality of life, as well as a decrease in pain.

PICK AN APPROPRIATE EXERCISE

Peripheral neuropathy is a general term for a group of diseases that affects motor and sensory nerves outside the brain and spinal cord. There are different types of neuropathy, and each has different causes and effects. Focal neuropathy, for instance, usually affects just one nerve or group of nerves. A common example is carpal tunnel syndrome, which involves nerve damage in the wrist. Any exercise that involves repetitive motion directly on the joint, such as playing tennis or texting or typing for hours on end, could aggravate the condition. Proximal neuropathy can reduce muscle strength in the legs and hips, so patients with this type of neuropathy might try riding a recumbent bike to avoid putting too much force on a compromised leg or hip joint.

STAY WITHIN YOUR LIMITS

When people think of exercise, they often think of the intense workout regimens of Olympic athletes like Michael Phelps and Katie Ledecky. But for most people, intense exercise is counterproductive. For people with neuropathy in particular, overstressed muscles may not recover as well because of existing nerve problems. A good rule of thumb during exercise is the talk test: If you can maintain a conversation without becoming breathless while exercising, you are likely at the right exertion level.

MAKE EXERCISE ENJOYABLE

If physical activity feels like a chore or is inconvenient, you'll eventually stop doing it. Decide what you like to do—swimming, biking, walking, dancing, yoga, tai chi—and how you like to do it—with friends, at home, in nature, as part of a class—and you're more likely to stick with it. The goal is to create a positive association with exercise so you do it more often. Consider an activity tracker, which logs your steps every day; seeing the steps add up can be very motivating for some people.

START SLOWLY AND BUILD

Before beginning any exercise program, talk to your doctor. You want to be sure you don't have any conditions that may affect the type of exercise you can do or how long you can safely do it. Once you get the all-clear, start out with five to 20 minutes of exercise three times a week. As your fitness improves, gradually add minutes, distance, or intensity. A good way to start is by walking around a large indoor shopping mall or store. The surface is level, the temperature is comfortable, you can use a shopping cart for stability, and it's free—unless, of course, you buy things.

Dr. Ensrud is director of neuromuscular disease rehabilitation at St. Luke's Rehabilitation Institute in Spokane, WA. He is also a member of the American Academy of Neurology.

© 2016 American Academy of Neurology

http://journals.lww.com/neurologynow/Pages/articleviewer.aspx?year=2016&issue=12050&article=00019&type=Fulltext

Testing For Small Fibre Neuropathy Why It Matters

Today's post from neuropathyjournal.org (see link below) highlights the necessity for doctors to test properly for neuropathy (if they are going to test at all). Many patients go home with clear neuropathic symptoms but a negative diagnosis, purely because the neurologist hasn't tested for small fibre neuropathy and has instead concentrated on large fibre nerve damage by using EMGs and nerve conduct studies. Strictly speaking, the only way to confirm small fibre neuropathy is by conducting a skin biopsy but most neurologists and doctors won't do this because of cost and other difficulties. For this reason, many patients are simply misdiagnosed as not having neuropathy when in fact they do. This useful article provides the facts about small fibre neuropathy and if you recognise yourself in these descriptions, it may be worth having another discussion with your doctor about your original diagnosis.

Small Fiber Neuropathy
By LtCol Eugene B Richardson, USA (Retired) BA, MDiv, EdM, MS1 

So many neuropathy patients have heard these words from very qualified neurologists and health professionals. “Your EMG and Nerve Conduct Studies are normal and you do not have neuropathy!” Right? Wrong!

Dr. Norman Latov of Cornell University states clearly along with many other professionals that the EMG and Nerve Conduct Studies only measure damage to the large fibers. In fact it is well known that a patient can have symptoms of Peripheral Neuropathy long before damage is done to either the large or small fiber nerves! Plus small fiber damage can only be measured by a simple Skin Biopsy to determine if the patient has damage to the small fibers.

David Saperstein M.D. and Todd Levine M.D. write for the GBS/CIDP Foundation International in Summer 2012 in The Communicator: “Immune-Mediated Small Fiber Neuropathy: A Treatable Condition That Can Mimic GBS and CIDP” . The authors note that “some patients may have elevated spinal fluid protein levels as in (GBS and CIDP), while other patients will have evidence of a monoclonal protein in their blood (which can be associated with some kinds of CIDP) and note that acute onset SFN can be immune-mediated and may respond to the same therapies used for GBS, such as intravenous immunoglobulin (IVIg). In contrast to GBS, however patients with acute onset SFN may respond to corticosteroid medications such as prednisone.” The doctors continue with a recommendation that the skin biopsy is a very useful tool in the diagnosis of SFN.

Testing-Skin Biopsy

Therapath Pathology does epidermal nerve fiber density testing. Skin Biopsy

Small Fiber Neuropathy

Small fiber neuropathies affect the small, unmyelinated nerve fibers in the sensory nerves. These fibers convey pain and temperature sensations from the skin, as well as maintain autonomic functions (Stewart el al, 1992; Novak et al 2001). The diagnosis can easily be missed, as the neurological examination may reveal only minor sensory abnormalities and EMG and nerve conduction studies, that measure the large fibers, are frequently normal. Consequently, some patients with small fiber neuropathy are misdiagnosed as having a psychosomatic disorder, RSD, fibromyalgia, or restless leg syndrome instead. (Lacomia, 2002; Hermann et al, 2004; Polydefkis et al, 2005).

Symptoms of Small Fiber Neuropathy

Symptoms of small fiber neuropathy include numbness and annoying or painful spontaneous sensations, called paresthesias, that are variably described as tingling, stinging, burning, freezing, itching, aching, pulling, squeezing, or electric shock-like in character. Innocuous stimuli can provoke unpleasant sensations, called dysesthesias, as when clothes feel like sandpaper against the skin, the hands are hypersensitive to touch, and pressure from shoes or socks causes severe pain. These symptoms can occur anywhere in the body, including the arms, legs, torso, face, or even the mouth. (Walk et al, 2003; Lauria et al. 2005)

Causes of Small Fiber Neuropathy

Small fiber neuropathy can result from a number of causes and the neuropathy is often the first manifestation of an underlying systemic disease. It can be caused by diabetes mellitus or glucose intolerance (Polydefkis and McArthur, 2005) and by such autoimmune conditions as Sjogren’s syndrome (Chat et al, 2005) Lupus (Omdal et al, 2002), sarcoid (Hoitsman et al, 2005) vasculitis (Lacomis et al, 1997; Zafrir et al, 2004) Lee et al, 2005), inflammatory bowel disease (Gondim et al. 2005) or variants of Guillain-Barre syndrome (Seneviraine and Gunasekera, 2002). Other causes include nutritional deficiencies, celiac disease (Brannagan et al, 2005), Lyme disease, HIV-1 infection (Polydefkis et al. 2002) hereditary disease (Dyck et al, 1985) Dutsch et al, 2003), amyloid, alcohol abuse (Zambelis et al, 2005) or toxins (Kuo et al, 2005). Some sensory neuropathies that affect both the small and large nerve fibers can cause a reduction in epidermal nerve fiber density, before electrodiagnostic abnormalities.

How is SFN diagnosed

The diagnosis of small fiber neuropathy can be made with certainty, by demonstrating a reduction in the density of small nerve fibers in the skin. EMG and nerve conduction studies are usually normal in this condition, as they mostly measure the large nerve fibers in the motor or sensory nerves. The epidermal nerve fiber is normal in patients with central nervous system disease. (Latov; Brannagan)

About the Author

Col Richardson has suffered with severe neuropathy for over 45 years. A 27 year military veteran and veteran of the Vietnam War, he was diagnosed with a progressive chronic peripheral neuropathy resulting in severe disability. This diagnosis has been confirmed as due to exposure to Agent Orange. It was not until 2010, 42 years after his exposure to Agent Orange, that his diagnosis was recognized by Veterans Affairs as service connected.

https://neuropathyjournal.org/small-fiber-neuropathy/

Just Saying That Exercise Helps Neuropathy Doesnt Necessarily Make It So

Today's post from nursing.onclive.com (see link below) again promotes exercise as a way of reducing neuropathy symptoms but in this case, the evidence seems a little thin. By testing a group of cancer patients with neuropathy as a side effect, they found that walking and other general exercise prevented the symptoms from worsening, especially in older patients. I would suggest that moderate exercise will help older patients feel generally better anyway than sitting or lying for long periods of time but they'll need to provide much more specific evidence to prove that neuropathic symptoms can be reduced by a graduated walking course. In this case, I would suggest that with this sort of patient, there are far too many variables to come to the conclusion that exercise is more effective in reducing or limiting nerve damage symptoms in older people. That said, there is a general consensus among doctors that regular exercise will improve neuropathy, or at least stop it getting worse but in this case, I feel too much is being assumed from too little data.

Walking and Resistance Training Eases CIPN, Especially Among Older Patients
LAUREN M. GREEN @OncNurseEditor Wednesday, July 20, 2016

Patients undergoing chemotherapy prescribed a formal exercise program experienced less chemotherapy-induced peripheral neuropathy (CIPN), and the finding held true across all chemotherapy regimens tested. The effect was strongest in older patients, according to findings from a nationwide randomized controlled trial reported at the 2016 ASCO Annual Meeting.

CIPN is a highly prevalent and severe side effect of certain chemotherapy types, such as platinums, taxanes, and vinca alkaloids, affecting more than 50% of patients receiving these therapies. Nevertheless, “there are currently no established treatments for CIPN—despite 50 randomized clinical trials—testing the efficacy of drugs to prevent or treat it,” explained lead study author Ian Kleckner, PhD.

Kleckner, a research assistant professor at the University of Rochester Medical Center, and colleagues performed a secondary analysis of a subset of 314 sedentary patients receiving taxane-, vinca alkaloid-, or platinum-based chemotherapy derived from a larger, phase III, national, randomized controlled trial (N = 619).

The majority of patients were women (92%), and 78% had breast cancer. They were randomized to chemotherapy alone or chemotherapy plus exercise. Patients randomized to the EXCAP arm (Exercise for Cancer Patients) which is a personalized, 6-week, home-based, moderate-intensity progressive program, were prescribed a daily walking regimen (eg, steps per day), supplied with pedometers, and also given a set of resistance bands to perform specific exercises.

Walking and resistance exercises were recommended for the control group. They did not receive any formalized support; however, control participants were given the exercise kit at the end of the study.

The investigators used patient self-report of tingling and numbness at baseline and after the intervention, rated on a 0-10 scale with 10 being the worst level of CIPN. In the EXCAP arm, CIPN was reduced compared with controls, with an effect size of 0.26 (P = .06), and the finding was independent of other variables, such as gender, BMI, and cancer stage. However, age was a moderating variable.

“We found that exercise was more effective for older patients,” said Kleckner. “Older patients in the control arm experienced a large increase in CIPN after 6 weeks of chemotherapy, whereas older patients in the experimental exercise arm had a very small, if any, increase in CIPN.”

Kleckner said that based on these findings, he and colleagues hope to expand their research. “What we’d like to do now is design a randomized clinical trial testing exercise against chemotherapy alone, where CIPN is the primary outcome. Only one trial to date has looked at this, and it was very small—60 patients.”

He hopes researchers can identify biomarkers in the brain circuitry or signals of the role inflammation may play to help better identify who is most at risk for CIPN.

Over the next few years, Kleckner would like to see this research continue to “scale up, so we can better learn about the effectiveness of exercise, understand what dose/intensity of exercise is important, what type of exercise, and who responds best to exercise … we’re hoping for an exercise prescription, instead of the generic ‘please exercise.’”

Kleckner I, Kamen CS, Peppone LJ, et al. A URCC NCORP nationwide randomized controlled trial investigating the effect of exercise on chemotherapy-induced peripheral neuropathy in 314 cancer patients. J Clin Oncol. 2016; 34 (suppl; abstr 10000).

http://nursing.onclive.com/web-exclusives/walking-and-resistance-training-eases-cipn-especially-among-older-patients

What it means to me

To be a Wise Woman Herbalist.

Upon preparation for teaching my workshop yesterday (a Wild Medicine Walk) I got inspired to try and articulate this, so I could print it out to include with the handouts.

How did I do? Did I forget anything?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

What it means to be a Wise Woman Herbalist

To be a Wise Woman Herbalist means to carry a philosophy of wholeness and inclusion. We view the human body as a self-actualized ecosystem, capable of complete healing and regeneration. We believe that health is innately ever-present and continues through nourishment and love. That health is nourished through whole foods and plant medicine. We believe that illness is the body’s way of bringing information to our conscious selves. It is the language of the body. We do not believe that the body is broken and is in need of fixing. We do not believe the body is filthy and needs cleaning and purging. Illness is our Teacher not our enemy. Herbs are our naturally available healing, nourishing allies.

To be a Wise Woman Herbalist means to use locally available, abundant, sensible resources; to use herbs wisely for food and medicine, ethically harvested or grown, and to ally with them. It means that I am the ultimate authority on my health, happiness and well being and I ask my self first and last before making any choices. I choose to listen to my body’s cues, and to trust my body’s capacity for health. I consciously prepare whole, holographic medicines.

Wise Women Herbalists honor the plant bodies as living beings, and honor their gifts of sacrifice upon harvest. Gifts of food or liquid or something sacred is offered to the plant in gratitude.

Our philosophy or paradigm is manifested as a spiral symbol. Life, death, birth, and rebirth are all an equal experience and a constant. We all grow, change, shed old patterns, and recreate ourselves and our environments. We are part of Mother Earth, therefore we embody her patterns and cellular knowledge. Life includes all expressions and experiences and is in constant flow.

Its Not What You Say Oh Wait A Minute It Is! A Guide For Pain Patient Supporters

Today's post from paindoctor.com is a very sensible list of better ways to support a pain patient via the things you say. It's not easy being a friend or relative of someone in chronic pain and most pain patients are well aware of that. Nevertheless, if people just took a second to think about how they phrase something, it can act as a positive and supporting moment for the patient. Unfortunately, thinking twice doesn't come naturally to most people. They think they're saying the right thing but are inadvertently hurting the patient's feelings by being a little insensitive. This article may just be able to act as a guide for friends and family; or at least make them think about how they approach certain issues.

Say This, Not That: Supporting The Chronic Pain Patient  
By Pain Doctor| September 30th, 2015

 People who have a chronic pain patient in their life often walk a fine line in terms of saying the wrong thing. Even the most caring person may inadvertently say things that can be hurtful. They may make assumptions or judgments in their language, not realizing they are doing so. In Say This, Not That, we identify some of these statements and offer alternatives.

Instead of: Does it really hurt that bad? Man up!

Suggesting that a chronic pain patient is less of a “man” or somehow less tough because they are in pain can be not only hurtful to the patient but also permanently damaging to your relationship with them.

Say: Time to call it a day? No problem. I’m ready, too.

Pain is the body’s way of protecting itself against further injury. In some cases, certain types of pain, such as the pain an athlete may feel in training, may be okay. When it comes to chronic pain, “manning up” can cause days or even weeks of backlash with intense pain and difficulty moving. Going at a chronic pain patient’s pace is telling them that it’s okay to feel what they are feeling and allows them the freedom to stop when they are done.

Instead of: There’s a lot you can’t do, isn’t there?

Talk about hurtful! Chronic pain patients are well aware that their condition has made life more challenging. There are activities that are no longer available to them, and they may never recover those abilities. To point this out is not only unsupportive but also downright cruel. There is no sense in highlighting what a chronic pain patient is missing out on.

Say: What do you enjoy doing?

Highlight the things that a chronic pain patient enjoys doing, and work towards those. If a patient says they loved to ride horses before their spinal injury, find a local horse rescue to visit. Do they love playing sports? Many types of adaptive sporting equipment are available for that. While they may never be able to compete in a hunter-pace or golf in a major tournament again, there are ways for chronic pain patients to enjoy the things they love. Accentuate what they can do instead of dwelling on what they can’t.

Instead of: Let me do that for you.

Chronic pain is often interpreted as helplessness. Even though awareness is growing, many still believe that chronic pain patients are unable to care for themselves in any capacity. Others may believe that physical exertion and activity are to be strenuously avoided and will rush in to take over every task, from little things like chopping onions to more physical actions like rearranging furniture.

Say: How can I help?

Before you take those groceries away from a chronic pain patient, ask first if you can help. Although chronic pain patients have days when even blinking is a painful activity, not every day is quite as challenging.

Treating a chronic pain patient as an invalid promotes a cycle of learned helplessness wherein the patient does little and then develops the ability to do even less. Physical activity and movement are actually recommended as much as possible for chronic pain patients, especially for those with conditions that worsen with inactivity (like rheumatoid arthritis). If you see a chronic pain patient struggling or about to fall from a burden they are carrying, don’t hesitate to assist. Otherwise, ask if they need help before swooping in.

Instead of: You are in pain? Here’s some aspirin/ibuprofen.

There are many different things that are wrong and potentially harmful in this statement.
Offering a chronic pain patient an aspirin for their pain is like bailing the ocean out with a teaspoon. Many chronic pain patients suffer from pain that an over-the-counter medication won’t even touch.
Assuming that chronic pain can be fixed by popping a pill – prescription or otherwise – is uninformed and plays into the stereotype of the addicted chronic pain patient.
Chronic pain patients who do take medication under the supervision of their doctors may have already taken their dose for the day, and to offer them more of anything can be dangerous.

Say: You are in pain? Is there any way I can help?

Chances are good that the answer to that question will be “no,” but asking to help instead of offering what you feel is the best solution is the fastest way to earn a chronic pain patient’s respect and trust. In doing so, you are not assuming anything about the chronic pain patient’s experience. You are making yourself available to help in any way that the patient needs, and that is an invaluable gift.
Instead of: Wow, you take a lot of pills!

Chronic pain patients who are taking prescription or over-the-counter medications for pain are already completely aware that they take “a lot” of pills. This statement may be embarrassing for them and may make them less likely to be open about their treatments with you.

If you are a caregiver, the last thing you want is a patient who feels like they have to hide their pills. This can make patients feel ashamed of their treatment and potentially less likely to follow it closely. There is also a strong emotional aspect of chronic pain, and treating a chronic pain patient like an overeager pill-popper is the fastest way to make them feel isolated and alone.

Say: I want to understand your treatment regimen. Are you willing to share?

Again, the answer to this might also be “no,” but asking the question instead of making assumptions is respectful and opens the door for better communication. In some cases, chronic pain patients may, indeed, be taking higher doses of over-the-counter medications than healthy people would take for muscle soreness or a headache. Encouraging the patient to communicate about their treatments, including medication and therapies, can build trust and let the patient know that you truly care about them getting better. If there is any question about medication amounts or you have concerns later on about prescription abuse, this foundation of nonjudgmental trust can make it easier to talk about your concerns.

Instead of: Have you tried______ (examples include: juicing, yoga, meditation, etc.)?

While some chronic pain patients have found relief from some of their symptoms through diet, low-impact exercise, and mindfulness meditation, others have tried everything they can find, to no avail. It can be very frustrating to have a pain-free person suggest treatments that may be scientifically unfounded and/or considered sham treatments or “snake oil.”

Say: What treatments have worked for you?

Chronic pain patients often have a long list of treatments they have tried, some of which may have worked better than others. Rather than assuming you can fix your friend’s pain with a well-intentioned but potentially uniformed suggestion, ask them what has worked or what they might try next. There is a fine line between wanting to be helpful by providing suggestions and being condescending and ignorant in assuming the patient hasn’t tried what they can. If you are a caregiver of a chronic pain patient, you will know where that line is. Others need to be more sensitive when offering suggestions and seek first to understand what has already been tried.

It is important to assume nothing and communicate with kindness and compassion. What are some other potentially hurtful questions or statements, and how can they be turned around?

https://paindoctor.com/say-this-not-that-supporting-the-chronic-pain-patient/

Opioids It Can Be A Matter Of Semantics For Chronic Pain Sufferers

Today's short post from health.economictimes.indiatimes.com (see link below) has implications for neuropathy patients who have been forced to take opioids in order to control their pain. The current hoo-ha about opioids presents a real danger to patients who genuinely need them because literally nothing else works! This article takes the view that opioid prescription is questionable if there are no ensuing physical function benefits. However, you have to ask whether opioids were ever thought to improve physical function - they're not steroids after all. The point of opioids is that they dampen pain signals and if used properly, they're very effective indeed, so improved physical function is of secondary importance to neuropathy patients - the fact that their pain is reduced to a point where they can live more or less normal lives, is the priority. Physical function improvement can come from other sources. 

Opioids don't guarantee improvement in physical function IANS 24 January 2016

 Patients who were not prescribed any opioids had statistically lower disability and higher physical functioning scores.

People suffering from neuropathic pain complex, chronic pain that usually is accompanied by tissue injury report no improvement in physical functioning after taking opioids that tackle pain, researchers said.

"Even though opioid medications can be a powerful pain killer, it does not necessarily mean improved function will follow," said lead author Geoff Bostick, associate professor at the University of Alberta in Canada.

Patients who were not prescribed any opioids had statistically lower disability and higher physical functioning scores, the findings showed.

Opioids can help people with severe pain be more comfortable, but if they are not facilitating improved physical function, the impact of these medications on quality of life should be questioned, the researchers said in the study published in the journal Pain Medicine.

Stressing the importance of physical function, the researchers suggested that patients who are experiencing chronic pain and are medically cleared for physical activity should find a way to promote movement, even if it is painful.

The study looked at 789 patients across Canada who provided baseline measures of self-reported function, and again at six and 12 months after treatment.

These patients suffered with neuropathic pain from nerve injuries such as diabetic neuropathy and pinched nerves.

http://health.economictimes.indiatimes.com/news/industry/opioids-dont-guarantee-improvement-in-physical-function/50703209

Is It Normal To Bleed During Pregnancy

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Curcumin Curcuma Turmeric Does It Help With Neuropathy Pain

Today's post from informahealthcare.com (see link below) takes another look at the potential for curcuma, (Turmeric) to help reduce the discomfort of neuropathy. In this case, the study was done on mice and achieved significant success but what this does is really back-up the mass of evidence produced by ordinary people who have tried curcuma and also found it to be beneficial. It's one of those alternative treatments that have a place in folklore but are rarely tested scientifically but because of all the apocryphal evidence, this and other tests are justified. The problem is that like all potential treatments for neuropathic pain, it works for some and not for others and furthermore, it's not just a question of taking supplements for a month and seeing if they make a difference; in reality curcuma has to form part of a long-term plan, even if it is just as a supplement. The evidence certainly seems to bear out what many people claim but you will need to discover for yourself if you can benefit personally. One big plus is the price - as a pill or capsule supplement, it's not expensive and is widely available.

Effect of curcumin in mice model of vincristine-induced neuropathy Anand Babu, K. G. Prasanth, and Bhaskar Balaji June 2015, Vol. 53, No. 6 , Pages 838-848 (doi:10.3109/13880209.2014.943247)

Department of Pharmacology, PSG College of Pharmacy,
Coimbatore, Tamil Nadu , India

Abstract

Context: Curcumin exhibits a wide spectrum of biological activities which include neuroprotective, antinociceptive, anti-inflammatory, and antioxidant activity.

Objective: The present study evaluates the effect of curcumin in vincristine-induced neuropathy in a mice model.

Materials and methods: Vincristine sulfate (0.1 mg/kg, i.p. for 10 consecutive days) was administered to mice to induce neuropathy. Pain behavior was assessed at different days, i.e., 0, 7, 10, and 14 d. Sciatic nerve total calcium, superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), reduced glutathione (GSH), nitric oxide (NO), and lipid peroxidation (LPO) were also estimated after the 14th day of study. Pregabalin (10 mg/kg, p.o.) and curcumin (15, 30, and 60 mg/kg, p.o.) were administered for 14 consecutive days.

Results: Curcumin at 60 mg/kg significantly attenuated the vincristine-induced neuropathic pain manifestations in terms of thermal hyperalgesia (p < 0.001) and allodynia (p < 0.001); mechanical hyperalgesia (p < 0.001); functional loss (p < 0.001); and in the delayed phase of formalin test (p < 0.001). Curcumin at 30 and 60 mg/kg exhibited significant changes (p < 0.001) in antioxidant levels and in total calcium levels in vincristine-injected mice.

Conclusion: Curcumin at 30 and 60 mg/kg dose levels significantly attenuated vincristine-induced neuropathy which may be due to its multiple actions including antinociceptive, calcium inhibitory, and antioxidant effect.

http://informahealthcare.com/doi/abs/10.3109/13880209.2014.943247