Why Nerve Cells Die Important To Neuropathy Patients

Today's post from neurosciencenews.com (see link below) provides further information on the subject of an earlier post here on the blog (Sat. 25th April - scroll down to find), concerning the death of nerve cells and how learning about this can lead to new neuropathy treatments in the future. Finding out why nerve cells and axons either die or degenerate is vital to finding out ways to stop that process from happening. This article both fills in the gaps of the earlier article and explains the science in a much easier understood way. It teaches neuropathy patients what goes on in our nervous system and why that can cause such extreme symptoms but more importantly, gives us hope that serious research is being done to improve the situation. Worth a read.

Major Pathway Identified in Nerve Cell Death Offers Hope for Therapies
Neuroscience News April 23, 2015

New research highlights how nerves – whether harmed by disease or traumatic injury – start to die, a discovery that unveils novel targets for developing drugs to slow or halt peripheral neuropathies and devastating neurodegenerative disorders such as Alzheimer’s disease, Parkinson’s disease and amyotrophic lateral sclerosis (ALS).

Peripheral neuropathy damages nerves in the body’s extremities and can cause unrelenting pain, stinging, burning, itching and sensitivity to touch. The condition is commonly associated with diabetes or develops as a side effect of chemotherapy.

The research, by scientists at Washington University School of Medicine in St. Louis, is reported online April 23 in the journal Science.

Nerve cells talk to each other by transmitting signals along communication cables called axons. Such signals underlie vital activities, such as thinking and memory, movement and language.

As part of the study, the researchers showed they could prevent axons from dying, a finding that suggests therapies could be developed to counteract the withering away of nerve axons.

“We have uncovered new details that let us piece together a major pathway involved in axon degeneration,” said senior author Jeffrey Milbrandt, MD, PhD, the James S. McDonnell Professor and head of the Department of Genetics. “This is an important step forward and helps to identify new therapeutic targets. That we were able to block axon degeneration in the lab also gives us hope that drugs could be developed to treat patients suffering from a variety of neurological conditions.”

A common thread among many neurological disorders and traumatic nerve injuries is the degeneration of axons, which interrupts nerve signaling and prevents nerves from communicating with one another. Axon degeneration is thought to be an initiating event in many of these disorders. In fact, an unhealthy axon is known to trigger its own death, and researchers are keenly interested in understanding how this happens.

Working in cell cultures, fruit flies and mice, Milbrandt and co-author Aaron DiAntonio, MD, PhD, the Alan A. and Edith L. Wolff Professor of Developmental Biology, and their colleagues showed that a protein already known to be involved in axon degeneration, acts like a switch to trigger axon degeneration after an injury.


Axon degeneration (top), caused by nerve injury or disease, depletes the energy supply within axons, shutting down communication between nerve cells. Washington University scientists blocked axon degeneration by supplementing neurons with a chemical called nicotinamide riboside, which kept the axons energized and healthy (bottom). The image is for illustrative purposes only. Image credit: Milbrandt lab.

Moreover, they found that this protein, once unleashed, causes a rapid decline in the energy supply within axons. Within minutes after the protein – called SARM1 – is activated in neurons, a massive loss of nicotinamide adenine dinucleotide (NAD), a chemical central to a cell’s energy production, occurs within the axon.

“When a nerve is diseased or injured, SARM1 becomes more active, initiating a series of events that quickly causes an energetic catastrophe within the axon, and the axon undergoes self-destruction,” said first author Josiah Gerdts, an MD/PhD student in Milbrandt’s laboratory.

Working in neurons in which SARM1 was activated, the researchers showed they could completely block axon degeneration and neuron cell death by supplementing the cells with a precursor to NAD, a chemical called nicotinamide riboside. The neurons were able to use nicotinamide riboside to keep the axons energized and healthy.

Nicotinamide riboside has been linked in animal studies to good health and longevity, but its benefits have not been shown in people. The researchers said much more research is needed to know whether the chemical could slow or halt axon degeneration in the body.

“We are encouraged by the findings and think that identifying a class of drugs that block SARM1 activity has therapeutic potential in neurological disorders,” Milbrandt said. “The molecular details this pathway provides give us a number of therapeutic avenues to attack.”
About this neurology research

Funding: The research is funded by the National Institutes of Health (NIH), grants RO1DA020812, RO1AG013730, RO1NS065053, RO1NS087632, RO1NS078007 and F31NS074517, and a grant from Vertex Pharmaceuticals.

Source: Diane Duke Williams – Washington University School of Medicine in St. Louis
Image Credit: The image is credited to Milbrandt lab
Original Research: Abstract for “SARM1 activation triggers axon degeneration locally via NAD+ destruction” by Josiah Gerdts, E.J. Brace, Yo Sasaki, Aaron DiAntonio, and Jeffrey Milbrandt in Science. Published online April 23 2015 doi:10.1126/science.1258366

Abstract

SARM1 activation triggers axon degeneration locally via NAD+ destruction

Axon degeneration is an intrinsic self-destruction program that underlies axon loss during injury and disease. Sterile alpha and TIR motif–containing 1 (SARM1) protein is an essential mediator of axon degeneration. We report that SARM1 initiates a local destruction program involving rapid breakdown of nicotinamide adenine dinucleotide (NAD+) after injury. We used an engineered protease-sensitized SARM1 to demonstrate that SARM1 activity is required after axon injury to induce axon degeneration. Dimerization of the Toll–interleukin receptor (TIR) domain of SARM1 alone was sufficient to induce locally mediated axon degeneration. Formation of the SARM1 TIR dimer triggered rapid breakdown of NAD+, whereas SARM1-induced axon destruction could be counteracted by increased NAD+ synthesis. SARM1-induced depletion of NAD+ may explain the potent axon protection in Wallerian degeneration slow (Wlds) mutant mice.

“SARM1 activation triggers axon degeneration locally via NAD+ destruction” by Josiah Gerdts, E.J. Brace, Yo Sasaki, Aaron DiAntonio, and Jeffrey Milbrandt in Science. Published online April 23 2015 doi:10.1126/science.1258366

http://neurosciencenews.com/peripheral-neuropathy-sarm1-1987/

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/

Why Do Our Hands And Or Feet Tingle

Today's post from webmd.com (see link below) is a thorough answer to the question why our hands and feet tingle. Many people ask this question long before having heard the word neuropathy and for many people, the symptoms are temporary but equally, for millions across the world, the symptoms never go away and become progressively worse. They then have a form of neuropathy or nerve damage. This article will set you on the right path as regards opening information; after that, you need to discuss your problem with your doctor and do as much further research of your own until you have built up sufficient knowledge to be best able to live with the disease.

Tingling in Hands and Feet
WebMD Medical Reference View Article Sources
Reviewed by Varnada Karriem-Norwood, MD on September 26, 2014

Tingling hands, feet, or both is an extremely common and bothersome symptom. Such tingling can sometimes be benign and temporary. For example, it could result from pressure on nerves when your arm is crooked under your head as you fall asleep. Or it could be from pressure on nerves when you cross your legs too long. In either case, the "pins and needles" effect -- which is usually painless -- is soon relieved by removing the pressure that caused it.

In many cases, however, tingling in the hands, feet, or both can be severe, episodic, or chronic. It also can accompany other symptoms. such as pain, itching, numbness, and muscle wasting. In such cases, tingling may be a sign of nerve damage, which can result from causes as varied as traumatic injuries or repetitive stress injuries, bacterial or viral infections, toxic exposures, and systemic diseases such as diabetes.

Such nerve damage is known as peripheral neuropathy because it affects nerves distant from the brain and spinal cord, often in the hands and feet. There are more than 100 different types of peripheral neuropathy. Over time, peripheral neuropathy can worsen, resulting in decreased mobility and even disability. More than 20 million Americans, most of them older adults, are estimated to have peripheral neuropathy.

It's important to seek prompt medical evaluation for any persistent tingling in your hands, feet, or both. The earlier the underlying cause of your tingling is identified and brought under control, the less likely you are to suffer potentially lifelong consequences.

Causes of Tingling in the Hands and Feet

Diabetes is one of the most common causes of peripheral neuropathy, accounting for about 30% of cases. In diabetic neuropathy, tingling and other symptoms often first develop in both feet and go up the legs, followed by tingling and other symptoms that affect both hands and go up the arms. About two-thirds of people with diabetes have mild to severe forms of nerve damage. In many cases, these symptoms are the first signs of diabetes.

In another 30% of peripheral neuropathy cases, the cause is unknown or "idiopathic."

The remaining 40% of cases have a variety of causes such as:

Nerve entrapment syndromes. These include carpal tunnel syndrome, ulnar nerve palsy, peroneal nerve palsy, and radial nerve palsy.

Systemic diseases. These include kidney disorders, liver disease, vascular damage and blood diseases, amyloidosis, connective tissue disorders and chronic inflammation, hormonal imbalances (including hypothyroidism), and cancers and benign tumors that impinge on nerves.

Vitamin deficiencies. Vitamins E, B1, B6, B12, and niacin are essential for healthy nerve function. A B12 deficiency, for example, can lead to pernicious anemia, an important cause of peripheral neuropathy. But too much B6 also can cause tingling in the hands and feet.

Alcoholism. Alcoholics are more likely to have a thiamine or other important vitamin deficiencies because of poor dietary habits, a common cause of peripheral neuropathy. It's also possible that alcoholism itself can cause nerve damage, a condition that some researchers call alcoholic neuropathy.

Toxins. These include heavy metals such as lead, arsenic, mercury, and thallium, and some industrial and environmental chemicals. They also include certain medications -- especially chemotherapy drugs used for lung cancer -- but also some antiviral and antibiotic drugs.

Infections. These include Lyme disease, shingles (varicella-zoster), cytomegalovirus, Epstein-Barr, herpes simplex, and HIV/AIDS.

Autoimmune diseases. These include Guillain-Barre syndrome, lupus, and rheumatoid arthritis.

Inherited disorders. These include a group of disorders collectively known as Charcot-Marie-Tooth disease.

Injury. Often related to trauma, nerves can be compressed, crushed, or damaged, resulting in nerve pain. Examples include nerve compression caused by a herniated disc or dislocated bone.

Diagnosis of Tingling Hands and Feet

If you seek care for your tingling hands or feet, your health care provider will do a physical exam and take an extensive medical history addressing your symptoms, work environment, social habits (including alcohol use), toxic exposure, risk of HIV or other infectious diseases, and family history of neurological disease.

He or she also may perform additional tests such as:
Blood tests. These can include tests to detect diabetes, vitamin deficiencies, liver or kidney dysfunction, other metabolic disorders, and signs of abnormal immune system activity.
An examination of cerebrospinal fluid. This can identify antibodies associated with peripheral neuropathy.
An electromyogram (EMG), a test of the electrical activity of muscle
Nerve conduction velocity (NCV)

Other tests may include:
Computed tomography (CT)
Magnetic resonance imaging (MRI)
Nerve biopsy
Skin biopsy to look at nerve fiber endings

Treatments for Tingling Hands and Feet

Successful treatment depends on an accurate diagnosis and treatment of the underlying cause of the tingling. As long as the peripheral nerve cells have not been killed, they have the ability to regenerate.

Although no treatments are available for inherited types of peripheral neuropathy, many of the acquired types can be improved with treatment. For example, good blood sugar control in diabetes can slow the progression of diabetic neuropathy; vitamin supplementation can correct peripheral neuropathy in people with vitamin deficiencies.

General lifestyle recommendations include maintaining an optimal weight, avoiding exposure to toxins, following a doctor-supervised exercise program, eating a balanced diet, and avoiding or limiting alcohol consumption. Recommendations also include quitting smoking, which constricts blood supply to blood vessels supplying nutrients to peripheral nerves.

In some cases, tingling and other symptoms of peripheral neuropathy may be reduced with prescriptions originally developed for treating seizures and depression.

http://www.webmd.com/brain/tingling-in-hands-and-feet

Why I offer the Ladys Slipper Ring Home Study course Herbal CSM

Marketing is so annoying.

I was talking to my close girlfriend last night and found myself in an honest kind of rant. 

She asked me about my Lady's Slipper Ring.....

"Hey! Your membership is open again for another year!"

"Yep :) it is!", I reply.

"Are you excited, or nervous?" She inquires.

"Both" (of course)

You see, there's a world of fancy marketing plans out there, and many of them are very slick, very savvy, and very effective. 

They are also designed by folks who know all about marketing and get paid to do that with their time, and can tell everyone all about it. 

I raise kids. I harvest plants. I make medicines and oils and fragrant delights - instead  of weaving a string of drip campaigns into your email box every day, laced with this deadline and this incentive and this push and shove. 

I bend time in order to make dinner for my family, and escape soccer practices to get into the woods. I move mountains in order to keep homeschooling my kids, and I try like hell to make sure that every way I choose to spend my time is in alignment with my values. 

Perhaps I should apologize, because I'm not giving you a proper spiel to be properly coaxed and convinced. I don't actually want to sell you something that requires lubrication. 

Perhaps you want more information, or more insight and my lack of big showy buttons and videos make me small and hard to find.

And maybe you just want the truth from the horses mouth, without the airbrushed words and glittery splash pages. Maybe you just want to hear what I really think, and why the Lady's Slipper Ring is what I choose to put out in the world. 

So here it is, black and white:

I offer this work because I've been to hell and back. A few times. I know the fight to remain heart centered.

This is the work, the insight and loving kind of contemplation that got me through my dark nights of the soul.

These are the affirmations I needed when I wanted to throw in the towel. 

Mornings when I wished with all my heart, that I didn't even wake up, the thread of life was held to my heart by the smell of the plants. By the grounding of vetiver and cinnamon on my feet, I was able to walk that hard day. I was able to let the tears fall with a little more compassion. 

I do this work because honesty can set us free, but sometimes the truth is hiding under a pile of shit.

I do this work because I'm in service to the plants - it is my duty to share their sensual, intuitive powers. It's my thank you to them for resuscitating me time after time after time.

It's the Echinacea roots that carried my grief when I could no longer. 

It's the Bloodroot that called me a medicine woman before I could. 

It's the Pine tree that climbed my bones first. 

It's the Oats that sowed me. 

I'm not a doctor, I'm not a psychologist, I'm not a naturopath. 

I'm not a therapist.

I am a woman 

who's been to hell and back

and these are the tools that carry me through

the challenges of being woman, authentically and wholly

beautifully and dynamically

and I want women to 

not only

know these tools, 

but always have a fragrant oil to put on before bed

to have a healing salve in their bag

and feel the support of the plants

in their bodies and lives

and know you are not alone

as you give

and give

and give

to your families, 

your lovers

your communities

your work

it is you that shines greatness and sweetness

and cannot bear fruit without water 

at your feet.

And so I have not spent time and labor on fancy technological email patterns, and perhaps this is a mistake. 

But instead I have gathered primrose and mullein and artemisia for you, for your body, your pleasure, for your health and joy. 

I have climbed trunks for resins so that you may soothe your weary ankles, and collected the tiniest of skullcap flowers from nearly invisible patches of meadow. I splash through swampy frog streams to reach the bluest of the vervain, and balance precariously on the shoulders of my girlfriend in the thick of the forest so that I can reach enough Elder flowers to last the winter. 

And I will continue to fill my baskets with unruly beauty so that you may always know yours ... your beauty, and your basket full with nourishment. 

In service of the Green Goddess that is in all,

Ananda Lakshmi

for the

Lady's Slipper Ring, Pleasure Medicine Membership UPDATE - LSR 2012-2013 is FULL. Please sign up for the newsletter to stay connected.

beauty blessings

xoxo

Why Neuropathic Pain Hurts Vid

Today's YouTube video is a Ted Talk video about why pain hurts and this applies to neuropathic pain too. In fact, you'll learn more about how your nervous system responds to and delivers pain signals than from a host of text-only articles. There's a good chance you'll have a giggle too (something never to be turned down) because this guy is funny and knows how to engage an audience. If he can engage an audience of neuropathic patients (that's you, the readers), he's a freaking genius! he may use the word 'groovy' a bit too much but you'll forgive him. Give it a try, you're going to learn something about your brain and the nervous system for sure. Definitely worth 15 minutes of your time.

TEDxAdelaide - Lorimer Moseley - Why Things Hurt

Uploaded on 21 Nov 2011 Why do we hurt?

Do we actually experience pain, or is it merely illusion?

In this video, Lorimer Moseley explores these questions, and position the pain that we feel as our bodies' way of protecting us from damaging tissues further. He also looks at what this might mean for those who suffer from chronic pain.




https://www.youtube.com/watch?v=gwd-wLdIHjs#t=8s

Why Does Neuropathy Make Us So Damned Tired

Today's post from neuropathyjournal.org (see link below) tries to explain why many people living with neuropathy (especially autonomic neuropathy) become progressively more tired as the years go on. There's no easy answer and there can also be many other reasons why fatigue and weakness start to affect our lives so strongly but for many people, along with degradation of nerve fibres, comes muscle and mental fatigue and it can be very difficult to live with. LtCol Richardson does a good job of explaining the process but also offers some helpful tips to help us cope with and improve our tiredness levels. Worth a read.

Fatigue in Peripheral Neuropathy 
By LtCol Eugene B Richardson, USA (Retired) BA, MDiv, EdM, MS9

Unfortunately fatigue is a central part of many neuropathies and especially the immune mediated neuropathies. It is central to many other chronic illnesses that affect the body’s immune system. The causes are often complex and many.

Dr. Scott Berman, in his book Coping with Chronic Neuropathy notes in chapter VIII “Dealing with Fatigue and Insomnia” that this symptom is one of the most difficult and challenging for the neuropathy patient. Dr. Berman is a Psychiatrist, a member of the Board of Directors of the NSN and a Medical Advisor. Scott lives with untreatable CIDP.

He notes:

…that in one study looking at fatigue in autoimmune neuropathy 80% of 113 patients had severe fatigue. The fatigue was independent of motor or sensory symptoms and was rated as one of the top three most disabling symptoms. (“Fatigue in Immune-Mediated Polyneuropathies,” Neurology 53: 8 November 1999, I.S.J. Merkies, et al).

For decades in living with untreated Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), Autonomic Neuropathy (AN) and Progressive Polyneuropathy due to exposure to Agent Orange in Vietnam, I can attest to the facts noted above. While other major symptoms respond to treatment with Immune Globulin (IVIg), the symptom of severe fatigue continues as one of the symptoms that responds only temporarily to the infusions followed by several days of total fatigue following infusion and then with some lessening until the next infusion.

Dr. Norman Latov in his book “Coping with Peripheral Neuropathy”, states what I have heard other neurologists share, that the fatigue we feel, first appearing as weakness, increases as the weakness (or damage) of motor nerves expands. At this point with only a few muscles doing the whole job of lifting a leg or arm or carrying on autonomic functions, the body becomes weak and eventually extreme fatigue occurs. Think of a young child who tires easily because the muscles and nerves are not fully developed and only a few underdeveloped nerves or muscles are doing the job of moving!

On the other hand, to state the obvious, pain in some neuropathies does not help us sleep. Neuropathy patients must seek medical help in finding medications or other options which works for them. The medical practitioners have increased their knowledge in recognizing the reality of neuropathic pain. These strange symptoms from damaged peripheral nerves are present in sensory neuropathies. It is become less common for these patients to be told that it is all in their ‘head’ and are finally getting the help they need.

Impact on family and friends:

Families and friends, as we all have learned, may not understand this reality since we “look so good” and may even believe/suggest that you are just lazy or unmotivated or worse. The best thing you can do for them is to have them watch the DVD Coping with Chronic Neuropathy which will be an education about the impact of any neuropathy on our lives.

Educating yourself about neuropathy:

At any rate, fatigue is something we struggle with every day and often regulates/determines our daily activities.

While fatigue in neuropathy and other chronic illnesses is not fully understood by the experts, from a practical standpoint, here is what I have learned to do or not do in coping with fatigue. If you have found other things that help, send us a message and we will add it to the list.

1. DO NOT think negatively about fatigue, thus feeling guilty about your fatigue. Go take a nap! (See DVD “Coping with Chronic Neuropathy”).

2. Learn when your “fatigue” periods occur, as these often establish a pattern at certain times of the day. Then go lay down and stop moaning about it, as it is what it is until it isn’t.

3. I have learned that you do not even have to actually “sleep”, but just allowing your body to rest/stop for an hour takes care of the exhaustion as the body recovers. But whatever works for you, do it without guilt or apology.

4. For nighttime, have a standard bedtime routine in preparing for sleep that tells your body that it is time to sleep.

5. Do not eat a large meal just before bedtime or take a stimulant that keeps you awake or might interfere with sound sleep (i.e. caffeine, for some alcohol).

6. Do consider drinking a glass of milk as for many this encourages the body to sleep.

7. Do consider one of those special recordings of quiet music or rain falling or similar if it helps.

8. Do consider using a ticking clock if that helps. As a child in the 40s I got my best sleep on the floor in front of the big radio in the living room listening to Dragnet or was it the Lone Ranger, maybe the Big Story. Today most TV programs have the same effect, sleep! Pun intended.

9. Muscle spasms and/or restless leg can make sleeping difficult and rob you of needed sleep. Speak to your doctor and have tests done for calcium, salt, potassium levels and other deficiencies which can make it difficult for muscles to work properly. This is especially true if you are on a diuretic which can empty your body of needed minerals. Getting up and having a glass of orange juice worked for my mother and works for me. If the lack of something is not the problem, have the doctor find out what may be causing these muscle problems. There are also medications to help prevent these muscle spasms and cramps for they are very common in neuropathy.

10. I have found that if I wake up with my mind creating solutions to an issue or writing poetry (happens) and not able to sleep, I go to another room or go do some work on my computer (write out the solution or poetry) until I begin to feel sleepy again. It works for me.

11. For some insomnia is a real curse. There are medications that one can use as Dr. Scott Berman mentions in his book, so speak to your doctor. Frankly, I would work on natural solutions first and be creative to see what works for you. But if ALL else fails these medications may help and be a heaven sent blessing.

12. My Nurse told me that many patients with this effect of a chronic illness, take Folic Acid and it is known to help. So you many want to speak to your doctor in this regard.

13. Dr. Erika Schwartz, M.D. (national leading expert on wellness) suggests that patients with extreme fatigue have the physician check your basal metabolic rate and your thyroid function. Low thyroid is a common cause of fatigue. So speak to your doctor in this regard.

14. So what do you do or not do that helps? Send it to us and we will enter it here!

DISCLAIMER: The information in this article and on the website or the links or in the guidance provided is intended to be educational and informative and not medically prescriptive or diagnostic. All patients are encouraged to consult with their own medical doctor when considering any this information.

Copyright – 2014-2015 Network for Neuropathy Support, Inc., 501c3, dba as Neuropathy Support Network. This article or its contents may be reprinted or published for educational purposes as long as the printing or publishing is not for profit and acknowledgement is granted the author.

https://neuropathyjournal.org/fatigue-in-peripheral-neuropathy/

Why Isnt Neuropathy Better Known

Today's post from ihavepn.com (see link below) asks the question why so many Americans suffer in silence with neuropathy but the same question can be applied across the world. You can safely bet that 9 out of 10 people on the street will never have heard of it, let alone pronounce it, yet it is so widespread - how's this possible? You get the feeling that we need a sort of advertising organisation on the scale of Saatchi and Saatchi, to promote awareness of neuropathy and the fact that it's one of those diseases that's actually growing instead of decreasing. Modern lifestyles, diets and choices are contributing to this growth and yet there's nothing about neuropathy that makes it sexy for the media. Maybe we need highly visible role models! What do you think?

Why 42 Million Americans Suffer in Silence with Peripheral Neuropathy
July 2015 (no author mentioned)

Imagine that your feet feel like they are asleep while simultaneously on fire, all the while 10,000 pins and needles are poking at them. Your toes and balls of your feet are numb to your touch, and over time this feeling is progressing in your legs and hands too. What if this feeling were chronic and never went away, causing misery both day and night? This is what 42 million Americans are dealing with everyday, it is a condition called “Peripheral Neuropathy” or PN.

President Clinton famously once said “I feel your pain”, and well, unfortunately I do too. you see, I have Peripheral Neuropathy, the condition listed above, and fortunately at this point I just have these awkward feelings in my feet but my fear is that over time it will spread into my legs and my hands and eventually become debilitating.

I had never heard of Peripheral Neuropathy until I started researching the nature of my symptoms. Consider that 42 Million Americans suffer from some form of peripheral neuropathy whether very light beginning stage symptoms or late stage debilitating symptoms. That is 14% of the American population. But hold on, that seems like a very high number for a condition that most people don’t even know how to pronounce let alone have heard of. Well the fact is that about half of the 14% or 7% (21 million Americans) just have a very mild form of PN that may manifest itself in just a few numb, tingly toes. Because of this the PN subject does not pay much attention to the symptoms to the degree that they don’t even mention it to their doctor during the official start of their symptoms. Given that, it means there are 21 Million Americans that suffer from much more sever symptoms of PN some of them debilitating to the degree that it affects mobility. Still, I am at a loss to understand why more people do not know about this condition. Several people I have talked to recently have never heard of it let alone pronounce it. With a world population of 7 billion people, more than 500 million people may have this condition today around the world. This is one of those conditions that can really make your life miserable. I know it sounds morose and negative but we suffer in silence, not really sharing our pain and frustration with anyone other than our doctor and close family most of the time. But I think it is time to elevate awareness.

Over time as Peripheral Neuropathy progresses it can become crippling and debilitating. Sure there are drugs that will relieve the pain and discomfort to some degree, often not much more than by a factor of 20%. That is partially due to the fact that many of these drugs were designed to control epileptic seizures that in essence slow down the rate at which the mind perceives pain so that sensation is also slowed and thus abated. The side effects inhibit the thought process of the brain and make people feel like they are zombies. Because of these irritating side effects we have no choice but to look for other alternative treatments.

Let’s first go on the hunt for the primary root cause of this condition. Although there are many contributing factors that cause Peripheral Neuropathy to develop, the leading cause is high glucose or blood sugar levels. You don’t have to be diabetic to be considered having high glucose levels anymore, pre-diabetics are also on the list. Higher than normal glucose levels damage the micro veins and arteries starting with those which are furthest from the heart and have the least amount of circulation, that means your feet and hands. Pre-diabetics and diabetics alike are predisposed to impairing the micro veins and arteries in their extremities.

Once the micro veins and arteries are damaged they no longer can supply oxygen to the nerves in the extremities which ultimately means that the nerve cells begin to die. As these nerve cells die they essentially create intermittent signals of sensation to the brain which are felt as pins and needles, burning, numbness and the occasional shooting of lightening pain in the feet and hands.

Diabetes is growing by leaps and bounds in the United States and many of the western cultures around the world. Fine, but how did we get here? Well it boils down to the fact that in order to provide foods that are fast and economical, our society has opted to consume processed foods over whole foods. Processed foods are foods that contain highly refined ingredients like white rice, bleached flour, white sugar or any unnatural form of food and more important they are extremely high in carbohydrates and low in fibre. Carbohydrates are what you have to keep at reasonable levels in your body because carbohydrates are converted to glucose by your body. Too much glucose in your body ultimately leads to glucose intolerance by your cells which is diabetes. Whole foods are those that are whole and cooked in the home like roast chicken with broccoli or green beans. And no, green beans are not whole if they are from a can because they often add salt and preservatives to the broth. Fresh green beans and other fresh produce from the grocer are what we need to be consuming.

The American fast food diet has been killing us and it is taking its toll, causing us to develop various miserable conditions ultimately related to our diet like Peripheral Neuropathy.

Our first lady, Michelle Obama, has been spreading the word to help our young generation have an appreciation for whole fresh foods and I think she is doing a great job by growing veggies in the White House back yard. What we are really facing here is a very influential processed food industry and lobby that does not want to behave in a way that will promote a healthy lifestyle.

If you really want to make a change with yourself and those companies that are supplying us currently with unhealthy processed foods, then you really need to consider making a change by reducing your carbohydrate intake by preparing your own whole foods. I know that we can’t always do that every single day and there are food deserts in America where it is very challenging. Let’s learn how to read food labels properly so that we really understand what we are about to put in our families bodies. Yes, there are actually good healthy foods that come in paper or plastic packages but you have to read the nutrition information to make sure that you are getting what you want and is right for you.

So now you understand that our love of excessive carbohydrates is what has lead most of us to develop the condition of Peripheral Neuropathy. Now that we know what to do to prevent it, what are we going to do about the millions of people that already have it or are in the process of developing it? Drug companies have medications available that will relieve the discomfort to some degree but you would have to weigh the benefits with the side effects, particularly the ongoing drowsiness and “the zombie lifestyle” you will experience. That is not to say that drugs will not work for some as it likely will be just right for some but a complete flop for others.

Those with PN (Peripheral Neuropathy) need to be on an exploratory quest to 1) stop the symptoms from spreading and 2) relieve the pain and discomfort.

There are many products and services available to those with PN. First and foremost, get as much information from various sources as possible. This will help guide the PN sufferer to make better decisions about treatment options.

Also PN sufferers need to open the lines of communication. The more interest around this topic the more likely that big money will be looking for a real cure. PN sufferers need to start local interest groups that meet regularly on the topic. There are great organization like the Foundation for Peripheral Neuropathy and the Peripheral Neuropathy Association that a PN sufferer or loved one can take part in.

http://ihavepn.com/million-american-suffer-silence-peripheral-neuropathy/

Why People With Neuropathy Need to Get Off Our Backsides!

Today's post from thebody.com (see link below) looks at the importance of exercise for people living with neuropathy. It's understandably not something people want to hear because the discomfort of neuropathy can make the idea of exercising a mountain to climb. However, if only to maintain circulation and prevent muscle wastage, it has to be done in one form or another. The benefits of exercise for neuropathy patients are also much more wide ranging than just circulation and muscular definition and in the end, it's all a matter of scale and doing what you can do but never doing nothing. Even 5 minutes a day is better than nothing but hopefully everyone can manage more than that. There are all sorts of possibilities mentioned here without having to leave the door and certainly expensive gym fees aren't necessary (unless you want to go to the gym).

Attack of the Killer Couches, or Why People With HIV and Neuropathy Need to Get Off Our Backsides! 

By Dave R. March 29, 2012

Internet links shown in these posts are designed to provide more detailed information if required.

Nobody with neuropathic pain, or tingling, or numbness wants to hear it. Neither do those people with HIV who are exhausted from the pressures, both physical and psychological, of living with HIV and its medications. These are people who on some days are so tired they can't move one foot in front of another and they just don't want to be told to go forth and exercise. Yet they have to; we must! It's a question of how much longer we want to live.

I've always resisted this sort of fire and brimstone rhetoric; whether it came from the pulpit, or politicians, or medical authorities, or from well meaning friends. Tell me to go one way and I'll go the other and with that sort of bloody-minded stubbornness driving my philosophy on life, it took me until seven years ago to give up smoking. The fact that my lung capacity improved dramatically after that particular lifestyle change certainly made me more open to logical advice but I'd still smoked like a chimney for thirty five years!

All that said I've had to summon up the courage to be arrogant and preach to people about exercise here. Please forgive the bullying tone; it's not my job to tell you what to do with your lives and I am allergic to evangelists of any sort but I do feel it's important to pass the following information on to other people who might be in the same situation.

Actually, until neuropathy put a stop to several of my physical activities, I never considered that I needed any extra physical training. Then within a couple of years of the symptoms beginning; my stomach ballooned, my muscles began to lose their tone and my fat and cholesterol levels began to rise alarmingly. I became a TOFI (thin on the outside, unhealthy fat on the inside and on the stomach). This was almost certainly thanks to my enforced lifestyle change. I've never been a narcissist but looking objectively in the mirror really shocked me! Many people with HIV will recognise the feeling that their attractiveness and self-worth can evaporate before they know it yet even with that in mind, I still didn't seriously consider doing anything about it. Neuropathic pain, sleepless nights and physical weakness were just too dominant and quickly destroyed any good intentions. I began to accept a sedentary lifestyle as being unavoidable.

My mindset all changed after watching a BBC Horizon programme about the new science of exercise (see link below). Then, for the first time I began to realise what would happen inside my body if I sat in front of the TV for the rest of my life. I confess, I haven't yet done much about it but at least I've realised what I have to do. I suddenly realised that if HIV plus neuropathy doesn't kill me then eventually, inactivity most certainly will.

More Information: Horizon: The Truth About Exercise (BBC, 2012)

So what's new about exercise?

So what sort of dramatic information provided me with a wake-up call to change my outlook and given my neuropathy problem is there anything I can do about it? First of all, the idea of hours in the gym for someone with neuropathy is pretty much a non-starter. Foot and leg issues; muscle weakness, lack of feeling in some places and pain in others; don't get me started! So when this TV programme backed by new U.S. Canadian and British research began by stating that hours in the gym and running or jogging could be unnecessary, my ears pricked up.

The second premise that all exercise regimes should be tailored to your own situation was even more attractive. The video still virtually excludes most people with neuropathy or other HIV-related problems but the mental barrier caused by the thought of months on end in an expensive gym, with no guarantee of success, is removed. Although we still won't be able to do intensive short bursts, we can see the value of doing something. Anything is so much better than nothing.

More Information: Exercises for Neuropathy

The fact that 80% of fit and healthy people don't exercise and spend up to twelve hours of the day in a chair, made scientists want to explore other options based on good science. They looked at how a sedentary lifestyle changes how the body behaves and concluded that traditional views of how to lose weight may be flawed.

Most people think they'll lose weight if they burn off the calories with lots of exercise but very few people like doing the hours of activity required. Furthermore, to burn off the calories after eating a banana, a muffin and a cappuccino, you need to run for 55 minutes! You can imagine the effort needed to burn off a McDonald's diet! In the long term, most people just won't put in the effort and these are people without illnesses to slow them down even further. Some people even 'compensate' for a couple of hours in the gym by eating more; either as a reward, or as a misguided 'energy-replacement'. So finding a shorter 'cure' would encourage more people to exercise in such a way that they will lose weight and increase the health of a nation in the process. People with neuropathy and HIV will still be reading this and muttering that walking to the gym alone would be too much, never mind doing anything when you get there, but bear with me.

When you eat fat-rich foods, the fat goes into the gut and then into the bloodstream. Unless you can keep it moving, or convert it to energy, this causes changes to your metabolism, which in turn cause a build up of fatty deposits on the walls of the blood vessels. It's a no-brainer then, to realise that you need to reduce the levels of fat in your blood.

There are different sorts of fat and it is thought that fat below the waist may not be too harmful and may even be protective in nature. Similarly, subcutaneous fat is not as dangerous as the fat stored around the organs deeper under the skin. This is called visceral fat and when it builds up around the liver and pancreas, you're heading for trouble. On an MRI scan, you'll be able to see this fat as white areas surrounding the organs deep under the skin surface. You may well be a relatively thin person but can still have dangerous levels of visceral fat. These fats are the ones that lead to Type 2 Diabetes, which if you already have neuropathy, you definitely do not want added to the list, as it is a prime cause of neuropathy itself! Diabetes is caused when insulin stops working in your system and insulin normally removes sugar from the blood.

We've got to get rid of visceral fat and that brings us back to exercise and fitness training. Scientists have found that a long walk (brisk is better but any walk will do) before, or directly after a meal, triggers the release of an enzyme which changes how the body processes fat. Nothing new there then; we've always been advised to take a walk after a heavy meal. However, the difference between walking and not walking is substantially less fat in the bloodstream. Exercise causes the fat that's trying to make its way through your blood vessels to be dumped into the muscles, where it's converted to energy, or 'burned off'. The walking also switches on genes that make a protein called lipoprotein lipase and this protein reduces fat deposits in the blood. The catch is that the exercise needs to be strenuous in order to achieve the necessary effect. I know, I agree with neuropathy patients shouting, 'Hello, we're still here!' and I also sympathise with other, fitter people with HIV, who are asking what's actually new here.

A study referenced in the BBC programme was done on the results of a thousand people, exercising four hours a week for twenty weeks. The results were startlingly different for different people. Many people just don't respond to 'normal' fitness centre regimes, which is why so many people just give up after achieving little difference in their shape. Strangely enough, it's just been established that it's also genetic and you may be a responder or a non-responder but hours of exercise won't do anything to change what is predetermined. In the future a simple DNA test will be able to determine whether you'll gain any benefit from consistent strenuous exercise but for now, you need to tailor your exercise to your own condition and the results you achieve. All exercise is good but the results will still be different for different people. This brings us a little closer to the neuropathy patient, who may be one of the most limited regarding exercise potential.

The BBC programme looked at the possibility of doing a few minutes of really intensive exercise a week (speed cycling on a home machine) and found the results to be astonishingly just as good as if you'd spent hours in the gym. It doesn't sound much but it works. Are you now beginning to hope that there may be something you can do?

More Information: Exercise to Help Ease Neuropathy Symptoms

Apart from trying to stop fat deposits building up in stores in your body, the other major benefit of exercise is of course, for your heart and lungs. They don't really know why but how good your lungs are in getting oxygen into your body is called the VO2 max and it's an important marker for future health. Improving your VO2 level will also improve your insulin sensitivity and enable sugar to be removed from your blood. Aerobic exercise also helps your physical functions, maintain body weight, fight depression and increase pain tolerance. The reward is living longer. What the scientists still don't completely understand is why short bursts of high intensity exercise will change your metabolism so positively. Glycogen stored in the muscle is apparently quickly broken down by intensive exercise and this gives a signal to your bloodstream that it must provide more glucose for energy. This in turn causes more glucose/fat to be sucked out of the blood thus not allowing it to eventually build up dangerously around your organs. It goes right against the fitness industry maxims and is definitely not in its commercial interest, but who's important here!

All this is big news for those (healthy or unhealthy) who sit a lot. We need to increase our NEAT levels. This is Non-Exercise Activity Thermogenesis and means nothing more than increasing the number of calories we can burn off during every-day living but sometimes a catchy acronym can help you remember. Being active switches on the genes that control fat levels and movement of any sort increases your metabolic rate (again the burning of calories). If 80% of people are really not taking regular exercise and have an unhealthy diet, the results are filling up the hospital wards of western societies. As neuropathy sufferers we can't feel in any way smug. The reason for all this information is to alert people with HIV to the fact that, however difficult, inactivity is a terrible option. Your body goes to standby when you sit too long and all sorts of junk builds up in your system.

Okay, all that information probably leaves you feeling somewhat frustrated if your movement is already limited by pain and disability. So what can we do for ourselves?

We've been pushed reluctantly into our chairs by neuropathy and have learned that activity can be painful but there must surely be things we can do. Unfortunately, immobility is a huge problem for neuropathy patients. It can shrink your muscles even further and cause them to lose flexibility. Your metabolism will decrease, which means again, less energy and more fat gain.

There's a huge range of physical abilities amongst neuropathy patients, according to what the disease has done to you. Many people with just numbness or tingling in a few toes may be able to carry out a great many 'normal' exercise activities. On the other hand, many people for whom every step is painful will need to search hard for things they can do. Remember, the message is, we're trying to maintain our lung and heart health with some sort of aerobic movement and we're trying to reduce the dangerous fat build-up in the blood stream and around our organs by burning off calories.

More Information: Exercise Rx for Nerve Pain

There's no way around it, whatever exercise we find to do, needs to be backed up with a healthy diet. That's obvious and doesn't need further explanation here; there are thousands of advice sources for healthy eating.

Low impact exercise rather than inactivity is the answer. In the past, people with neurological problems were often told not to exercise at all. Hopefully the information in this article has convinced you that it's pretty much essential. Sitting for hours on the couch is only going to put a stop to efficient metabolism and slow up every part of your system. It may be painful or tiring, or both but you should try never to be sitting still for more than an hour. Even if it's just five minutes exercise while you're walking around the house, try to make a habit of breaking up the pattern of sitting or lying down and try to exercise as many parts of your body as you can think of. The four links from eHow.com at the end of this article, give some excellent, easy to understand advice for people with neuropathy, who are wondering how to go about improving their fitness and general health.

It's important to reassure people who are still depressed at the thought; not because they're lazy but because exercise is just so difficult. Whatever you can manage to do is better than nothing at all. You will feel so much better if you can achieve even small steps on the road to getting fitter. See it as a daily challenge and a break from the routine of being in pain, or being exhausted. Try to give yourself a reason to be so tired.

Music is a good motivator. Put on your favourite music and let your body decide how you want to respond to it. It's a silly example but even lying on the couch, you can flex the muscles in your buttocks to the rhythm. Lying on the couch or bed, you can do all sorts of exercises: moving your legs; making letters of the alphabet with your feet. Wave your arms in circles; push your palms together, or clasp them and try to pull them apart. Flex your stomach muscles to the music; breathe deeply, squeeze a tennis ball, push full Cola bottles into the air and use them as weights, whatever; do whatever you can; invent stuff! There are so many possibilities without expensive equipment or fashionable sports gear and you know you always wanted to find a legitimate reason to listen to Abba!

More Information: Exercise (From the Foundation for Peripheral Neuropathy)

It is important to warm up before doing anything and that warming up will be relative to what you can eventually achieve. It's vitally important that you don't pull muscles, or inflame joints; that will only destroy your will to push on. Start gently and build up until you can beat your own record at whatever you're doing. It sounds childish but for the person who's disabled in some way by neuropathy or HIV-related exhaustion, literally every little bit helps and if you can make it just a little bit fun, you'll want to do more.

It's a question of building up a series of good habits; just like it is with healthy eating. Even getting up and cleaning something will give you satisfaction because it's an excellent physical exercise involving more than one group of muscles. Ideally you want to be able to build up a sweat and then you know the calories will be burned off but not everybody can do that, or come even close. This is why it's even more important that you do something, no matter how small. At the same time, you need to listen to your body. Only you will know when you've really had enough, or have done too much. Equally, only you will know if you could have done just that little bit more!

To sum up, the person struggling with neuropathy, or HIV-related fatigue, or other disabling health problems should bear in mind the four sorts of activities we need to aim towards:

Aerobic Exercise: Aerobic activities increase your heart rate, get your muscles working and raise your breathing rate.
Flexibility Exercise: Flexibility exercises mainly done during warm-ups help keep your joints flexible and reduce your chances of injury.
Strength Training Exercise: Strength training helps increase strength in bones and muscles and makes daily tasks like shopping and lifting easier for your body.
Balance Exercise: Keeping your balance system as normal as possible is especially important for neuropathy patients who have loss of feeling in their feet, or numbness, or pain. Stumbling happens far too often but there are ways of practising walking and standing in the correct manner.

For us it's all a matter of scale but hopefully you now have a good idea of why you should develop your own exercise regime based on those exercise types.

Now I understand all too well, how this will still appear as a mountain to climb for significant numbers of people. The whole message of this article is to tailor your activities to your own situation. If five, or ten minutes a day is all you can do, then it's all you can do but it's still so much better than doing nothing. Think of it as prolonging your life maybe just by minutes, or hours, or days and maybe for years!

For many others, whose physical abilities have not been so compromised by the effects of HIV, this will just appear common sense but regular exercise is also important for the person with HIV who has no health problems at all. It's logical; keeping fat down, building up muscle strength and improving your heart and lung capacity is money in the bank for the future. Michelle Obama says 'Let's move' to families but let's pretend she's also directly talking to us; hey, if it works ...!

I admit I hate exercise: most of the time I just don't have the energy; or the pain in my feet is too much, or I feel too weak. I just want to lie down in front of the TV with some comfort food at hand and take the pressure off. However, one TV programme shocked me enough to realise what's probably happening inside my body. I need to train myself to do something every day and the following day or week, do a bit more. I also need to be conscious of what I'm eating and not reward the pain and discomfort by feeding it treats!

It'll take time; as I say, I'm naturally resistant but I now realise how important it is. I want to reduce the mass of visceral fat that's both visible and having an effect on my breathing and other bodily functions. So I'm going to try to exercise my way back. I won't be turning into a gym-bunny and certainly won't be joining the ranks of muscle Mary's but the alternative of living more and more slowly and grinding to a halt on the killer couch is not an option!

Further information:
How to Walk With Neuropathy in Feet
Benefits of Exercise for People with Peripheral Neuropathy
Exercises for Idiopathic Peripheral Neuropathy
Exercises for Peripheral Neuropathy

This and other posts are based on my opinions and impressions of living with both neuropathy and HIV. Although I do my best to ensure that facts are accurate and evidence-based, that is no substitute for discussing your own treatment with your HIV specialist or neurologist. All comments are welcome.

http://www.thebody.com/content/66453/attack-of-the-killer-couches-or-why-people-with-hi.html

WHY YOUR BRAIN MAKES YOU REACH FOR JUNK FOOD

Will that be a pizza for you or will you go for a salad? Choosing what you eat is not simply a matter of taste, conclude scientists in a new study at the Montreal Neurological Institute and Hospital of McGill University and the McGill University Health Centre. As you glance over a menu or peruse the shelves in a supermarket, your brain is making decisions based more on a food's caloric content.

The study, published in Psychological Science, is based on brain scans of healthy participants who were asked to examine pictures of various foods. Participants rated which foods they would like to consume and were asked to estimate the calorie content of each food. Surprisingly, they were poor at accurately judging the number of calories in the various foods, but their choices and their willingness to pay still centered on those foods with higher caloric content.

"Earlier studies found that children and adults tend to choose high-calorie food" says Dr. Alain Dagher, neurologist at the Montreal Neurological Institute and Hospital and lead author of the study. "The easy availability and low cost of high-calorie food has been blamed for the rise in obesity. Their consumption is largely governed by the anticipated effects of these foods, which are likely learned through experience. Our study sought to determine how people's awareness of caloric content influenced the brain areas known to be implicated in evaluating food options. We found that brain activity tracked the true caloric content of foods."

Decisions about food consumption and caloric density are linked to a part of the brain called the ventromedial prefrontal cortex, an area that encodes the value of stimuli and predicts immediate consumption.

Understanding the reasons for people's food choices could help to control the factors that lead to obesity, a condition affecting 1 in 4 Canadian adults and 1 in 10 children. Obesity is linked to many health problems including high blood pressure, heart disease and type 2 diabetes. Treating Canadians who have these problems costs billions of tax health dollars.

This work was funded by the Canadian Institutes of Health Research.