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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Starfruit vs Soursop – Which is Healthier?
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Our Verdict
When comparing starfruit to soursop, we picked the soursop.
Why?
First, by starfruit, we also mean carambola, which is a different name for the same fruit, and by soursop we also mean graviola/guyabano/guanábana, which are different namers for the same fruit. Now, as for their health qualities:
In terms of macros, the soursop has more carbs and fiber, the ratio of which also give it the lower glycemic index. So, a win for soursop here.
When it comes to vitamins, starfruit has more of vitamins A, B5, C, and E, while soursop has more of vitamins B1, B2, B3, B6, B7, B9, and K. Another win for soursop.
In the category of minerals, starfruit has slightly more copper, manganese, and zinc, while soursop has much more calcium, iron, magnesium, phosphorus, and potassium. One more win for soursop!
Adding up the sections makes for a clear and overwhelming win for soursop, but let’s address to quick safety considerations while we’re here:
- Soursop extract has been claimed to be an effective cancer treatment. It isn’t. There is no evidence for this at all; just one unscrupulous company that spread the claims.
- Soursop contains annonacin, a neurotoxin. That sounds scary, but much like with apple seeds and cyanide, the quantities you’d have to consume to suffer ill effects are absurd. Remember how capsaicin (as found in hot peppers) is also a neurotoxin, too and has many health benefits. Humans have a long and happy tradition of enjoying things that are toxic at high doses, but in small doses are neutral or even beneficial. Pretty much all things we can consume (including oxygen, and water) are toxic at sufficient doses.
In short, both of these fruits are fine and good, neither will treat cancer, but both will help to keep you in good health. As for nutritional density, the soursop wins in every category.
Want to learn more?
You might like to read:
Top 8 Fruits That Prevent & Kill Cancer ← soursop has no special cancer treatment properties, but actual evidence shows these fruits are beneficial (being good as a preventative, and also definitely a worthy adjunct to—but not a replacement for—mainstream anticancer therapies if you have cancer).
Take care!
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Goji Berries vs Blueberries – Which is Healthier?
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Our Verdict
When comparing goji berries to blueberries, we picked the goji berries.
Why?
As you might have guessed, both are very good options:
- Both have plenty of vitamins and minerals, and/but goji berries have more. How much more? It varies, but for example about 5x more vitamin C, about 25x more iron, about 30x more calcium, about 50x more vitamin A.
- Blueberries beat goji berries with some vitamins (B, E, K), but only in quite small amounts.
- Both are great sources of antioxidants, and/but goji berries have 2–4 times the antioxidants that blueberries do.
- Goji berries do have more sugar, but since they have about 4x more sugar and 5x more fiber, we’re still calling this a win for goji berries on the glycemic index front (and indeed, the GI of goji berries is lower).
In short: blueberries are great, but goji berries beat them in most metrics.
Want to read more?
Check out our previous main features, detailing some of the science, and also where to get them:
Enjoy!
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Safe Effective Sleep Aids For Seniors
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Safe Efective Sleep Aids For Seniors
Choosing a safe, effective sleep aid can be difficult, especially as we get older. Take for example this research review, which practically says, when it comes to drugs, “Nope nope nope nope nope, definitely not, we don’t know, wow no, useful in one (1) circumstance only, definitely not, fine if you must”:
Review of Safety and Efficacy of Sleep Medicines in Older Adults
Let’s break it down…
What’s not so great
Tranquilizers aren’t very healthy ways to get to sleep, and are generally only well-used as a last resort. The most common of these are benzodiazepines, which is the general family of drugs with names usually ending in –azepam and –azolam.
Their downsides are many, but perhaps their biggest is their tendency to induce tolerance, dependence, and addiction.
Non-benzo hypnotics aren’t fabulous either. Z-drugs such as zolpidem tartrate (popularly known by the brand name Ambien, amongst others), comes with warnings that it shouldn’t be prescribed if you have sleep apnea (i.e., one of the most common causes of insomnia), and should be used only with caution in patients who have depression or are elderly, as it may cause protracted daytime sedation and/or ataxia.
See also: Benzodiazepine and z-drug withdrawal
(and here’s a user-friendly US-based resource for benzodiazepine addiction specifically)
Antihistamines are commonly sold as over-the-counter sleep aids, because they can cause drowsiness, but a) they often don’t b) they may reduce your immune response that you may actually need for something. They’re still a lot safer than tranquilizers, though.
What about cannabis products?
We wrote about some of the myths and realities of cannabis use yesterday, but it does have some medical uses beyond pain relief, and use as a sleep aid is one of them—but there’s another caveat.
How it works: CBD, and especially THC, reduces REM sleep, causing you to spend longer in deep sleep. Deep sleep is more restorative and restful. And, if part of your sleep problem was nightmares, they can only occur during REM sleep, so you’ll be skipping those, too. However, REM sleep is also necessary for good brain health, and missing too much of it will result in cognitive impairment.
Opting for a CBD product that doesn’t contain THC may improve sleep with less (in fact, no known) risk of long-term impairment.
See: Cannabis, Cannabinoids, and Sleep: a Review of the Literature
Melatonin: a powerful helper with a good safety profile
We did a main feature on this recently, so we won’t take up too much space here, but suffice it to say: melatonin is our body’s own natural sleep hormone, and our body is good at scrubbing it when we see white/blue light (so, look at such if you feel groggy upon awakening, and it should clear up quickly), so that and its very short elimination half-life again make it quite safe.
Unlike tranquilizers, we don’t develop a tolerance to it, let alone dependence or addiction, and unlike cannabis, it doesn’t produce long-term adverse effects (after all, our brains are supposed to have melatonin in them every night). You can read our previous main feature (including a link to get melatonin, if you want) here:
Melatonin: A Safe Natural Sleep Supplement
Herbal options: which really work?
Valerian? Probably not, but it seems safe to try. Data on this is very inconsistent, and many studies supporting it had poor methodology. Shinjyo et al. also hypothesized that the inconsistency may be due to the highly variable quality of the supplements, and lack of regulation, as they are provided “based on traditional use only”.
Chamomile? Given the fame of chamomile tea as a soothing, relaxing bedtime drink, there’s surprisingly little research out there for this specifically (as opposed to other medicinal features of chamomile, of which there are plenty).
But here’s one study that found it helped significantly:
The effects of chamomile extract on sleep quality among elderly people: A clinical trial
Unlike valerian, which is often sold as tablets, chamomile is most often sold as a herbal preparation for making chamomile tea, so the quality is probably quite consistent. You can also easily grow your own in most places!
Technological interventions
We may not have sci-fi style regeneration alcoves just yet, but white noise machines, or better yet, pink noise machines, help:
White Noise Is Good; Pink Noise Is Better
Note: the noise machine can be a literal physical device purchased to do that (most often sold as for babies, but babies aren’t the only ones who need to sleep!), but it can also just be your phone playing an appropriate audio file (there are apps available) or YouTube video.
We reviewed some sleep apps; you might like those too:
The Head-To-Head Of Google and Apple’s Top Apps For Getting Your Head Down
Enjoy, and rest well!
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Seasonal Affective Disorder (Beyond Sunlight!)
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For those of us in the Northern Hemisphere, the time of increasing darkness is upon us again. Depending on our latitude, the sun barely rises before it skitters off again. And depending on other factors of our geography, we might not get much sun during that time (writer’s example: the ancient bog from which I write has been surrounded by fog for two weeks now).
So, what to do about it?
Firstly, we can make the most of whatever sun we do get (especially in the morning, if possible), and we can of course make some use of artificial sunlight. To save doubling up, we’ll link to what we previously wrote about optimizing both of those things:
‘Tis To Season To Be SAD-Savvy
More ways to get serotonin
Sunlight, of course, triggers our bodies to make serotonin, and hence we often make less of it during winter. But, there are other ways to get serotonin too, and one of the best ways is spending time in nature. Yes, even if the weather is gloomy, provided there are still visible green things and you are seeing them, it will promote serotonin production.
Of course, it may not be the season for picnics, but a morning walk through a local park or other green space is ideal.
On which note, gardening remains a good activity. Not a lot of people do so much gardening after a certain point in the year, but in one way, it’s more important than ever to get some soil under your fingernails:
There are bacteria in soil (specifically: Mycobacterium vaccae) that work similarly to antidepressants.
When something is described as having an effect similar to antidepressants, it’s usually hyperbole. In this case, it’s medicine, and literally works directly on the serotonergic system (as do many, but not all, antidepressants).
See also: Antidepressants: Personalization Is Key!
While many antidepressants are selective serotonin uptake inhibitors (i.e., they slow the rate at which your brain loses serotonin), Mycobacterium vaccae increases the rate at which you produce serotonin. So, you feel happier, more relaxed, while also feeling more energized.
^this one’s a mouse study, but we’re including it because it covers exactly how it works in the brain, which is something that the ethics board wouldn’t let them do on humans, due to the need for slicing the brains up for examination.
As to how to benefit: touching soil will get you “infected” by the bacteria, yes, even if you wash your hands later. Growing food in the soil and eating the good (including if you wash and cook it) is even better.
Boost the other “happiness chemicals”
Serotonin is just one “happiness hormone”, other feel-good neurotransmitters that are just as important include dopamine and oxytocin.
Dopamine is most associated with being the “reward chemical”, so it pays to do things that you find rewarding. If you’re stuck for ideas, engaging in small acts of kindness is a sure-fire way to get dopamine flowing and lift your own mood as well as theirs.
See also: 10 Ways To Naturally Boost Dopamine
Oxytocin, meanwhile is the “cuddle chemical”, and can be triggered even if you have nobody to cuddle*. If you do, by the way, make it at least 20–30 seconds, as that’s generally how long it takes to get oxytocin flowing.
*Vividly imagining it has much the same effect, since the brain can’t tell the difference. Alternatively, looking at pictures/videos (your choice) of small cute animals tends to work for most people also.
For more on these things, check out: Neurotransmitter Cheatsheet
Take care!
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Caffeine Blues – by Stephen Cherniske
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Caffeine use is an interesting and often-underexamined factor in health. Beyond the most superficial of sleep hygiene advice (à la “if you aren’t sleeping well, consider skipping your triple espresso martini at bedtime”), it’s often considered a “everybody has this” drug.
In this book, Cherniske explores a lot of the lesser-known effects of caffeine, and the book certainly is a litany against caffeine dependence, ultimately arguing strongly against caffeine use itself. The goal is certainly to persuade the reader to desist in caffeine use, and while the book’s selling point is “learn about caffeine” not “how to quit caffeine”, a program for quitting caffeine is nevertheless included.
You may notice the title and cover design are strongly reminiscent of “Sugar Blues”, which came decades before it, and that’s clearly not accidental. The style is similar—very sensationalist, and with a lot of strong claims. In this case, however, there is actually a more robust bibliography, albeit somewhat dated now as science has continued to progress since this book was published.
Bottom line: in this reviewer’s opinion, the book overstates its case a little, and is prone to undue sensationalism, but there is a lot of genuinely very good information in here too, making it definitely worth reading.
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The Good Life – by Robert Waldinger, MD, and Marc Schulz, PhD
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For any who have thought “there must be some middle-ground between entirely subjective self-help books advising how to feel better, and sifting through clinical data on what actually affects people’s moods“, this book is exactly that middle-ground!
Drs. Waldinger and Schultz went through the 80-year-long Harvard Study of Adult Development with a fine-toothed comb, and this book details—more readably—what they found.
There are frequent references to data from the study. Not just numbers, though, people’s answers to questions, too. And how different factors about people’s lives affected their answers to the same questions.
We hear from all ages, from young adults to octagenarians, and learn how attitudes (including: of the same people) change over time. Not because people are fickle, but because people grow… or become disillusioned. Or sometimes, both.
We learn about the importance of money… And where that importance ends.
We learn importance of relationships of various kinds, and this is certainly a recurring theme throughout the study—and thus, throughout the book.
The book doesn’t just present data, though, it also presents actionable insights along the way.
Bottom line: the combined wisdom and life-experiences of a lot of people provide a very “big picture” view of life, and what makes us happy, really. We highly recommend it!
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