If you suffer from peripheral neuropathy, your first line of defense should be diet and lifestyle. (1) Good nutrition can help to slow nerve damage and even reverse nerve pain.
Peripheral neuropathy is a painful and disruptive condition that many with diabetes experience. Symptoms tend to start small, with numbness or tingling in the extremities, however this discomfort increases over time if no steps are taken to fight it. Eventually, the pain from peripheral neuropathy can be so severe that normal activities, like walking or putting on gloves, can become unbearable.
Fortunately, with the correct diet, you can calm nerves and help relieve nerve pain. There are foods that have been shown to help alleviate neuropathic pain and help to heal nerves, avoiding future complications.
Neuropathy is not an inevitable consequence of diabetes. If you want to stop this disease in its tracks and begin to feel relief, you must take steps to optimize your nutrition.
The pain and other symptoms of peripheral neuropathy are due to damage to neurons, which are the cells that make up your nervous system. By improving the health of your nervous system and providing your body with the nutrients that it needs to regenerate nerves, you can protect yourself from further pain.
The regeneration of nerves has been tied to improved quality of life and reduced symptoms for those with neuropathy. (1,2) There are numerous foods that have been found to encourage the growth of new neurons.
Leafy greens, such as spinach, kale, dandelion greens, cilantro, and parsley, are packed full of phytonutrients that are known to boost human health. Two of these nutrients that have been shown to help neuropathy are folate and magnesium.
Folate, also known as folic acid, is another name for vitamin B9. Folate is commonly found in plant foods, and is important for cell growth.
Metformin is a prescription drug often used to treat those with type 2 diabetes. (3) With long-term use, it helps to lower blood sugar levels. While metformin is effective at lowering blood sugar levels, it does not do so without side effects.
One of the side effects is a reduction in serum levels of folic acid and cobalamin, with an increase in Hcy. This alteration of serum makeup has been implicated in the pathogenesis of peripheral neuropathy, suggesting that metformin may lead to this complication.
In order to counteract these effects and protect your peripheral neurons, it may be helpful to increase your intake of folic acid to counteract these effects. (4) In an animal study it was found that folic acid supplementation resulted in higher expression of nerve growth factor (NGF) in rats with a condition similar to diabetic peripheral neuropathy. This research suggests that folic acid may play a protective role for nerve health and function in those with diabetes.
Spinach is one of the foods richest in folate, leading to benefits in nerve regeneration and a possible role in protecting against the pathogenesis of diabetic neuropathy.
Human studies on those with type 2 diabetes have found that lower blood levels of magnesium are associated with dampened peripheral nerve function. (6) Other studies have found that supplementing with magnesium may help to improve blood glucose levels, blood pressure, and cholesterol levels in those with type 2 diabetes. (7)
Studies suggest that higher magnesium levels are tied to improved functioning of the peripheral nerves, helping to reduce the likelihood of peripheral diabetic neuropathy progression.
As spinach is second only to almonds as a dietary source of magnesium, adding spinach to your daily diet can help to protect peripheral nerve function. (8)
When it comes to quality sources of dietary magnesium, only almonds have higher quantities than spinach. (8) In one ounce of dry roasted almonds, you can acquire 20% of the recommended daily allotment of magnesium.
Cashews and peanuts are two other sources high in magnesium. As outlined above, type 2 diabetes patients who have higher blood levels of magnesium tend to have better peripheral nerve function, as well as other parameters associated with diabetes and diabetic neuropathy progression, such as blood glucose levels. (6,7)
By consuming more magnesium-rich foods, you may be able to protect the health and function of your peripheral nerves.
Three other healthful foods that are high in magnesium are black beans, edamame, and kidney beans. Thanks to rich levels of this mineral, these foods may help to protect against damage to peripheral nerves.
Broccoli is a cruciferous vegetable that is rich in a wide array of nutrients, including chromium, an essential element that has been found to protect nerves from damage and improve insulin sensitivity.
Chromium deficiency has been tied to impaired glucose tolerance and nerve dysfunction. Animal studies suggest that chromium supplementation can help in managing glucose levels in diabetes, which may also help to protect nerve function. (9)
In one case study, a 40 year old female who suddenly developed neuropathy was found to have a chromium deficiency. Supplementing with chromium reversed this neuropathy and the associated symptoms. (10)
While chromium deficiency is rare, adding in broccoli, the richest dietary source of chromium, may help those who are unknowingly deficient in this trace mineral. (11)
There are some foods that are known to help with the pain caused by peripheral neuropathy, calming nerves and thereby helping those with neuropathy find relief.
Flax seeds, chia seed, and walnuts are three of the richest plant sources of omega-3 fatty acids. The type of omega-3 fatty acid that they are rich in is ALA, or alpha-lipoic acid. It is this fatty acid in particular that has been shown in studies to help those suffering from neuropathy.
ALA, which is an antioxidant with potential for lowering blood glucose levels, has been shown in studies to offer an additional benefit of reducing diabetic neuropathic pain. (12)
In a human study on peripheral neuropathy, 600 mg of ALA supplemented for 90 days was found to decrease neuropathy symptoms in some, and fully resolve them in others. Pain, pressure, and sensation were improved.
It is easy to obtain 600 mg/day ALA with dietary sources only. You can get far more than 600 mg/day through 1 tablespoon of either flaxseed oil, chia seeds, walnuts or flaxseeds.
Wild-caught, cold-water fish, such as salmon, trout, tuna, and sardines, are rich sources of omega-3 fatty acids and vitamin B12. Research suggests that these two nutrients may help to encourage nerve growth, protect nerves from damage, and reduce the feelings of pain associated with neuropathy.
While nuts and seeds are high in the omega-3 fatty acid APA, coldwater fish are high in EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). Research examining the effect of fish oil and these fatty acids on neuropathy are limited, but this limited research suggests that these fatty acids may help to encourage nerve growth and act as neuroprotectants. (14)
Earlier in this article, we discussed how the diabetes medication metformin has been shown to lead to deficiencies in folate. The same study showed that those who take metformin also often suffer from a vitamin B12 deficiency. (3) These changes in serum makeup are thought to be the reason why it often leads to diabetic neuropathy in patients.
Vitamin B12 is critical for proper neurological function, with deficient levels implicated in nerve damage. (15) Some studies have found that supplementation with vitamin B12 may help to relieve the pain caused by neuropathy.
Seafood and fish are the primary sources of vitamin B12 in the human diet. It is primarily coldwater fish that are the highest in vitamin B12. In order to increase your intake of this vitamin and omega-3 fatty acids, it is recommended to consume 2-3 servings of coldwater fish each week.
Two of your best options for both are wild-caught salmon and trout. Other contenders are sardines, anchovies, and herring.
Turmeric is a spice most well-known for its role in the Indian dish curry, where it is the primary spice. Its health benefits have been touted for thousands of years in an ancient form of holistic medicine in India known as Ayurveda.
Research has found that the primary compound in turmeric that provides its powerful health benefits is curcumin. Studies have found that curcumin may be beneficial for those with diabetes and diabetic neuropathy.
The health benefits of curcumin are largely thanks to its anti-inflammatory and antioxidant capacity. (16) It has demonstrated benefits in lowering blood glucose levels and protecting against diabetic neuropathy. Animal studies found reduced pain behavior and increased pain threshold in those treated with curcumin.
Additionally, it is important not to eat foods that exacerbate your underlying diabetes. Elevated blood sugar levels are implicated in the pathogenesis of diabetic neuropathy, meaning that elevated blood sugar levels are likely to lead to disease progression and increased pain.There are numerous foods that have been implicated in the progression of diabetes and diabetic neuropathy. These foods are often to thank for oxidative damage and inflammation that contribute to nerve pain.
With these things in mind, you should avoid the following foods: (17)
Refined carbs are those that have had the healthful portions of the grains removed. Examples include white flour and white rice. Common foods that include refined carbs are white bread, bagels, baked goods, pancakes, crackers, and more.
Not only do these foods lack fiber and nutrients, but they are known to cause a spike in blood glucose levels. This glucose is involved in damaging nerves and thus the progression of diabetic neuropathy.
Another common example of foods that have had any beneficial nutrients removed are white sugar and high fructose corn syrup. Unfortunately, nearly every fast food item and the vast majority of processed and packaged food at the supermarket include these ingredients.
Common examples of some of the worst offenders are sodas, candy, ice cream, baked goods, and fast food. These foods cause the biggest spike in blood sugar of any food out there, so it is important to avoid these as much as possible.
Fats are a complicated and often confusing category of food for those with diabetes and other health concerns. There are some fats that are good for your health, some that are bad, and some that are alright in moderation.
Generally, you want to stay away from saturated fats, which are those that tend to be solid at room temperature, and trans fats. Examples of foods high in saturated fats include lard, cream, butter, processed meats, and red meats. Those high in trans fats include margarine, shortening, and fast food.
Click here for a complete guide on “good” and “bad” fats.
When consumed in moderation, alcohol may not cause much damage when it comes to neuropathy, but when consumed in excess, alcohol can cause damage to nerves. In fact, there is such thing as alcoholic neuropathy, where excess alcohol consumption causes nerve damage similar to that of diabetic neuropathy.
Additionally, alcoholism is associated with difficulties absorbing important nutrients whose deficiencies have been found to correlate with diabetic neuropathy. These include folate and vitamin B12.
When it comes to what type of diet to follow, a low-fat, vegetarian diet appears to have benefits for those with diabetic neuropathy. (17,18) This type of diet is associated with improvements in blood glucose levels, blood pressure, and blood lipid concentration, all three factors which are thought to play a role in the pathogenesis of both diabetes and diabetic neuropathy.
Even if you are unable to fully make the switch to a low-fat, vegetarian diet, you can use this diet as a kind of template for best practices. By cutting down on meat and dairy, particularly high-fat meat and dairy, and increasing your consumption of nutrient-rich plant foods, you can improve your health and your symptoms of diabetic neuropathy.
Additionally, you may want to work with a doctor if you suspect that you may have trouble digesting gluten. Celiac disease and neuropathy are related. It has been found that 2.5% of those with neuropathy have celiac disease, in comparison to only 1% of the normal population. (19) Because of this, you want to be sure that you do not have an underlying allergy to gluten that could be making your symptoms worse.
1. Lifestyle intervention for pre-diabetic neuropathyhttps://www.ncbi.nlm.nih.gov/pubmed/16732011/
2. Diabetic neuropathy and nerve regenerationhttps://www.ncbi.nlm.nih.gov/pubmed/12757748
3. Study of vitamin B12 deficiency and peripheral neuropathy in metformin-treated early type 2 diabetes mellitushttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5040042/
4. Neuroprotective effects of folic acid on experimental diabetic peripheral neuropathyhttps://www.ncbi.nlm.nih.gov/pubmed/24311627
5. Folate fact sheet for health professionalshttps://ods.od.nih.gov/factsheets/Folate-HealthProfessional/
6. Low serum magnesium levels are associated with impaired peripheral nerve function in type 2 diabeteshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013481/
7. Oral magnesium supplementation in type II diabetic patientshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219896/
8. Magnesium fact sheet for health professionalshttps://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
9. Chromium supplementation improves glucose tolerance in diabetic Goto-Kakizaki ratshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869864/
10. Chromium deficiency, glucose intolerance, and neuropathy reversed by chromium supplementation, in a patient receiving long-term total parenteral nutritionhttps://docs.google.com/document/d/1z2PnnxV3IOd-hrbp6u5x9M7PWNHsMjjhgkWSf7qUDec/edit
11. Chromium dietary supplement fact sheethttps://ods.od.nih.gov/factsheets/Chromium-HealthProfessional/
12. The efficacy of alpha-lipoic acid in the management of peripheral neuropathy in type 2 diabetic patientshttps://www.researchgate.net/publication/286366587_The_efficacy_of_a-lipoic_acid_Neurolipon-MIP_600_in_the_management_of_peripheral_neuropathy_in_type_2_diabetic_patients
13. Omega-3 fatty acids fact sheet for health professionalshttps://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/
14. Is fish oil a potential treatment for diabetic peripheral neuropathyhttps://www.ncbi.nlm.nih.gov/pubmed/28530530
15. B vitamins relieve neuropathic pain behaviors induced by infraorbital nerve constriction in ratshttps://www.ncbi.nlm.nih.gov/pubmed/22940269
16. An overview of curcumin in neurological disordershttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2929771/
17. A plant-based diet for the prevention and treatment of type 2 diabeteshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466941/
18. A dietary intervention for chronic diabetic neuropathy pain: a randomized controlled pilot studyhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4450462/
19. Neuropathy associated with gluten sensitivityhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077388/