Sexual Problems for Men with Neuropathy

This is another topic which has been covered before on the blog but recently a 50 year old man from Arkansas mailed and said that despite having both neuropathy and HIV for some years, his doctor had told him that his erectile disfunction was a result of his age and a lifetime of smoking, nothing more. This may perhaps be the case but some doctors need to realise that ED can definitely be a result of neuropathic complaints and not dismiss someone's concerns with a cliche. Losing their potency is a really big deal for many men and having a genuine medical reason for it can perversely, ease the blow. This article is from medicalxpress.com (see link below) and shows the link between ED and neuropathy revealed by the results of Spanish research in this area.

Erectile dysfunction study shows high prevalence of peripheral neuropathy
November 15, 2011

Spanish researchers have uncovered clear links between erectile dysfunction (ED) and peripheral neuropathy, according to a paper in the December issue of the urology journal BJUI.

"Up to now the impact of damaged nerves in the peripheral nervous system on ED has been underestimated" says lead author Dr Consuelo Valles-Antuña, from the Department of Neurophysiology at the Hospital Universitario Central de Asturias in Oviedo.

"However our study of 90 patients shows that men with more severe symptoms of peripheral neuropathy, which can be caused by disease, trauma or illness, had greater self-reported ED and required more aggressive treatment.

"Our findings underline the importance of clinicians carrying out neurophysiological tests on patients with ED, particularly in the pelvic area."

The research team, which included experts on both neurophysiology and urology, studied 90 consecutive patients with sexual problems recruited from the hospital's Department of Andrology.

ED was diagnosed using the five-item version of the International Index of Erectile Dysfunction (IIEF-5) and the occurrence of peripheral neuropathy was predicted using the Neuropathy Symptom Score.

A range of neurophysiology tests were carried out to assess the presence of large and small fibre peripheral neuropathy.

The researchers found that:

•The average age of the men in the study was 54 years of age. Ten per cent were under 40 and only two per cent were over 70.
•No significant correlation between IIEF-5 scores and increasing age was found. In fact, younger patients had lower (worse) IIEF-5 scores, which could be due to higher expectations or a higher number of organic risk factors.
•Just under a third of the patients (30 per cent) had cardiovascular disease, 16 per cent had neurogenic risk factors (relating to the nerves or nervous system) 16 per cent had diabetes and 11 per cent had no risk factors. Just over seven per cent had been diagnosed with mental health issues.
•Patients with more severe symptoms of peripheral neuropathy showed lower (worse) IIEF-5 scores and required more aggressive therapies.
•Neurophysiological exploration confirmed that just under 69 per cent of patients had neurological pathology. Of these, 61 per cent had some type of peripheral neuropathy and eight per cent had myelopathy - problems with their spinal chord.
•Just under 38 per cent of the patients had polyneuropathy, which occurs when a number of the peripheral nerves throughout the body malfunction simultaneously. Of these nine per cent had small fibre neuropathy, damage to the small unmyelinated peripheral nerve fibres, and just over 14 per cent had pudendal neuropathy, affecting the somatic nerve in the pelvic region.
•The findings of the sympathetic skin response tests underlined the importance of checking nerve problems in the pelvic area, as response alterations were much more common in the penis than hand or foot.
•No association between neurophysiological diagnosis and IIEF-5 scores was detected, but a statistical association was found between neuropathy and the Neuropathy Symptom Scores.
."To our knowledge, this is the first study to assess the whole peripheral nerve fibre spectrum in a non-selected group of patients with erectile dysfunction" says Dr Valles-Antuña.

http://medicalxpress.com/news/2011-11-erectile-dysfunction-high-prevalence-peripheral.html

POOR SPERM QUALITY LINKED TO HYPERTENSION OTHER HEALTH PROBLEMS

A study of men who were evaluated for the cause of their infertility finds previously unknown relationships between deficiencies in their semen and other, seemingly unrelated health problems.

A study of more than 9,000 men with fertility problems has revealed a correlation between the number of different defects in a man's semen and the likelihood that the man has other health problems.

The study, conducted by investigators at the Stanford University School of Medicine, also links poor semen quality to a higher chance of having various specific health conditions, such as hypertension, and more generally to skin and endocrine disorders.

The findings, published online Dec. 10 in Fertility and Sterility, may spur more-comprehensive approaches to treating male infertility. They also point to the wisdom of performing complete physical examinations of men experiencing reproductive difficulties.

"About 15 percent of all couples have fertility issues, and in half of those cases the male partner has semen deficiencies," said the study's lead author, Michael Eisenberg, MD, assistant professor of urology and director of male reproductive medicine and surgery at Stanford. "We should be paying more attention to these millions of men. Infertility is a warning: Problems with reproduction may mean problems with overall health."

A study Eisenberg co-authored a few years ago showed that infertile men had higher rates of overall mortality, as well as mortality linked to heart problems, in the years following an infertility evaluation. "But here, we're already spotting signs of trouble in young men in their 30s," he said.

Analyzing medical records

In the new study, Eisenberg and his colleagues analyzed the medical records of 9,387 men, mostly between 30 and 50 years old, who had been evaluated at Stanford Hospital & Clinics (now Stanford Health Care) between 1994 and 2011 to determine the cause of their infertility. The men had routinely provided semen samples, which the researchers assessed for characteristics including volume, concentration and motility. In about half of all the male infertility cases, the problem was abnormal semen; in the rest, the fault lay elsewhere. So, using the database, the investigators were able to compare the overall health status of men who had semen defects to that of the men who didn't.

With a median age of 38, this was a fairly young group of men. However, 44 percent of all the men had some additional health problem besides the fertility problem that brought them to the clinic. In particular, the investigators found a substantial link between poor semen quality and specific diseases of the circulatory system, notably hypertension, vascular disease and heart disease. "To the best of my knowledge, there's never been a study showing this association before," said Eisenberg. "There are a lot of men who have hypertension, so understanding that correlation is of huge interest to us."

In addition, as the number of different kinds of defects in a man's semen rose, so did his likelihood of having a skin disease or endocrine disorder. When looking at the severity of all health problems, the scientists observed a statistically significant connection between the number of different ways in which a man's semen was deficient and the likelihood of his having a substantial health problem.

Health, semen quality 'strongly correlated'

The study wasn't designed to determine precisely how connections between semen deficiencies and seemingly unrelated disorders, such as cardiovascular or endocrine disease, come about. But, Eisenberg noted, some 15 percent of all genes in the human genome are connected fairly directly to reproduction, and most of these genes also have diverse functions in other bodily systems. He also noted that it may not be a disease itself, but the treatment for the disease, that's actually responsible for reproductive malfunction. He said he is exploring this possibility now.

As we treat men's infertility, we should also assess their overall health.

"A man's health is strongly correlated with his semen quality," he said. "Given the high incidence of infertility, we need to take a broader view. As we treat men's infertility, we should also assess their overall health. That visit to a fertility clinic represents a big opportunity to improve their treatment for other conditions, which we now suspect could actually help resolve the infertility they came in for in the first place."

The senior author of the study is Mark Cullen, MD, professor of medicine at Stanford. Other Stanford co-authors are professor of reproductive endocrinology and fertility Barry Behr, PhD; former professor of obstetrics and gynecology Renee Reijo Pera, PhD; and statistical programmer Shufeng Li.

Can Chiropractic Techniques Help With Neuropathic Problems

Today's post from diabetesnewsjournal.com (see link below) addresses the perennially thorny topic of whether chiropractitioners can be of help to neuropathy sufferers. It's fair to say that 9 out of 10 neurologists will dismiss this idea with a snigger but there are many cases of nerve damage patients being helped by chiropractic techniques but it may depend on the cause of the nerve damage and whether that can be helped directly. At least this article doesn't claim that chiropractic care can 'cure' neuropathy; it makes a claim for this sort of care to be an element in an overall strategy. If you see chiropractic clinics offering 'cures' for nerve damage, please ignore them and don't waste your money or run the risk of further damage. These clinics, or so-called medical practitioners can not provide a cure - there is no cure - end of argument. However if a chiropractioner offers his or her services as part of a wider treatment strategy, it may be worth discussing it with your home doctor or neurologist. Remember though, if you're paying for this treatment, you need to be convinced that it will help.

Chiropractic Care May Help Control Peripheral Neuropathy in Diabetics
March 17th, 2015 Leonor Mateus Ferreira 

While about 60% of patients who suffer from diabetes also develop peripheral neuropathy, a nerve condition that causes tingling, numbing and tickling in the extremities, the Raveling Chiropractic Center is implementing a new technique to treat the disease. According to the center, chiropractic care may offer several benefits to treat the disorder.

Chiropractor Paul Raveling administers chiropractic care at his center with patients who suffer from peripheral neuropathy to help with the management of pain as well by treating the underlying cause. In addition to pain and numbness, the condition can include a variety of other symptoms such as prickling and throbbing or a freezing sensation. In addition, it can also damage the brain’s capacity to communicate properly with regions of the body.

“Chiropractic care is an effective treatment for peripheral neuropathy because it targets the root cause for a patient’s pain symptoms; we do not simply rely on medication to numb this pain,” explained Raveling in a press release. “While chiropractic care is not a ‘cure’ for peripheral neuropathy, it is an important part of an effective treatment program.”

“Treatment programs that cover up the symptoms are ignoring the bigger problem. As a chiropractor, I follow a ‘whole body’ approach to treatment, which means we start by addressing the underlying trigger for a patient’s pain,” he continued, explaining that a diagnostic exam is conducted in order to identify the cause of the pain and understand which specialty of care is needed in addition to chiropractic care.

The chiropractor believes that early diagnosis and treatment may reduce the severity of the motor nerve and sensory nerve damage, as well as help patients with the management of the disease. In addition, Raveling noted that the pain symptoms associated with peripheral neuropathy indicate poor health conditions and need to be evaluated carefully.

Peripheral neuropathy is a condition often associated with diabetes, despite the fact it can also be caused by autoimmune disorders, tumors, nutritional imbalances or infections, and it can even be hereditary. The nerve disorder currently affects about 20 million people in the United States, according to the National Institute of Neurological Disorders and Stroke, and while the symptoms may seem unimportant, early diagnosis may prevent further complications.

“Everyone experiences peripheral neuropathy a little differently. For some individuals, the pain may come and go, while for others, the pain may be constant. As the condition worsens, individuals may experience coordination and balance loss, along with a freezing pain, muscle weakness or extreme sensitivity to touch. I urge anyone who may be experiencing these symptoms to seek immediate treatment,” added Raveling.

The University of Kansas and Irving-based company Reata Pharmaceuticals have also recently established a partnership to develop drug technologies discovered by a professor of medicinal chemistry Brian Blagg and professor of pharmacology and toxicology Rick Dobrowsky. These compounds, called “novologues,” are expected to become a treatment option for diabetic peripheral neuropathy as well.

http://diabetesnewsjournal.com/2015/03/17/chiropractic-care-may-help-control-peripheral-neuropathy-in-diabetics/

Prion Proteins The Sci Fi Villains Behind Mad Cow Disease And Human Chronic Nerve Problems

Today's post from media.uzh.ch (see link below) may seem light years away from the sorts of neuropathy we experience every day but in fact is much closer than you think. With all these things, you have to continually remind yourself exactly what neuropathy is:- damage to the nerves. There are dozens of causes and dozens of types but nerve damage leads to the symptoms we most frequently feel. This fascinating article brings images from the 90's of cows struggling to stay on their feet under the same general umbrella description as the tingling and burning we suffer from when we report our symptoms to our doctors. Scientists are seemingly just beginning to scratch the surface of the knowledge that concludes that certain proteins can be responsible for all this strange behaviour in our nervous systems. It's fascinating and frightening at the same time but you do get the feeling that we're on the point of huge scientific discoveries regarding neuropathy and that can only be a good thing as we struggle with drug treatments that clearly only work to a limited extent. Worth a read - fascinating stuff!

Impact of prion proteins on the nerves revealed for the first time
News release, 8 August 2016 
 
When prion proteins mutate, they trigger mad cow and Creutzfeldt-Jakob disease. Although they are found in virtually every organism, the function of these proteins remained unclear. Researchers from the University of Zurich and the University Hospital Zurich now demonstrate that prion proteins, coupled with a particular receptor, are responsible for nerve health. The discovery could yield novel treatments for chronic nerve diseases.


Without the prion proteins, the so-called Schwann cells around the sensitive nerve fibers no longer form an insulating layer to protect the nerves. (Image: NatureReview / Neuroscience)

Ever since the prion gene was discovered in 1985, its role and biological impact on the neurons has remained a mystery. “Finally, we can ascribe a clear-cut function to prion proteins and reveal that, combined with particular receptor, they are responsible for the long-term integrity of the nerves,” says Professor Adriano Aguzzi from the Neuropathological Institute at the University of Zurich and University Hospital Zurich. The present study therefore clears up a question that researchers have been puzzling over for 30 years, but ultimately went unanswered.

Prions are dangerous pathogens that trigger fatal brain degeneration in humans and animals. In the 1990s, they were responsible for the BSE epidemic more commonly known as mad cow disease. In humans, they cause Creutzfeldt-Jakob disease and other neurological disorders that are fatal and untreatable. Meanwhile, we know that infectious prions consist of a defectively folded form of a normal prion protein called PrPC located in the neuron membrane. The infectious prions multiply by kidnapping PrPC and converting it into other infectious prions. 

Absent prion proteins cause nerve diseases

For a long time, it remained unclear why we humans – like most other organisms – have a protein in our neurons that does not perform any obvious function, yet can be extremely dangerous. Aguzzi has spent decades researching this issue and examining the theory that animals without the PrPC gene are resistant to prion diseases. But what are the repercussions for the organism if the prion protein is deactivated?

A few years ago, Aguzzi and his team discovered that mice without the PrPC gene suffer from a chronic disease of the peripheral nervous system. The reason: The so-called Schwann cells around the sensitive nerve fibers no longer form an insulating layer to protect the nerves. Due to this insulating myelin deficit, the peripheral nerves become diseased, potentially resulting in motoric disorders in the motion tract and paralysis.

The researchers have now gone one step further in the lab: In a new study, Alexander Küffer and Asvin Lakkaraju clarify exactly why the peripheral nerves become damaged in the absence of the prion protein PrPC. They discovered how the PrPC produced by the neurons docks onto the Schwann cells: namely via a receptor called Gpr126. If the prion protein and the receptor work together, a particular messenger substance (cAMP) which regulates the chemical interaction in the cells and is essential for the integrity of the nerve’s protective sheath increases. Gpr126 belongs to the large family of “G-protein-coupled receptors”, which are involved in many physiological processes and diseases.

30-year-old research question finally answered

This discovery solves a key question that has long puzzled neuroscientists and points towards future applications in hospitals. “If you want to deactivate the prion protein PrPC fully for potential Creutzfeld-Jakob disease treatments, you need to know the potential side effects on the nerves in the future,” explains Aguzzi. Moreover, the present results on the effect of PrPC at molecular level could yield a new approach for peripheral neuropathy. Currently, there are only extremely limited therapeutic options for these chronic debilitating diseases of the nervous system.
Literature:

Alexander Küffer, Asvin K. K. Lakkaraju, Amit Mogha, Sarah C. Petersen, Kristina Airich, Cédric Doucerain, Rajlakshmi Marpakwar, Pamela Bakirci, Assunta Senatore, Arnaud Monnard, Carmen Schiavi, Mario Nuvolone, Bianka Grosshans, Simone Hornemann, Frederic Bassilana, Kelly R. Monk & Adriano Aguzzi. The prion protein is an agonistic ligand of the G-protein-coupled receptor Gpr1/Adgrg6. Nature, 8 August 2016. doi:10.1038/nature19312

http://www.media.uzh.ch/en/Press-Releases/2016/Prion-Proteine.html

How To Help Problems With Standing If You Have Neuropathy

Today's short post from paincommunity.org (see link below) gives some practical tips for people who find standing for long periods of time both uncomfortable and painful (almost all neuropathy sufferers). In this case the advice applies to the kitchen. Worth a quick read.

TPC Comfort Cookin’ – Stand Your Ground: Comfortably
Posted by Janice Reynolds | February 11, 2014

Do you find that standing for any length of time can be difficult? Does that keep you from spending time in the kitchen cooking your favorite meals? I find that when your feet or hands hurt, your overall pain may worsen.

Tip #1: Look at what is under your feet.
One thing that can help is strategically placing a thick area rug in the kitchen. I highly recommend that it has a no skid backing and that the edges that do not roll up (which I have in my work area) or better yet–a gel mat. These can be found in stores or online by names such as “comfort “mat, “anti-fatigue” mat and “wellness” mats. They are widely available, in a variety of sizes as well as price ranges from low-cost to expensive. User reviews indicate that they have been helpful for back pain, a variety of foot problems, joint problems, and fatigue. I know when my rug has been taken up for cleaning that I notice the difference immediately.
Tip #2: Look at what is under your bum.
For those longer periods of time (like doing prep work) when it is really difficult to stand, a bar chair/stool (preferably with a study back) is wonderful. Just be sure, for you, it is easy to sit on, easy to get up on or down from and if it swivels that it does not move too freely that you miss your mark and down on the floor you go

http://paincommunity.org/tpc-comfort-cookin-stand-ground-comfortably/

Mental Health Problems From Opioids

Today's post from the ever-reliable pain-topics.org (see link below) discusses some of the potential effects of long term (and recreational) opioid use. Now many people living with neuropathy have no choice; they have to take opioids long term, to help control the pain but it is always worth knowing what they might do to you. The article looks at recent studies and assesses their accuracy. If you're concerned, discuss the issues with your prescribing doctor - he or she should be carefully monitoring you anyway, to reduce the risk of addiction and the question underlying this is whether long term opioid use actually makes us misusers (however unintentionally).

 

Pain, Depression, Anxiety in Rx-Opioid Misusers

Posted bySB. Leavitt, MA, PhD Wednesday, November 21, 2012
 Nonmedical prescription opioid use has become a substantial public health concern in North America and most other countries. Limited epidemiological data suggest an association between such Rx-opioid misuse and mental health or pain symptoms in different populations, although these correlations have not been systematically assessed, which was the purpose of a new study.

A team of Canadian researchers conducted a thorough systematic search, review, and meta-analysis to examine mental health problem symptoms and pain in general population samples reporting nonmedical Rx-opioid use [Fischer et al. 2012]. Overall, 9 qualifying epidemiological studies were identified and included in the review; 5 contributed data on the prevalence of mental health issues and 4 had data on the prevalence of pain in the target population. Most studies (8) were based on populations in the United States and the other one was centered in Ontario, Canada.

Writing in the November 2012 edition of the Journal of Pain, the researchers report that the pooled prevalence of any mental health symptoms in general population samples reporting nonmedical Rx-opioid use was 32% (95% confidence interval [CI], 24–40). Specifically, the pooled prevalence of depression was 17% (95% CI, 14–19) and the prevalence of anxiety was 16% (95% CI, 1–30). The pooled prevalence of pain in the population of interest was found to be 48% (95% CI, 37–59).

The researchers conclude that their study found evidence for disproportionately high prevalence levels of mental health problems (anxiety and depression) and pain among nonmedical Rx-opioid users in the general population. While causality cannot be established by such data, these comorbidities may influence Rx-opioid misuse and should be considered in preventive and treatment interventions.

COMMENTARY: Curiously, Fischer and colleagues do not even mention in their report the prevalence of nonmedical Rx-opioid use found in the 9 epidemiological studies they examined. However, they do include raw data in a table of study characteristics and extrapolating from those data we calculated the prevalence of Rx-opioid misuse as ranging from 1.8% to 12% (mean 5.6%; 95% CI, 3-8.2).

Judging whether 5.6% on average is an extraordinarily high and intolerable prevalence of Rx-opioid misuse requires further consideration of all factors that might be contributing to or account for the alleged aberrant behaviors. However, the wide prevalence range alone suggests that either the measurement of Rx-opioid misuse across studies was inconsistent or the populations examined were significantly different from each other.

The researchers defined “nonmedical use” or “misuse” as the use of Rx-opioids without being medically sanctioned, which may include, but is not limited to, the consumption of these medications for purposes other than prescribed, or taking nonprescribed, diverted, or illicitly obtained Rx-opioids. However, considering the high prevalence of pain, one must question how much of the putative “nonmedical use” actually was for medical purposes (pain relief), which raises questions about access to healthcare and/or the undertreatment of pain via legitimate healthcare channels.

Prevalence levels of anxiety and depression also were considered to be quite high by the researchers, but it is not known if these factors influenced Rx-opioid misuse, if they resulted from such misbehavior, or if they were largely related to unrelieved pain. These are important concerns worthy of further investigation.

Most, but not all, of the included epidemiological studies were of significant size; however, since all of them were focused in North America (primarily the U.S.), the results cannot be generalized to other populations. It is somewhat surprising that these issues have not been investigated by large-scale epidemiological surveys in the general populations of other countries.

There were some critical limitations of this review and meta-analysis by Fischer et al. that are noteworthy and question its validity. Concepts of systematic reviews and meta-analyses were discussed in a recent UPDATE here, and here are some of the concerns in the present study:
There was a significantly high degree of heterogeneity across all of the studies included in meta-analyses, even though differences between many of the studies were small and their confidence intervals were very narrow. For the 4 major analyses — any mental health symptoms, depression, anxiety, and pain — I² values (suggesting the amount of heterogeneity) were 97.3%, 94.8%, 99.8%, and 95.5%, respectively.

Also, there were extremely few studies for each of the 4 meta-analyses regarding factors of interest: 3 studies for any mental health symptoms, 2 each for depression and anxiety, and 4 for pain.

Appropriately, the researchers used random-effects modeling in the pooling of data; however, with so few studies they could not do any sensitivity analyses to determine sources of bias and reliability of results.

In sum, there were so many fundamental differences between studies — eg, population composition, definitions, assessment measures, etc. — influencing heterogeneity, and so few studies for each analysis, that it is questionable whether conducting meta-analyses of the data was appropriate. Perhaps, there have been other studies on these issues that were undiscovered by the researchers’ systematic review, although it did seem to be quite thorough. In any case, there is clearly a need for additional and more consistent research before reliable and valid conclusions can be reached on this subject of factors associated with nonmedical Rx-opioid use.

REFERENCE: Fischer B, Lusted A, Roerecke M, et al. The Prevalence of Mental Health and Pain Symptoms in General Population Samples Reporting Nonmedical Use of Prescription Opioids: A Systematic Review and Meta-Analysis. J Pain. 2012(Nov);13(11):1029-1044 [abstract here].

http://updates.pain-topics.org/2012/11/pain-depression-anxiety-in-rx-opioid.html

Is Intravenous Immune Globulin The Answer To Neuropathy Problems

Today's post from kiich.sharedby.co (see link below) is a St Louis Post Despatch, letters-to-the-doctor example, which asks the question whether Intravenous immune globulin is the answer to the neuropathy patient's problem. It's a specific question relating to a specific case but if it's  got you curious as to what IVIG is, then you may want to research further to see if it's a possibility for you.

IVIG is primarily for autoimmune neuropathy 
Dr. K Roach November 06, 2014 12:00 am 
Dr. Keith Roach is a physician at Weill Cornell Medical College and New York Presbyterian Hospital.Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, Fla. 32853-6475

Dear Dr. Roach • My brother has been treated for peripheral neuropathy for the past 10 years. He turns 60 in October. After an MRI found a left parietal tumor, he was seen by a prominent neurosurgeon who felt that the tumor had been there since birth and is not connected to the symptoms of pain and decreased sensation in his feet and hands. He is not diabetic, has no cardiovascular problems and does not use alcohol. Basically, all tests come back normal. For now, they just monitor the tumor.

My brother resisted taking any narcotics until three years ago and is now on a long-acting narcotic twice a day. The physicians seem to think this is a genetic/autoimmune problem, and my brother is less inclined to keep searching for help.

My question is: Would a trial of IVIG infusion therapy be reasonable? I don’t know if his bloodwork supports checking his immune status, but I am not sure that the results necessarily would reflect the problem. I have read of IVIG use for some neuropathies, but before I try to get my brother to see a neurologist again, I would like to know if this is a possible therapy to try. — M.S.

Answer • Peripheral neuropathy is one of the most frequent topics I get questions about, but it is very difficult to answer the questions, because there are many different kinds of peripheral neuropathies (“peripheral” means the part of the nervous system outside the brain and spinal cord, while “neuropathy” simply means that something is wrong with the nerve).

In general, peripheral neuropathies can be broken down into several categories. Diabetes is the most prevalent one I see, but those caused by prolonged alcohol use and HIV are other common types. Some are indeed autoimmune, such as Guillain-Barre. Other toxins besides alcohol, especially chemotherapy, may cause symptoms in the peripheral nerves. There are genetic or hereditary causes that are relatively rare. Other important causes include infection, especially Lyme disease; hypothyroidism; vitamin deficiencies; and amyloidosis. One cause I see rarely is called paraneoplastic, associated with an existing tumor. That is one way the tumor in the parietal area of the brain could possibly cause the neuropathy.

If the underlying condition can be treated, it should be, but it sounds in your brother’s case that despite looking, his doctors haven’t been able to find a cause. About 1/4 of cases of peripheral neuropathy fall into the idiopathic, or unexplained, category. Intravenous immune globulin is used primarily for the autoimmune types of neuropathy. Only his neurologist can say if it’s right for him.

When the underlying condition can’t be treated, then we rely on medications to ease symptoms. While opiates are sometimes needed, most experts try to avoid them, because the body can get used to them over time. Probably the most effective medications for neuropathies are antidepressants (the older tricyclic antidepressants, such as amitriptyline) and seizure medicines, such as gabapentin (Neurontin) and pregabalin (Lyrica). I always recommend physical therapy, because movement prevents weakness and may improve symptoms.

http://kiich.sharedby.co/de4d996b4c7488eb/?web=50fca7&dst=http%3A//www.stltoday.com/lifestyles/health-med-fit/health/to-your-good-health/ivig-is-primarily-for-autoimmune-neuropathy/article_c72824f0-b93e-5e9e-a0ab-8d16292332f1.html

Nerve Problems in the Feet

Today's video (Uploaded to YouTube by DrMichaelGrahamDPM on 1 Mar 2011) is not a good one if you've got a hangover I'm afraid, (with apologies to all reumatologists, neurologists and other specialists who will understand every word!). It's a 'silent movie' or slide show looking at the workings of the nerves in the feet and is fascinating if you wondered what the nerves. muscles and bones actually look like in the feet that are giving you such strange sensations or pain for much of the day. You may not understand much of the descriptive text but can mostly get the gist of what's going on. After six and a half minutes you can probably recognise the connections with neuropathy.
It's another world!



Nerves on the bottom of the foot have to make it through 2 tunnels in order to make it to the spine. Faulty foot mechanics and severely afftect these nerves. Watch this video to learn more about this very condition and to find out about what additional factors can taken to help.

Autonomic Dysfunction Problems With Neuropathy

Today's post from healthline.com (see link below) is especially helpful for those neuropathy patients who have been diagnosed with autonomic neuropathy but aren't quite sure what that is and what's going on inside their bodies. It takes a good look at the whole autonomic system; how it works and how it can go wrong. It may raise more questions than answers and may require a certain amount of Googling to explain medical terms but it's worth the effort.

Autonomic Dysfunction
Written by Christine Case-Lo
Medically Reviewed on May 21, 2013 by George Krucik, MD, MBA

Overview

Your autonomic nervous system is made up of nerves that control those “automatic” things you need to do to survive. A few of those necessary things include blood pressure, heart rate, sweating, and digestion of your food. Autonomic dysfunction or dysautonomia refers to problems with this autonomic nervous system.

What Is Autonomic Dysfunction?

The autonomic nervous system (ANS) controls several basic bodily functions. These include heart rate, body temperature, breathing rate, digestion, and many other systems as well. You don’t have to consciously think about these systems in order for them to work. The ANS provides the connection between your brain and your internal organs. For instance, it connects to the heart, liver, sweat glands, and even the interior muscles of your eye.

The ANS is made up of two subsystems: the sympathetic autonomic nervous system (SANS) and the parasympathetic autonomic nervous system (PANS). Most organs have nerves from both the sympathetic and parasympathetic systems.

The SANS usually stimulates organs. For instance, it increases heart rate and blood pressure when necessary. The PANS, on the other hand usually slows down bodily processes. For example, it reduces heart rate and blood pressure. There are certainly exceptions. Digestion and urination, for instance are stimulated by the PANS and slowed by the SANS.

The general responsibility of the SANS is to trigger emergency responses when required. These “fight or flight” responses get you ready to respond to stressful situations. The PANS, on the other hand, conserves your energy and restores tissues for ordinary functions.

Problems with the ANS can range from mild to life threatening. Sometimes only one part of the nervous system is affected. In other cases, the entire ANS is affected. Some conditions are temporary and can be reversed, while others are chronic and will continue to worsen over time. Diseases such as diabetes or Parkinson’s disease can cause irregularities with the ANS. Problems with ANS regulation often involve organ failure, or the failure of the nerves to transmit a necessary signal.

Symptoms of Autonomic Dysfunction

Effects of autonomic dysfunction can include just a small part of the ANS, or the entire ANS. Some symptoms that may indicate the presence of an autonomic nerve disorder include:

dizziness and fainting upon standing up (orthostatic hypotension)
inability to alter heart rate with exercise (exercise intolerance)
sweating abnormalities, which could alternately be too much sweat or insufficient sweat
digestion difficulties due to slow digestion. Resulting symptoms could include loss of appetite, bloating, diarrhea or constipation, and difficulty swallowing.
urinary problems. These can include difficulty starting urination, incontinence, and incomplete emptying of the bladder
sexual problems. In men, this could be difficulty with ejaculation and/or maintaining an erection. In women, this could be vaginal dryness and/or difficulty with orgasm
vision problems. This could be blurry vision, or the failure of the pupils to react quickly enough to changes in light.

Any or all of these symptoms may be present, and effects may be mild to severe.

Orthostatic hypotension or orthostatic intolerance (a milder form of orthostatic hypotension) are two of the most common conditions resulting from ANS disorders. Orthostatic intolerance, which results in low blood pressure on standing, causes alarming symptoms. These include lightheadedness, fainting, and heart palpitations.

Parkinson’s disease-like symptoms, such as tremor and muscle weakness, may also result from certain forms of autonomic dysfunction.

Autonomic Dysfunction Conditions

Certain types of autonomic dysfunction can be very sudden and severe, yet also reversible. Guillain-Barre syndrome is an autoimmune disease affecting nerves of the ANS. It has a rapid onset of symptoms, including muscle weakness, tingling, and paralysis. However, most functions affected by this condition can be regained over time.

Primary forms of dysautonomia are conditions that can result in general autonomic failure. The systems associated with the ANS nerves no longer work effectively when general autonomic failure occurs. Multiple system atrophy (MSA) is a progressive deterioration of the ANS. MSA affects all ANS-associated functions and causes orthostatic hypotension and Parkinson’s-like symptoms. Onset is usually in adults over 50.

Other primary forms of dysautonomia include:

hereditary sensory and autonomic neuropathies (HSAN). This is a group of related genetic disorders that cause widespread nerve dysfunction in children and young adults. Familial dysautonomia is in this group of diseases.
autoimmune autonomic ganglionopathy. This is an autoimmune disease in which the body attacks a particular set of ANS nerve cells.
Holmes-Adie syndrome. This condition mostly affects the nerves controlling the muscles of the eye, causing vision problems.
neutrally mediated syncope. This affects regulation of heart rate and blood pressure, causing episodes of fainting.

Other dysautonomias can result from disease or damage to the body. Autonomic neuropathy refers to damage to nerves from certain medications, injury, or disease. Diseases causing this neuropathy include bacterial infections, alcoholism, diabetes, and autoimmune disorders. Parkinson’s disease causes orthostatic hypotension and other ANS failure symptoms.

Treatment of Autonomic Dysfunction

Autonomic dysfunction is treated by addressing the symptoms of whatever form of dysfunction you are experiencing. Orthostatic hypotension, for instance, can be treated with lifestyle changes and medication. Symptoms can respond to elevating the head of the bed you sleep in, drinking enough fluids, and compression stockings to prevent blood pooling in your legs. Medications like midodrine are also used for treating autonomic dysfunction.

Treating underlying conditions like alcoholism, diabetes, or Parkinson’s may help alleviate the progression of ANS dysfunction. Damage is difficult to cure. More severe symptoms may be addressed with the help of physical therapy. Walking aides, feeding tubes, and other methods may be used for bypassing damaged internal systems.

Prognosis for Autonomic Dysfunction

Damage to the nerves of the autonomic system is often not reversible. Some illnesses like Guillain-Barre may see significant recovery. Orthostatic hypotension responds to treatment, but there is an increased risk of stroke due to the sudden blood pressure changes. More general and severe conditions, such as multiple system atrophy, might have a life expectancy of six to ten years (Mayo Clinic, 2011).

http://www.healthline.com/health/autonomic-dysfunction

Curcumin Turmeric Curcuma For Neuropathic Problems

There are other posts on this blog about Turmeric/Curcuma/Cuurcumin (all the same thing) but this one from savvynaturalhealer.com (see link below) adds a little more information as to why it may be good for nerve damage and nerve protection. The article talks specifically about diabetic neuropathy but as with so many of these things, the information applies to most forms of neuropathy. Turmeric/Curcumin is certainly fast building up a reputation as something that really can help and has become a sort of 'trend' supplement across the Net. This of course, must be viewed with some reservation because although the medical establishment thinks there is probably some justification for the hype, they haven't done enough testing to prove anything yet. The best you can say is that it probably won't do you any harm, is cheap and many people swear by it. It may well be worth a try but you need to do your own research before you decide.

Curcumin for Diabetic Neuropathy

Saturday, September 8, 2012

Recently I posted about the potential of curcumin, the antioxidant that is relatively abundant in turmeric, as a treatment for type 2 diabetes. I got a question about using curcumin for the most common long-term type 2 diabetes, diabetic neuropathy. Here's a reposting of a a comment I made on my other blog last year.

The bottom line of the current state of research is, curcumin seems like a good idea for treating diabetic neuropathy although the potential is yet to be proven. There is one subgroup of type 2 diabetics, however, who are especially likely to benefit.

The March-April 2010 edition of the Indian Journal of Pharmaceutical Sciences featured an article on the potential of curcumin, the prominent antioxidant in the curry spice turmeric, to treat a great variety of nerve disorders. "Curcumin demonstrates neuroprotective action" in "major depression, tardive dyskinesia, and diabetic neuropathy," authors of the paper stated, although "the mechanism of its neuroprotective action is not completely understood."

There is good evidence that curcumin is non-toxic. Curcumin is touted as antimicrobial, antiinflammatory, antihypertensive, antihyperlipidemic, antitumor, anticancer, antiphlogistic, antidiabetic, antipsoriasis, antithrombotic, and antihepatotoxic. Since it is a relatively small molecule, it enters the human bloodstream easily, and since it is a polar molecule (it has regions of relatively high positive and negative charge), it is easily absorbed by the brain. One of the peculiar characteristics of curcumin while it is still in turmeric is that it protects against radiation. It protects against radiation so well that any insects in bags of turmeric survive irradiation, and irradiating turmeric to make it shelf-stable actually accelerates its spoilage.

There are numerous theoretical reasons that curcumin should be helpful as a treatment for diabetic neuropathy. At the test-tube level, it protects astrocytes taken from brain tissue from destruction by free radicals. It seems to play a role in the regulatory evidence that control dopamine and serotonin levels.

The clinical evidence for curcumin as a treatment for diabetic neuropathy, unfortunately, does not yet exist. Panjab University in India did find that curcumin reduces insulin resistance in lab rats and increases sensitivity to pain (when the rats' paws were placed on a hot plate), but the study involved giving the rats insulin injections equivalent to 500 to 1,500 U a day in a human, half a vial to a vial and a half a day, vastly more than even the most insulin-resistant type 1 diabetic takes. And there's no way to know if these results with lab rats would translate even for the most insulin-resistant type 2 diabetics, who happen to take large amounts of insulin.

Moreover, while curcumin circulates in the body easily once it is absorbed from the digestive tract, it is very difficult for the body to absorb curcumin from the digestive tract. Curcumin bound to a phytosome is absorbed about twice as well as other forms of the supplement, but it's a little early to be recommending curcumin as more than optional treatment for type 2 diabetics. It won't hurt, but it's far from guaranteed to help for most diabetics.

Type 2 diabetics whose underlying problem is a condition called hemochromatosis (high iron levels), however, are a lot more likely to be helped by taking curcumin. Just don't use curcumin as your sole method of treatment for the disease. Work with a physician who has experience with the disease to create a comprehensive treatment plan.

Selected References:

Messner DJ, Sivam G, Kowdley KV. Curcumin reduces the toxic effects of iron loading in rat liver epithelial cells. Liver Int. 2009 Jan;29(1):63-72. Epub 2008 May 19.

Sharma S, Kulkarni SK, Agrewala JN, Chopra K. Curcumin attenuates thermal hyperalgesia in a diabetic mouse model of neuropathic pain. Eur J Pharmacol. 2006;536:256–61.

Sharma S, Chopra K, Kulkarni SK. Effect of insulin and its combination with resveratrol or curcumin in attenuation of diabetic neuropathic pain: Participation of nitric oxide and TNF-alpha. Phytother Res. 2007;21:278–83.

 

http://www.savvynaturalhealer.com/2012/09/curcumin-for-diabetic-neuropathy.html

HOMOEOPATHIC REMEDIES FOR SLEEP PROBLEMS IN CHILDREN

Sleep is essential to a child’s’ health. Learning how to sleep soundly is a normal part of development. It is typical for children to wake during the night. However, returning to sleep may be difficult at times for children. Children who get little sleep are more likely to have behavioral problems, be prone to general moodiness, and have difficulties living up to their potential. Having a child that is not getting restful sleep or enough sleep can put significant stress on the family. Fortunately, many of the common sleep problems that children have are easily remedied after they are identified.

Sleep problems occur when your child has difficulty settling down to sleep. It can also include small episodes of sleep or sleep interruptions. The constant night interruption can lead to baby irritation and parental fatigue. When your baby has trouble sleeping, it can be a hard time for the entire family. You can make bedtime less problematic and more enjoyable by learning some healthy sleeping tips.

Your doctor may advise you of the average number of hours of sleep your child needs. Still, every child’s sleeping patterns are different. On average, newborns up to 6 months of age sleep 16 hours a day. Some babies sleep as little as 11 hours and some others sleep as much as 20 hours. Older babies (6 months to 1 year) sleep about 14 hours a day. Toddlers sleep between 10 to 13 hours. Pre-schoolers sleep between 10 to 12 hours.

TYPES OF SLEEPING PROBLEMS

Difficulty settling down to sleep

It is very common for babies, toddlers, and young children to have trouble falling asleep. Up to 1 in 3 children show an unwillingness to go to sleep.

Separation issues and co-sleeping

In many families, parents choose to sleep in the same bed as their babies and small children. The Canadian Paediatric Society does not recommend co-sleeping. Some parents say co-sleeping can help in maintaining regular breastfeedings. But it may disrupt the parents’ sleep, cause tension in the parents’ intimate relationship, or cause your baby to become dependent on you to fall asleep. There is also an association between co-bedding and crib death (Sudden Infant Death Syndrome).

Night awakening

Night awakenings occur when a child wakes up in the middle of the night and cannot settle back to sleep. Often the child will cry or call out for their parents, or get out of bed. This is common. Many parents allow the child to sleep in the parents’ bed for the rest of the night. This may lead to dependency on the parent to resume sleep. The child should be reassured and brought back to his bed. The child eventually learns self-soothing strategies.

Nightmares

Nightmares are dreams that bring about fear or anxiety. Nightmares are very common. They occur in as many as 1 in 2 children.

 Nightmares are different from nightmares. Night terrors are characterized by the child appearing to waken in horror. The child often screams in panic. Usually, the child does not remember what led to the feelings of fear.

Sleepwalking

Sleepwalking occurs in about 15 percent of all children. It occurs most often in children between the ages of 4 to 12 years. Sleepwalking children usually walk around the house aimlessly. They appear uncoordinated, often do not make sense, or start urinating in some place other than the toilet. A bell hung on the child’s door or on the front door may provide reassurance that you will hear your child sleep-walking.

Healthy sleeping habits

Newborns and young children seem to fall asleep easily when they are held or rocked. Newborns fall asleep very easily when sucking on a nipple or pacifier.

Develop a consistent nap and bed time routine

Children respond well to routine. Your child will likely respond well to a fixed nap and bedtime routine. Naps for toddlers should be no longer than 2 hours and should end before 4 p.m.

Your child’s bedtime will depend on his age and energy levels. Bedtime routines can include:

·         giving a bath

·         putting on pajamas

·         offering a breastfeed or bottle

·         dimming the lights

·         nighttime cuddling, stroking, singing,

·         storytime

Afterward you can put the baby in the crib or the young child in bed. You can kiss the child goodnight and leave the room. Maintaining a consistent bedtime routine will help your child settle down more easily.

Create a welcoming sleeping environment

Keep the room dark and quiet. Nightlights are not recommended. Instead, keep the light on in the hallway with the door ajar. This will allow the child to go to the bathroom without fear of the dark and will allow you to use a closed door as a motivation to get the child back in bed should they begin to use delay tactics to go to bed at night.

Your baby should sleep on her back, toward the bottom of the crib. When they are old enough to roll from front to back there is no need to reposition them. There should be no blankets or crib bumpers or other soft materials that may block a baby’s breathing. They should wear a sleeper that is warm enough to make a blanket unnecessary.

When your child becomes aware of separation at bedtime, you may give him a stuffed animal or blanket to offer a sense of comfort. Do not give such items during early infancy as these may be risk factors for crib death.

Your baby should learn to fall asleep by himself. If he were to wake up and find you gone, the whole process of soothing to sleep may be required several times per night.

React to infant crying when appropriate

Respond to the cries of newborns and babies in their first few months of life. The crying is a way to express a need.

As for 7 or 8 month year old babies, it is entirely normal if they cry prior to falling asleep.

It’s alright to let your baby cry a little before settling down by. If, however, your baby has grown accustomed to having you around when falling asleep, you can try to reduce this dependency by gradually lessening your time in the bedroom. One approach is to lay your child down, leave for a few minutes, return and stay until the child sleeps. Every evening, stay out of the room for a little longer. After about 5 to 7 days your baby will learn to sleep alone.

Recognize your child’s delaying tactics

Once your child understands the bedtime routine, he can manipulate the situation. Toddlers and young children are particularly skillful at prolonging the bedtime routine. They will ask for water, another story, or a cuddle. Parents and caregivers should return the child to bed immediately. Warn the child there will be consequences if the behaviour is repeated. Consequences can include closing the door, or not offering stories at the next bedtime.

Tips for Improving Your Child's Sleep

• Establish a regular time for bed each night and do not vary from it. Similarly, the waking time should not differ from weekday to weekend by more than one to one and a half hours.
• Create a relaxing bedtime  routine, such as giving your child a warm bath or reading a story.
• Do not give children any food or drinks with caffeine  less than six hours before bedtime .
• Make sure the temperature in the bedroom is comfortable and that the bedroom is dark.
• Make sure the noise level in the house is low.
• Avoid giving children large meals close to bedtime .
• Make after-dinner playtime a relaxing time as too much activity close to bedtime can keep children awake.
• There should be no television, computer, mobile phone, radio, or music playing while the child is going to sleep. TV and video games should be turned off at least one hour prior to bedtime.
• Infants and children should be put to bed when they appear tired but still awake (rather than falling asleep in their parent's arms, or in another room). Parents should avoid getting into bed with a child in order to get them to sleep.

HOMOEOPATHIC REMEDIES

BELLADONNA 30- –Half opened eyes, restless sleep with sudden starts; moaning and screaming during sleep. Grinding, stertorous sleep. Somnolence, sleepy yet cannot sleep. Sleeps with hands under the head.

BENZOICUM ACIDUM 30-  —Starts up. Awakes with breathlessness and palpitation.

BARYTA CARB 30-- –Talks in sleep Twitching. Lies on one side.

CALCAREA CARB 30- —-Screams and cannot be pacified. Nightmares Fearful &fantastic dreams. Snoring.

ARG MET 30 —Restless sleep, anxious frightful dreams, Screams.

CAUSTICUM 30- —-Restless sleep. Starts laughs and cries. Drowsy can hardly keep wakes up. No sensation of passing urine; scarcely believes until he makes sure of sense of touch.

CINA 30-—–Restless during sleep. Lies on abdomen, knee -chest. Talks, cries, screams; wakes frightful. Hangs his head to one side .will not sleep unless rocked.

EQUISETUM  30—Dreams of seeing crowds of people.

FERRUM MET 30— Sleepy: of debility. Restless lies on back. Vivid unpleasant, fell into water.

KALI BROM 30 —Somnambulism starts. Deep sleep, Moans, cries, Grinding. Horrible dreams.

KALI PHOS  30—Night terrors. Somnambulism. Amorous dreams. Restlessness. Wakes up with fright.

KEREOSTEM  30-—Dreams of falling poisoned. Fire, of urination in a descent manner. Wakes with urinating from deep sleep but cannot retain. Restless, Tosses. Would not sleep until caressed &foundled.

LAC CANINUM 30 —She dreams of urination

MERCURIUS  30-—Sleepless of anxiety Restlessness, dreams of water ; thieves, animals .

NATRUM MUR 30 —Somnambulism starts and takes in sleep Dreams of robbers, vivid, frightful, Tosses

PHOSPHORUS  30-—Somnambulism. Dreams of fire lewd, vivid; business she couldn’t finish. Starts in sleep. Lies on right side.

PULSATILA NIG. 30—Lies with hands over head or crossed on abdomen and feet drawn up. Talks, screams. Restless. Tosses. Dreams confused, frightful.

RHUS TOX 30- —Dreams of exertion, fire : blood. Restless; tossing.

SEPIA  30-—Talks loud. Wakes up. Restless. Dreams of urinating anxious.

SILICEA 30- —Somnambulism. Talks loudly, laughs. Dreams of Lascivious; pleasant, murders, restless, wakes up frightened.

SULPHUR 200- —Sleeps in catnaps, talks, jerks and twiches in sleep; wakes up singing vivid dreams

THUJA OCC. 30- —Dreams of death of falling from a height.

TUBERCULINUM 200-—–Dreams of vivid, frightful, restless, Tosses, screams. Awakes in horror.

ZINCUM METALLICUM 30-—Screams, jerks, starts, Somnambulism.