Peripheral Neuropathy Nutrition
Good nutrition is often the first line of defense to avoid many diseases, including peripheral neuropathy. The best way to prevent peripheral neuropathy is to carefully manage any medical condition that puts you at risk. That means controlling your blood sugar level if you have diabetes or talking to your doctor about safe and effective treatments if you think you may have a problem with alcohol. Whether or not you have a medical condition, eat a healthy diet rich in fruits, vegetables, whole grains and lean protein. Keep a food diary so you are aware of what you’re eating and to make sure you get all the nutrients you need each day to stay as healthy as possible.
Disclaimer: Please check with your doctor before beginning any diet or supplement regimens.
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If you have a nerve disorder, a diet rich in certain nutrients can help. The food you eat can improve your nervous system’s functioning. Knowing which nutrients nourish your nervous system can help you lead a healthier life and reduce your chances of nerve-related problems.
- Establish your diet around vegetables, fruits, whole grains, legumes, omega-3 rich foods and lean protein sources
- Aim for 5-10 servings of colorful fruits and/or vegetables daily (phytonutrients). 1 serving = 1/2 cup for all other fruits and vegetables
- 1 medium fruit or vegetable, example apple, orange
- 1/4 cup dried fruit
- 3/4 cup juice
- Limit/avoid alcohol
- Toxic effect on nerve tissue
- Be aware of sodium; use <2,300 mg per day
- Lower saturated fats and trans fatty acids by choosing lean meats and poultry, and low-fat or non-fat dairy products
- Choose monounsaturated fats and polyunsaturated fats (from fish, nuts, and vegetable oils) in lieu of saturated and trans fats
- Choose/prepare foods and beverages with little added sugars/caloric sweeteners
Low‐level, chronic inflammation lies so far below the skin’s surface that you can’t see it or feel it. It’s the result of an immune system in overdrive, damaging healthy tissue and leading to chronic illnesses. Follow these tips to help keep inflammation as low as possible:
Increase Omega–3 fatty acids:
- Use 1–2 Tbs. of flaxseed daily (grind the seeds for best effects)
- Eat 3–4 oz. of fatty fish at least 2 times per week. (e.g., wild salmon, halibut, mackerel, tuna)
- 3 oz. walnuts a day
Fiber and Antioxidants:
- Increase anti‐oxidants from fruits and vegetables (at least 5 daily)
- Eat foods that are more slowly absorbed into the blood stream (fruits, vegetables, nuts and beans)
Elevated blood sugar levels contribute to many chronic health conditions, including diabetic peripheral neuropathy. To help you maintain the best blood sugar level and manage your diabetes –
Know Your Carbohydrates!
Bread, cereal, pasta; starchy vegetables, like corn, peas, potatoes; dried beans, lentils, rice; fruits and fruit juices; milk, yogurt and other dairy foods; sweets, like cookies, candy, regular soda, sugar, syrup
High fiber/whole grains, fruits, beans/lentils, low-fat dairy
Count your carbohydrates, label reading for serving size AND total carbohydrate
Plate method (1/2 plate veg, ¼ starch, ¼ lean protein)
Spread out carbohydrate servings (3 small meals, 2-3 small snacks)
Often the medications and treatments that are used to fight chronic or life-threatening conditions, have a tendency for healthy cells to be affected, too, which may cause side effects. Some side effects may result to eating problems.
Nausea: 6-8 small meals, bland foods
Lack of appetite: Eat every few hours, fluids between meals
Unwanted weight loss: Add healthy fats (olive oil, nuts/seeds, avocado, olive)
Constipation: Increase fiber/fluids, regular meal times
Diarrhea: Limit milk products, small/bland/low-fat meals – easily digestible
Contributing factors to PN include vitamin deficiencies, traumautic injuries, diabetes, alcoholism, and others. Treatment may include managing underlying causes, physical therapy, medications and dietary changes. For best results seek guidance from your doctor.
Gluten: If you have a gluten allergy, celiac disease, consuming gluten can trigger and worsen your symptoms. Common sources include all food containing white, wheat, cake or baking flour. Look for products labeled ‘gluten free’.
Refined grains are highly glycemic meaning they have a dramatic impact on your blood sugar. Being able to control your blood sugar is the number one strategy to prevent neuropathy associated with diabetes. To improve the glyceminc impact of your diet, replace refined grains with whole grains.
Added sugars add flavor but few nutrients. Nutritional deficiencies can lead to neuropathy symptoms. Choose nutritious foods like fruits, vegetables and whole grains.
Saturated fat, prevalent in fatty meats and dairy products, can cause inflammation and an increased risk for type 2 diabetes. For enhanced wellness, replace fatty protein sources with lean alternatives and eat moderate amounts of healthy fat sources.
To help you keep track of your food and water intake, plus your activity levels, we have created a food and activity log for you. Download a printable copy of a weekly food diary.
A shopping guide may help you plan your meals and make good selections at the grocery store. Plan ahead and buy only what’s on your list to avoid impulse buying. Download a printable copy of a shopping list.
SUPPLEMENTS FOR PERIPHERAL NEUROPATHY
Below is a list of supplements for your nervous system.
Disclaimer: Dietary supplementation should NOT be initiated without the supervision of a qualified physician. Check with your doctor before you begin. Several of these supplements may have adverse effects.
- Has been studied for treatment of diabetic neuropathy
- Anti-inflammatory effects, reduces oxidative stress
- Several studies show improvement in neuropathy symptoms with long term use
- According to one study taking 600 mg orally each day provides optimal risk-to-benefit ratio
- Shown in clinical trials to be effective for diabetic neuropathy
- In studies of chronic peripheral neuropathy patients treated with 500-1,000 mg 3 times daily showed improvements in pain and improved sensation in fingers and toes
- Studies of other types of neuropathy have shown mixed results
- Studies have identified vitamin D deficiency as a risk factor for diabetic neuropathy
- Several trials showed improved pain levels in patients with diabetic neuropathy, with one study using an oral dose of 50,000 IU of vitamin D3 weekly
- Benefit of supplementation is less clear for patients with neuropathy and normal vitamin D levels
- Studies have shown diabetic patients are more vulnerable to vitamin B1 deficiency
- Vitamin B1 deficiency can cause peripheral neuropathy
- Taking vitamin B1 600 mg/day can help improve pain in patients with diabetic neuropathy
- Vitamin B12 deficiency can cause neuropathy
- Vitamin B12 deficiency is not uncommon in the USA, particular in older individuals when absorption declines
- In one study of patients with diabetic neuropathy and normal B12 levels, taking vitamin B12 500 mg 3 times daily helped improve symptoms of neuropathy after 4 months
- Vitamin B6 toxicity and vitamin B6 deficiency can cause peripheral neuropathy
- Eating a balanced diet including foods high in B6 (salmon, poultry, chickpeas, dark leafy greens, bananas, cantaloupe) helps prevent vitamin B6 deficiency in most individuals
- Powerful antioxidant that reduces levels of free radicals and oxidative stress
- Studies showed a beneficial effect on the incidence and symptoms related to chemotherapy-induced peripheral neuropathy for patients taking vitamin E 300-600 mg/day
OMEGA-3 FATTY ACIDS (FISH OIL)
- High quantities in cold-water fish (salmon) and widely consumed for anti‐inflammatory powers
- Essential fatty acids and important component of cell membranes, myelin sheath that protects nerves
- Studies are underway (estimated completion date 2025-2026) to determine whether fish oil supplements can be effective in treating diabetic peripheral neuropathy
Chen, Jie, et al. “Vitamin E for the Prevention of Chemotherapy-Induced Peripheral Neuropathy: A Meta-Analysis.” Frontiers in Pharmacology, vol. 12, 2021, https://www.frontiersin.org/articles/10.3389/fphar.2021.684550.
Didangelos, Triantafyllos, et al. “Vitamin B12 Supplementation in Diabetic Neuropathy: A 1-Year, Randomized, Double-Blind, Placebo-Controlled Trial.” Nutrients, vol. 13, no. 2, Jan. 2021, p. 395, https://doi.org/10.3390/nu13020395.
Rowin, Julie. “Integrative Neuromuscular Medicine: Neuropathy and Neuropathic Pain: Consider the alternatives.” Muscle & Nerve, vol. 60, no. 2, 2019, pp. 124–36, https://doi.org/10.1002/mus.26510.
Yorek, Mark A. Effects of Fish Oil ± Salsalate on the Omega-3 Index and the Circulating Lipodome of Omega-3 Polyunsaturated Fatty Acid Metabolites in Patients With Type 2 Diabetes and Diabetic Neuropathy. Clinical trial registration, NCT05169060, clinicaltrials.gov, 6 Jan. 2023, https://clinicaltrials.gov/ct2/show/NCT05169060.
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Established in 2007, FPN is a 501(c)(3) nonprofit organization dedicated to improving quality of life for PN patients, their caregivers and healthcare professionals. The Foundation serves as a leading resource for advancing collaborative and innovative therapeutic developments and accelerating the ability to diagnose, treat, prevent and cure peripheral neuropathy.
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