Peripheral Neuropathy: How To Avoid It, Manage It, Treat It
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Peripheral neuropathy (and what can be done about it)
Peripheral neuropathy is nerve damage, usually of the extremities. It can be caused by such things as:
- Diabetes
- Alcoholism
- Infection
- Injury
The manifestations can be different:
- In the case of diabetes, it’s also called diabetic neuropathy, and almost always affects the feet first.
- In the case of alcoholism, it is more generalized, but tends towards affecting the extremities first.
- In the case of infection, a lot depends on the nature of the infection and the body’s response.
- In the case of injury, it’ll naturally be the injured part, or a little “downstream” of the injured part.
- This could be the case of a single traumatic injury (e.g. hand got trapped in a slammed door)
This could be the case of a repetitive injury (carpal tunnel syndrome is a kind of peripheral neuropathy, and is usually caused by consistent misalignment of the carpal tunnel, the aperture through which a bundle of nerves make their way from the forearm to the hand)
Prevention is better than cure
If you already have peripheral neuropathy, don’t worry, we’ll get to that. But, if you can, prevention is better than cure. This means:
- Diabetes: if you can, avoid. This may seem like no-brainer advice, but it’s often something people don’t think about until hitting a pre-diabetic stage. Obviously, if you are Type 1 Diabetic, you don’t have this luxury. But in any case, whatever your current status, take care of your blood sugars as best you can, so that your blood can take care of you (and your nerves) in turn. You might want to check out our previous main feature about this:
- Alcoholism: obviously avoid, if you can. You might like this previous edition of 10almonds addressing this:
- Infection: this is so varied that one-liner advice is really just “try to look after your immune health”.
- We’ll do a main feature on this soon!
- Injury: obviously, try to be careful. But that goes for the more insidious version too! For example, if you spend a lot of time at your computer, consider an ergonomic mouse and keyboard.
- There are many kinds available, so read reviews, but here’s an example product on Amazon
Writer’s note: as you might guess, I spend a lot of time at my computer, and a lot of that time, writing. I additionally spend a lot of time reading. I also have assorted old injuries from my more exciting life long ago. Because of this, it’s been an investment in my health to have:
A standing desk
A vertical ergonomic mouse
An ergonomic split keyboard
A Kindle*
*Far lighter and more ergonomic than paper books. Don’t get me wrong, I’m writing to you from a room that also contains about a thousand paper books and I dearly love those too, but more often than not, I read on my e-reader for comfort and ease.
If you already have peripheral neuropathy
Most advice popular on the Internet is just about pain management, but what if we want to treat the cause rather than the symptom?
Let’s look at the things commonly suggested: try ice, try heat, try acupuncture, try spicy rubs (from brand names like Tiger Balm, to home-made chilli ointments), try meditation, try a warm bath, try massage.
And, all of these are good options; do you see what they have in common?
It’s about blood flow. And that’s why they can help even in the case of peripheral neuropathy that’s not painful (it can also manifest as numbness, and/or tingling sensations).
By getting the blood flowing nicely through the affected body part, the blood can nourish the nerves and help them function correctly. This is, in effect, the opposite of what the causes of peripheral neuropathy do.
But also don’t forget: rest
- Put your feet up (literally! But we’re talking horizontal here, not elevated past the height of your heart)
- Rest that weary wrist that has carpal tunnel syndrome (again, resting it flat, so your hand position is aligned with your forearm, so the nerves between are not kinked)
- Use a brace if necessary to help the affected part stay aligned correctly
- You can get made-for-purpose wrist and ankle braces—you can also get versions that are made for administering hot/cold therapy, too. That’s just an example product linked that we can recommend; by all means read reviews and choose for yourself, though. Try them and see what helps.
One more top tip
We did a feature not long back on lion’s mane mushroom, and it’s single most well-established, well-researched, well-evidenced, completely uncontested benefit is that it aids peripheral neurogenesis, that is to say, the regrowth and healing of the peripheral nervous system.
So you might want to check that out:
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Lose Weight, But Healthily
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What Do You Have To Lose?
For something that’s a very commonly sought-after thing, we’ve not yet done a main feature specifically about how to lose weight, so we’re going to do that today, and make it part of a three-part series about changing one’s weight:
- Losing weight (specifically, losing fat)
- Gaining weight (specifically, gaining muscle)
- Gaining weight (specifically, gaining fat)
And yes, that last one is something that some people want/need to do (healthily!), and want/need help with that.
There will be, however, no need for a “losing muscle” article, because (even though sometimes a person might have some reason to want to do this), it’s really just a case of “those things we said for gaining muscle? Don’t do those and the muscle will atrophy naturally”.
One reason we’ve not covered this before is because the association between weight loss and good health is not nearly so strong as the weight loss industry would have you believe:
And, while BMI is not a useful measure of health in general, it’s worth noting that over the age of 65, a BMI of 27 (which is in the high end of “overweight”, without being obese) is associated with the lowest all-cause mortality:
BMI and all-cause mortality in older adults: a meta-analysis
Important: the above does mean that for very many of our readers, weight loss would not actually be healthy.
Today’s article is intended as a guide only for those who are sure that weight loss is the correct path forward. If in doubt, please talk to your doctor.
With that in mind…
Start in the kitchen
You will not be able to exercise well if your body is malnourished.
Counterintuitively, malnourishment and obesity often go hand-in-hand, partly for this reason.
Important: it’s not the calories in your food; it’s the food in your calories
See also: Mythbusting Calories
The kind of diet that most readily produces unhealthy overweight, the diet that nutritional scientists often call the “Standard American Diet”, or “SAD” for short, is high on calories but low on nutrients.
So you will want to flip this, and focus on enjoying nutrient-dense whole foods.
The Mediterranean Diet is the current “gold standard” in this regard, so for your interest we offer:
Four Ways To Upgrade The Mediterranean Diet
And since you may be wondering:
Should You Go Light Or Heavy On Carbs?
The dining room is the next most important place
Many people do not appreciate food enough for good health. The trick here is, having prepared a nice meal, to actually take the time to enjoy it.
It can be tempting when hungry (or just plain busy) to want to wolf down dinner in 47 seconds, but that is the metabolic equivalent of “oh no, our campfire needs more fuel, let’s spray it with a gallon of gasoline”.
To counter this, here’s the very good advice of Dr. Rupy Aujla, “The Kitchen Doctor”:
Interoception & Mindful Eating
The bedroom is important too
You snooze, you lose… Visceral belly fat, anyway! We’ve talked before about how waist circumference is a better indicator of metabolic health than BMI, and in our article about trimming that down, we covered how good sleep is critical for one’s waistline:
Visceral Belly Fat & How To Lose It
Exercise, yes! But in one important way.
There are various types of exercise that are good for various kinds of health, but there’s only one type of exercise that is good for boosting one’s metabolism.
Whereas most kinds of exercise will raise one’s metabolism while exercising, and then lower it afterwards (to below its previous metabolic base rate!) to compensate, high-intensity interval training (HIIT) will raise your metabolism while training, and for two hours afterwards:
…which means that unlike most kinds of exercise, HIIT actually works for fat loss:
So if you’d like to take up HIIT, here’s how:
How (And Why) To Do HIIT (Without Wrecking Your Body)
Want more?
Check out our previous article about specifically how to…
Burn! How To Boost Your Metabolism
Take care!
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Less Common Oral Hygiene Options
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Less Common Alternatives For Oral Hygiene!
You almost certainly brush your teeth. You might use mouthwash. A lot of people floss for three weeks at a time, often in January.
There are a lot of options for oral hygiene; variations of the above, and many alternatives too. This is a big topic, so rather than try to squeeze it all in one, this will be a several-part series.
- The first part was: Toothpastes & Mouthwashes: Which Help And Which Harm?
- The second part was: Flossing, Better (And Easier!)
- The third (and for now at least, final) part will look at some less common alternatives.
Tooth soap
The idea here is simplicity, and brushing with as few ingredients as possible. Soap cleans your teeth the same way it cleans your (sometimes compositionally quite similar) dishes, without damaging them.
We’d love to link to some science here, but alas, it appears to have not yet been done—at least, we couldn’t find any!
You can make your own tooth soap if you are feeling confident, or you might prefer to buy one ready-made (here’s an example product on Amazon, with various flavor options)
Oil pulling
We are getting gradually more scientific now; there is science for this one… But the (scientific) reviews are mixed:
Wooley et al., 2020, conducted a review of extant studies, and concluded:
❝The limited evidence suggests that oil pulling with coconut oil may have a beneficial effect on improving oral health and dental hygiene❞
The “Science-Based Medicine” project was less positive in its assessment, and declared that all and any studies that found oil pulling to be effective were a matter of researcher/publication bias. We would note that SBM is a private project and is not without its own biases, but for balance, here is what they had to offer:
A more rounded view seems to be that it is a good method for cleaning your teeth if you don’t have better options available (whereby, “better options” is “almost any other method”).
One final consideration, which the above seemed not to consider, is:
If you have sensitive teeth/gums, oil-pulling is the gentlest way of cleaning them, and getting them back into sufficient order that you can comfortably use other methods.
Want to try it? You can use any food-grade oil (coconut oil or olive oil are common choices).
Chewing stick
Not just any stick—a twig of the Salvadora persica tree. This time, there’s lots of science for it, and it’s uncontroversially effective:
❝A number of scientific studies have demonstrated that the miswak (Salvadora persica) possesses antibacterial, anti-fungal, anti-viral, anti-cariogenic, and anti-plaque properties.
Several studies have also claimed that miswak has anti-oxidant, analgesic, and anti-inflammatory effects. The use of a miswak has an immediate effect on the composition of saliva.
Several clinical studies have confirmed that the mechanical and chemical cleansing efficacy of miswak chewing sticks are equal and at times greater than that of the toothbrush❞
Read in full: A review of the therapeutic effects of using miswak (Salvadora Persica) on oral health
And about the efficacy vs using a toothbrush, here’s an example:
Comparative effect of chewing sticks and toothbrushing on plaque removal and gingival health
Want to try the miswak stick? Here’s an example product on Amazon.
Enjoy!
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The Art Of Letting Go – by Nick Trenton
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You may be wondering: is this a basic CBT book? And, for the most part, no, it’s not.
It does touch on some of the time-tested CBT techniques, but a large part of the book is about reframing things in a different way, that’s a little more DBT-ish, and even straying into BA. But enough of the initialisms, let’s give an example:
It can be scary to let go of the past, or of present or future possibilities (bad ones as well as good!). However, it’s hard to consciously do something negative (same principle as “don’t think of a pink elephant”), so instead, look at it as taking hold of the present/future—and thus finding comfort and security in a new reality rather than an old memory or a never-actual imagining.
So, this book has a lot of ideas like that, and if even one of them helps, then it was worth reading.
The writing style is comprehensive, and goes for the “tell them what you’re gonna tell them; tell them; then tell them what you told them” approach, which a) is considered good for learning b) can feel a little like padding nonetheless.
Bottom line: this reviewer didn’t personally love the style, but the content made up for it.
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Fruit & Veg In The Fridge: Pros & Cons
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝What effect does refrigeration have on the nutritional value of fruit and vegetables??❞
It’s difficult to give a single definitive answer, because naturally there are a lot of different fruits and vegetables, and a lot of different climates. The answer may be different for tomatoes in Alaska vs bananas in Arizona!
However, we can still generalize at least somewhat
Refrigeration will generally slow down any degradation process, and in the case of fruit and vegetables, that can mean slowing down their “ripening” too, as applicable.
However…
Refrigeration will also impede helpful bioactivity too, and that includes quite a list of things.
Here’s a good study that’s quite illustrative; we’d summarize the conclusions but the rather long title already does that nicely:
So, this really is a case of “there are pros and cons, but probably more cons on balance”.
In practical terms, a good take-away from this can be twofold:
- don’t keep fruit and veg in the fridge unless the ambient temperature really requires it
- if the ambient temperature does require it, it’s best to get the produce in fresh each day if that’s feasible, to minimize time spent in the fridge
An extra thing not included there: often when it comes to the spoilage of fruit and veg, the problem is that it respires and oxidizes; reducing the temperature does lower the rate of those, but often a far better way is to remove the oxygen. So for example, if you get carried away and chop too many carrot batons for your hummus night, then putting them in a sealed container can go a long way to keeping them fresh.
See also: How Does the Nutritional Value of Fruits and Vegetables Change Over Time?
Enjoy!
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How Useful Are Our Dreams
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What’s In A Dream?
We were recently asked:
❝I have a question or a suggestion for coverage in your “Psychology Sunday”. Dreams: their relevance, meanings ( if any) interpretations? I just wondered what the modern psychological opinions are about dreams in general.❞
~ 10almonds subscriber
There are two main schools of thought, and one main effort to reconcile those two. The third one hasn’t quite caught on so far as to be considered a “school of thought” yet though.
The Top-Down Model (Psychoanalysts)
Psychoanalysts broadly follow the theories of Freud, or at least evolved from there. Freud was demonstrably wrong about very many things. Most of his theories have been debunked and ditched—hence the charitable “or at least evolved from there” phrasing when it comes to modern psychoanalytic schools of thought. Perhaps another day, we’ll go into all the ways Freud went wrong. However, for today, one thing he wasn’t bad at…
According to Freud, our dreams reveal our subconscious desires and fears, sometimes directly and sometimes dressed in metaphor.
Examples of literal representations might be:
- sex dreams (revealing our subconscious desires; perhaps consciously we had not thought about that person that way, or had not considered that sex act desirable)
- getting killed and dying (revealing our subconscious fear of death, not something most people give a lot of conscious thought to most of the time)
Examples of metaphorical representations might be:
- dreams of childhood (revealing our subconscious desires to feel safe and nurtured, or perhaps something else depending on the nature of the dream; maybe a return to innocence, or a clean slate)
- dreams of being pursued (revealing our subconscious fear of bad consequences of our actions/inactions, for example, responsibilities to which we have not attended, debts are a good example for many people; or social contact where the ball was left in our court and we dropped it, that kind of thing)
One can read all kinds of guides to dream symbology, and learn such arcane lore as “if you dream of your teeth crumbling, you have financial worries”, but the truth is that “this thing means that other thing” symbolic equations are not only highly personal, but also incredibly culture-bound.
For example:
- To one person, bees could be a symbol of feeling plagued by uncountable small threats; to another, they could be a symbol of abundance, or of teamwork
- One culture’s “crow as an omen of death” is another culture’s “crow as a symbol of wisdom”
- For that matter, in some cultures, white means purity; in others, it means death.
Even such classically Freudian things as dreaming of one’s mother and/or father (in whatever context) will be strongly informed by one’s own waking-world relationship (or lack thereof) with same. Even in Freud’s own psychoanalysis, the “mother” for the sake of such analysis was the person who nurtured, and the “father” was the person who drew the nurturer’s attention away, so they could be switched gender roles, or even different people entirely than one’s parents.
The only real way to know what, if anything, your dreams are trying to tell you, is to ask yourself. You can do that…
- by reflection and personal interrogation (see for example: The Easiest Way To Take Up Journaling)
- or by externalising parts of your subconscious (as in Internal Family Systems therapy)
- or by talking directly to your subconscious where it is, by means of lucid dreaming.
The idea with lucid dreaming is that since any dream character is a facet of your subconscious generated by your own mind, by talking to that character you can ask questions directly of your subconscious (the popular 2010 movie “Inception” was actually quite accurate in this regard, by the way).
To read more about how to do this kind of self-therapy through lucid dreaming, you might want to check out this book we reviewed previously; it is the go-to book of lucid dreaming enthusiasts, and will honestly give you everything you need in one go:
Lucid Dreaming: A Concise Guide to Awakening in Your Dreams and in Your Life – by Dr. Stephen LaBerge
The Bottom-Up Model (Neuroscientists)
This will take a lot less writing, because it’s practically a null hypothesis (i.e., the simplest default assumption before considering any additional evidence that might support or refute it; usually some variant of “nothing unusual going on here”).
The Bottom-Up model holds that our brains run regular maintenance cycles during REM sleep (a biological equivalent of defragging a computer), and the brain interprets these pieces of information flying by and, because of the mind’s tendency to look for patterns, fills in the rest (much like how modern generative AI can “expand” a source image to create more of the same and fill in the blanks), resulting in the often narratively wacky, but ultimately random, vivid hallucinations that we call dreams.
The Hybrid Model (per Cartwright, 2012)
This is really just one woman’s vision, but it’s an incredibly compelling one, that takes the Bottom-Up model and asks “what if we did all that bio-stuff, and then our subconscious mind influenced the interpretation of the random patterns, to create dreams that are subjectively meaningful, and thus do indeed represent our subconscious?
It’s best explained in her own words, though, so it’s time for another book recommendation (we’ve reviewed this one before, too):
Enjoy!
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Hair-Loss Remedies, By Science
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10almonds Gets Hairy
Hair loss is a thing that at some point affects most men and a large minority of women. It can be a source of considerable dysphoria for both, as it’s often seen as a loss of virility/femininity respectively, and is societally stigmatized in various ways.
Today we’re going to focus on the most common kind: androgenic alopecia, which is called “male pattern baldness” in men and “female pattern baldness” in women, despite being the same thing.
We won’t spend a lot of time on the science of why this happens (we’re going to focus on the remedies instead), but suffice it to say that genes and hormones both play a role, with dihydrogen testosterone (DHT) being the primary villain in this case.
We’ve talked before about the science of 5α-reductase inhibitors to block the conversion of regular testosterone* to DHT, its more potent form:
One Man’s Saw Palmetto Is Another Woman’s Serenoa Repens…
*We all make this to a greater or lesser degree, unless we have had our ovaries/testes removed.
Finasteride
Finasteride is a 5α-reductase inhibitor that performs similarly to saw palmetto, but comes in tiny pills instead of needing to take a much higher dose of supplement (5mg of finasteride is comparable in efficacy to a little over 300mg of saw palmetto).
Does it work? Yes!
Any drawbacks? A few:
- It’ll take 3–6 months to start seeing effects. This is because of the hormonal life-cycle of human hairs.
- Common side-effects include ED.
- It is popularly labelled/prescribed as “only for men”
On that latter point: the warnings about this are severe, detailing how women must not take it, must not even touch it if it has been cut up or crushed.
However… That’s because it can carry a big risk to our unborn fetuses. So, if we are confident we definitely don’t have one of those, it’s not actually applicable to us.
That said, finasteride’s results in women aren’t nearly so clear-cut as in men (though also, there has been less research, largely because of the above). Here’s an interesting breakdown in more words than we have room for here:
Finasteride for Women: Everything You Need to Know
Spironolactone
This one’s generally prescribed to women, not men, largely because it’s the drug sometimes popularly known as a “chemical castration” drug, which isn’t typically great marketing for men (although it can be applied topically, which will have less of an effect on the rest of the body). For women, this risk is simply not an issue.
We’ll be brief on this one, but we’ll just drop this, so that you know it’s an option that works:
❝Spironolactone is an effective and safe treatment of androgenic alopecia which can enhance the efficacy when combined with other conventional treatments such as minoxidil.
Topical spironolactone is safer than oral administration and is suitable for both male and female patients, and is expected to become a common drug for those who do not have a good response to minoxidil❞
Minoxidil
This one is available (to men and women) without prescription. It’s applied topically, and works by shortcutting the hair’s hormonal growth cycle, to reduce the resting phase and kick it into a growth phase.
Does it work? Yes!
Any drawbacks? A few:
- Whereas you’ll remember finasteride takes 3–6 months to see any effect, this one will have an effect very quickly
- Specifically, the immediate effect is: your rate of hair loss will appear to dramatically speed up
- This happens because when hairs are kicked into their growth phase if they were in a resting phase, the first part of that growth phase is to shed each old hair to make room for the new one
- You’ll then need the same 3–6 months as with finasteride, to see the regrowth effects
- If you stop using it, you will immediately shed whatever hair you gained by this method
Why do people choose this over finasteride? For one of three reasons, mainly:
- They are women, and not offered finasteride
- They are men, and do not want the side effects of finasteride
- They just saw an ad and tried it
As to how it works:
Some final notes:
There are some other contraindications and warnings with each of these drugs by the way, so do speak with your doctor/pharmacist. For example:
- Finasteride can tax the liver a little
- Spironolactone can reduce bone turnover
- Minoxidil is a hypotensive; this shouldn’t be an issue for most people, but for some people it could be a problem
There are other hair loss remedies and practices, but the above three are the heavy-hitters, so that’s what we spent our time/space on today. We’ll perhaps cover the less powerful (but less risky) options one of these days.
Meanwhile, take care!
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