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Peripheral Neuropathy Caused by Chemotherapy

Chemotherapy drugs spread through the whole body, and certain types can damage different nerves. Symptoms tend to start farthest away from the head, and in most cases, people will notice chemo-induced peripheral neuropathy (CIPN) symptoms in the feet, then later in the hands; symptoms will then travel upward (or inward) to the ankles and the legs, or move up from the fingers to the hands and arms. CIPN sufferers tend to also report extreme fatigue and depression as the mitochondria (the tiny factories in each of our cells that turn the food we eat and the oxygen we breathe into energy) throughout the body and neurons in the brain die.

Certain chemotherapy drugs are more often linked to CIPN. These include:

  • platinum drugs like cisplatin, carboplatin, and oxaliplatin
  • taxanes including paclitaxel, docetaxel, and cabazitaxel
  • epothilones, such as ixabepilone
  • plant alkaloids, such as vinblastine, vincristine, vinorelbine, and etopside
  • thalidomide, lenalidomide, and pomalidomide
  • bortezomib and carfilzomib
  • eribulin

There are numerous additional factors including your age, the numbers of additional prescription drugs you are taking, other cancer treatments like surgery or radiation, infections in the nerves, an underlying history of autoimmunity, diabetes, poor circulation, and so on, that can contribute to or cause these symptoms.

The American Society of Clinical Oncology issued new guidelines on the prevention and management of CIPN on April 14, 2014. Unfortunately, although the group was convened to discuss this particularly important adverse side effect, the expert consensus was that no approach exists that can be recommended for prevention. In other words, peripheral neuropathy is recognized as a potentially serious, long lasting, and even permanent disability, affecting everyday activities of daily living from buttoning your shirt to driving your car to pressure sensitivity from even light touch and so on. The side effect is seen as a serious but unavoidable compromise, yet alternative measures are not discussed.

Interestingly, the American Society of Clinical Oncology did make one strong recommendation against the use of one supplement, acetyl-L-carnitine, in its new guidelines for managing CIPN. A phase 3 study showed that patients (taking oral chemotherapy) who took that supplement actually fared worse than patients in the placebo group. They did not, however, discuss a 2008 investigation into the use of alpha-lipoic acid (ALA) as a neuroprotective agent. Preliminary studies indicate that ALA rescues the mitochondrial toxicity and induces the expression of frataxin, an essential mitochondrial protein with anti-oxidant properties. These findings suggest that halting oxidative stress might reduce the risk of developing peripheral nerve toxicity in patients undergoing chemotherapy and encourage further confirmatory clinical trials.

It is important for patients to be aware that they should let their physicians know as soon as they start to experience numbness, tingling, or pain. At the very least, there may be other cancer treatment options; at most, methods for reversing mitochondrial decay. Stress, sedentary lifestyles, free-radical damage, and exposure to infections, allergens, and toxins all cause our energy-generation network to falter.

Find out what you need to know about your thyroid hormone or health disorder diagnosis today, and get health news updates via Facebook, Twitter, Linkedin and The Wellness Essentials newsletter.

If you’d like to leave a question for me to answer in a future blog, you can do that via social media or email.

For more information about my clinic in Oradell, NJ, including Functional Medicine, Neurology & Nutrition, and The Grassroots Medicine Initiative, please call (201) 261-5430.

Brain Decline: Why Isn’t My Brain Working?

The worldwide prevalence of dementia has been estimated at 24 million, and this figure is predicted to double every 20 years at least until 2040 as the baby boom generation matures. Antidepressants are now the second most commonly prescribed medication in the country, suggesting that caring for the brain is as important as caring for the heart. More common than Alzheimer’s, which affects fewer than one in eight people over the age of 65, anxiety disorders, learning disabilities, and depression are more prevalent today than ever before. Moreover, the symptoms of poor brain health such as sleep disorders, brain fog, moodiness, poor concentration, and falling over for no reason have become commonplace.

We all experience a certain amount of ongoing brain decline as a natural result of living life. “Aging” is the commonly used term for this; not surprisingly, growing older is the number one risk factor for brain decline. That said, we all have known the octogenarian who is sharp as a tack. Equally, we have known someone, a relative perhaps, who develops dementia way before his or her “time.” Alongside the dietary and lifestyle triggers that create poor brain function, previous head injuries, subtle brain autoimmunity, poor circulation, and various other factors unrelated to diet can also cause the brain to fail and degenerate quickly.

We know that genetic and environmental factors play an important role in brain aging and brain function. Several risk factors are the same regardless of age and include:

  • altered methylation
  • hepatic detoxification
  • gastrointestinal permeability
  • poor cerebral circulation
  • dysglycemia
  • environmental pollutant exposure
  • essential fatty acid imbalances
  • impaired neurotransmitter synaptic activity
  • prior medication use

So why aren’t doctors taking better care of their patients’ brains? Because brain care is not part of the common health care paradigm in either a conventional or alternative model. While we have long investigated a theory of the mind, we have also confused the two. The brain is not the mind, and only recently have we begun thinking of the brain as an organ like the heart that should be exercised, fed, and properly used. In both branches, health care seems to be a “neck down” practice even though the brain can be incredibly fragile and the most susceptible organ to the health imbalances caused by poor diet, environmental exposure, and chronic stress.

For example, a man with chronic joint pain and workplace stress may find that ongoing inflammation and reduced dopamine levels are causing short temper, poor motivation, and feelings of worthlessness. Likewise, a woman with hormonal imbalances may find her estrogen drops too low before her periods, causing serotonin dysregulation and, consequently, irritability and depression. In other words, the brain is literally crying out for help. For the majority of people, brain nutrition, stress (in the form of cortisol), and blood sugar imbalances must be addressed first. To age gracefully, even to age well at all, you must learn to take care of your brain as you would any other part of your body.

Find out what you need to know about your thyroid hormone or health disorder diagnosis today, and get health news updates via Facebook, Twitter, Linkedin and The Wellness Essentials newsletter.

If you’d like to leave a question for me to answer in a future blog, you can do that via social media or email.

For more information about my clinic in Oradell, NJ, including Functional Medicine, Neurology & Nutrition, and The Grassroots Medicine Initiative, please call (201) 261-5430.

Statins, Neuropathic Pain and Cholesterol

As far back as 1992 a scholarly look into the actual research on statin drug use and heart disease, which had previously claimed that lowering cholesterol would prevent heart disease, determined instead that this claim was wrong. It found that lowering serum cholesterol concentrations does not reduce mortality and is unlikely to prevent chronic heart disease at all. Then in 2012 the FDA began requiring statin manufacturers to add “memory loss” as a side effect of this chemical class of drugs. Now, a study in the Journal of Diabetes reveals a clear association between statin drug use and nerve damage, or peripheral nerve pain.

The central nervous system is the brain and the spinal cord. It branches out to all “peripheral” parts of the body such as the arms, hands, and fingertips…likewise, to the legs, feet, and toes. It is this system that provides all the sensory input from the fingertips and toes back to the brain. It is also the communication pathway throughout the body that allows for movement. What this means is that if you are experiencing pain, numbness or burning in the hands or feet, you have a short circuit between the central and peripheral nervous systems and a lack of sensory input to the brain. To preserve itself, the brain will begin to shut down the communication pathways to the peripheral systems, causing them to atrophy, sting, and hurt as the nerve roots demyelinate.

Peripheral neuropathy is the term for demyelination, which disrupts the body’s ability to enervate muscles, joints, and internal organs. The four cardinal patterns of peripheral neuropathy are polyneuropathy, mononeuropathy, mononeuritis multiplex, and autonomic neuropathy. The most common condition, symmetrical peripheral neuropathy, mainly affects the sensory fibers of the feet and legs, and results in stabbing, sharp electric pain, burning, cramping, numbness, extreme prickling, or an inability to determine joint position. For many neuropathies, the sensation begins in the feet and creeps up the legs toward the center of the body as the condition worsens.

In fact, people who have Type II Diabetes have the same risk of heart attack and dying from heart disease as people who already have had heart attacks. Diabetes is a common cause for sensory neuropathy, though many cases are identified as “idiopathic”, since no direct causal relationship can be found. This ignores the known side effects of cholesterol lowering medications as much as it ignores what we know about the human body and how it operates. Guess what? Cholesterol makes up the largest portion of the myelin nerve sheath (the nerve strand, so to speak) and once you start removing it from the veins and arteries in an effort to lower total serum cholesterol in the bloodstream, the nerve strand begins to irritate. The raw nerve ends cause the pain symptoms until the nerve shrinks and atrophy (or nerve death) sets in. When left untreated, atrophy can result in amputation of a limb.

It turns out that cholesterol is not just a number on a lab test. It’s a reflection of antioxidant levels and inflammatory processes happening within vasculature and nervous systems. Even then, few people need to worry about cholesterol so much as they need worry about actual peripheral nerve pain. Blood cholesterol levels between 200 and 240 mg/dl are normal. These levels have always been normal. In older women, serum cholesterol levels greatly above these numbers have been shown to be associated with longevity. Since 1984, however, in the United States and other parts of the western world, these normal numbers have been treated as if they were an indication of a disease in progress or a potential for disease in the future.

Find out what you need to know about your thyroid hormone or health disorder diagnosis today, and get health news updates via Facebook, Twitter, Linkedin and The Wellness Essentials newsletter.

If you’d like to leave a question for me to answer in a future blog, you can do that via social media or email.

For more information about my clinic in Oradell, NJ, including Functional Medicine, Neurology & Nutrition, and The Grassroots Medicine Initiative, please call (201) 261-5430.

A Case of Nerves

Neuropathy is painful and scary. It affects 10-20 million people in the US, especially those with Type 2 diabetes who have a 50 per cent chance of developing this condition. Medical treatment for neuropathy is limited and can include prescriptions for anti-depressants, anti-seizure medications, and pain suppressants like oxycodone and other dangerous drugs. These medications may mask the problem for a while, but often they can cause side effects and lead to even worse issues.

A good example of this is Lola B, a young woman who was experiencing neuropathy, evidenced by tingling and numbness down her entire right side that was progressing into her foot. She also had neck pain and auras in her left eye that dominated her peripheral vision all day, every day. These ocular disturbances are migraines. She scheduled to see a neurologist in order to get to the bottom of her pain, and ended up being placed on mood-altering drugs instead.

Her neurologist ruled out any pathological cause for the migraines such as tumor, blood clot or stroke, and she was diagnosed with idiopathic intracranial hypertension (IIH). She was prescribed medications that effectively alleviated the auras and masked the pain, but in less than a month, these symptoms returned. Not only that, these strong medicines caused unwanted side effects such as depression, feelings of worthlessness and unwelcome thoughts. So her neurologist would proceed to take her off one medication, put her on another, and wait-and-see the result.

There is no one-size-fits-all solution to pain or any other health issues; obviously, every case is unique and each requires a tailored approach. Neurological pain can be reduced or even eliminated through in-office treatments, dietary changes and nutritional supplements. In Lola’s case she was young, still in school needed a better solution – one that would allow her to function normally, and she was hoping for one that was more holistic.

Lola’s auras disappeared once we balanced her hormones and stabilized her blood sugar. In other words, by supporting her blood sugar and hormonal spikes, we could control the migraines. Next, she needed visualization techniques that would allow her to alleviate her anxiety. In the past, she would experience this as inward trembling, which could also be attributed to blood sugar and thyroid issues. These treatments were coupled with neurological exercises that she could do at home to improve the neuropathy. She also began a nutritional regimen to reduce inflammation and pain.

Find out what you need to know about your thyroid hormone or health disorder diagnosis today, and get health news updates via Facebook, Twitter, Linkedin and The Wellness Essentials newsletter.

If you’d like to leave a question for me to answer in a future blog, you can do that via social media or email.

For more information about my clinic in Oradell, NJ, including Functional Medicine, Neurology & Nutrition, and The Grassroots Medicine Initiative, please call (201) 261-5430.