Neuropathic pain is what you would feel if your nerves were lacking in blood supply. There are a myriad of nutrients required for every cell in the body to carry out its functions and these important particles are transported by the blood to all body cells. Oxygen is one of these vital molecules, an essential player in the production of the energy required to perform all the reactions that cells carry out. If a cell is deprived of its blood supply, and therefore its oxygen, for too long, that cell will be irreversibly damaged and die. This is true of all body cells, including nerve cells. Neuropathic pain is a nerve cell’s cry for more oxygen. And it is not a gentle reminder. Neuropathic pain has been described as excruciating and agonizing and is impossible to ignore. (1)
Neuropathy is the name given to the results of damage, dysfunction or death of one or more peripheral nerves. Symptoms vary depending on the type of nerves affected. Our central nervous system includes the brain and spinal cord while the peripheral nervous system is the web of nerves found outside the central nervous system. These two neural networks are in constant communication with each other. It is the peripheral nervous system that is affected in neuropathy. (2,3)
The peripheral nervous system includes (2,3) …
1 … sensory nerves that originate from the senses of sight, hearing, smell, taste and touch. If sensory nerves are suffering from neuropathy, symptoms such as severe, sharp, lightning-like pain; burning pain; throbbing pain; or stabbing pain may occur, along with sensitivity to touch and numbness and/or tingling in the hands and feet.
2 … motor nerves that relay messages from the brain to tell the muscles how and when to contract to produce movement. If motor nerves are suffering from neuropathy, symptoms such as muscle weakness or paralysis; lack of coordination; and frequent falls may occur.
3 … autonomic nerves that are responsible for bodily functions outside of our direct control such as breathing; digesting; heart rate and blood pressure; body temperature; bladder and bowel control; and sexual arousal. If autonomic nerves are suffering from neuropathy, symptoms such as heat intolerance; excessive sweating; changes in blood pressure; erectile dysfunction; and problems with digestion, bowel function and bladder control may occur.
Neuropathy is not a disease but a symptom that can be caused by a variety of conditions. The leading cause of neuropathy is diabetes. In diabetes, high glucose levels in the blood cause damage to blood vessels and nerves with the result that 60% to 70% of diabetics experience some degree of neuropathy. Other causes of neuropathy include physical injuries; autoimmune disorders; infections; blood disorders; alcoholism; medications; chemotherapy; and toxic substances such as heavy metals (including mercury and lead) and industrial chemicals. (2,3)
The severe pain of neuropathy can be very difficult to treat. Regular pain medications are of little to no use. To ease the pain stemming from damaged nerves, medications must be able to adjust pain signaling pathways within the nervous system. However, even if such medications have a positive effect, they rarely provide complete pain relief and they don’t touch the actual cause of the nerve pain. Depending on its root cause, neuropathy is sometimes reversible. However, if the source of the condition does not respond to treatment, it is likely that the neuropathy will not be remedied either and will remain constant or escalate over time. (2,3)
Fortunately, research on the neuropathy resulting from diabetes over the last three decades has revealed the effects of the foods we choose to eat on the health of our nerves. The first science published on this topic appeared in 1994. It included 21 diabetics who had been suffering from painful neuropathy for up to 10 years. For this study, participants were placed on a whole food, plant-based diet and told to walk for 30 minutes every day. Surprisingly, 17 out of the 21 patients experienced complete relief of the pain within a few days. The remaining participants reported partial symptomatic relief. In addition, all patients lost weight, their blood sugar levels dropped and their insulin needs were greatly reduced, with some able to stop taking insulin completely. Their triglyceride and cholesterol levels improved and their high blood pressure began to come down. In fact, there was an 80% drop in the need for high blood pressure medication within the first three weeks of the study. The researchers observed that the neuropathy lessened long before the blood sugar levels of the patients fell significantly. They speculated that enhancement of the flow of blood in blood vessels resulting from the plant-sourced diet was the reason for such significant improvements in these patients. (4,1)
Since this first article came out, research on this topic has continued and the results of the 1994 report have been replicated many times.
A 2002 clinical report indicated that a low-fat whole-food vegan diet along with daily walking led to rapid remission of neuropathic pain in type-2 diabetics. Authors of the report pointed to the ability of a vegan diet to decrease the viscosity (thickness) of both whole blood and plasma, allowing it to more easily enter the tiny blood vessels in the feet and hands and deliver the oxygen needed by cells in those areas. They also noted the considerable existing evidence available illustrating that a lack of oxygen being distributed to tiny arteries far from the heart due to impaired circulation is a crucial factor in the development of neuropathy. (1)
A 2020 review characterized a whole-food plant-based diet as an alternative treatment strategy for neuropathy that is often overlooked. Plant-based diets can alleviate pain while significantly improving blood sugar control, overweight and blood lipid levels. Potential mechanisms of action include better blood flow and optimized intake of important nutrients which may contribute to improved blood transport to the tiny blood vessels of body areas at the end of the line such as in the feet and toes. (5)
In 2012, a review asserted that present treatments for neuropathy are not disease-modifying. In other words, though control of blood sugar levels and pain management can ease the burden of the illness, these treatments do not affect its actual cause and, in fact, neuropathy usually continues to worsen over time. Conversely, there is growing evidence of an association between metabolic syndrome and neuropathy. (6)
The Mayo Clinic describes metabolic syndrome as “a cluster of conditions that occur together, increasing the risk of heart disease, stroke and type-2 diabetes.” The conditions that constitute metabolic syndrome are increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels. Having just one of these problems does not mean that you have metabolic syndrome. But if you develop more of these disorders, your risk of progressing toward more serious disease is greatly increased. (6)
The authors of the 2012 review revealed that patients with metabolic syndrome have a higher prevalence of neuropathy than those without it. Initially, it was thought that the link was due to impaired blood sugar control. But more study has shown that neuropathy is also independently associated with other components of metabolic syndrome such as obesity; high BMI (Body Mass Index); hypertension (high blood pressure); abnormalities in lipids such as HDL (high-density lipoprotein), LDL (low density lipoprotein), and triglycerides; and smoking. (6)
These researchers stated that it may be more accurate to describe the varying pathways towards the development of neuropathy as a network that causes a self-perpetuating cycle of inflammation, oxidative stress and disruption of the normal function of cells. They postulated that, even in the absence of overt diabetes, other aspects of metabolic syndrome can be sufficient to cause neuropathy. The next challenge will be to discover how improving characteristics of metabolic syndrome might lead to effectively preventing neuropathy or limiting its progression. (6)
Recently, in 2021, another review updated the benefits of a whole-food, plant-based diet for neuropathy. Such a diet improves the ability of endothelial cells to produce nitric oxide, a natural chemical that promotes better blood flow through blood vessels. Plant-sourced foods also lower the viscosity of the blood. In addition, eating plants reduces the presence of persistent organic pollutants (POPs) since the exposure of humans to POPs is through the consumption of fat from animal-derived foods such as fish, dairy products and meat. The accumulation of POPs in body tissues has been shown to be a major factor in the development of Type-2 diabetes. All these factors lower the risk of neuropathy in diabetic patients and, in those already suffering from diabetic neuropathy, transitioning to a plant-based diet can result in significant improvement of neuropathic pain. Furthermore, the researchers reaffirmed that a plant-based diet has only beneficial side effects such as the prevention of common comorbidities like dyslipidemia, coronary artery disease, rheumatoid arthritis, fibromyalgia and inflammatory bowel syndrome. In addition, a plant-based diet is very cost effective. (7)
The research on food as it relates to neuropathy is overwhelmingly focused on diabetic neuropathy. Whether or not the benefits of a healthy diet that are being seen in diabetics with neuropathy will also translate to neuropathies stemming from other causes remains to be seen. In the meantime, there are no adverse effects of eating a whole-food plant-based diet and, with neuropathy being so difficult to treat, a decision to consume a trial diet consisting of all plant-sourced foods for a few months certainly makes sense. A vegetarian dietary pattern composed overwhelmingly of plants (with the consumption of meat, poultry or fish kept to less than once a month) has also been linked to lower incidence of metabolic syndrome, a condition that is now known to be associated with higher risk of neuropathy (8).
If you’re experiencing symptoms of neuropathy, consider this.
There is a positive choice available to you that may make all the difference in your enjoyment of life.
Taking one simple step can relieve neuropathy by …
…increasing blood flow in small blood vessels through increasing the production of nitric oxide within the blood vessels and lowering the thickness of the blood
… lessening the risk of metabolic syndrome
… reducing the amount of harmful POPs in the diet.
Eat plant-sourced foods (vegetables, fruits, legumes, whole grains, nuts, seeds).
Do not eat animal-sourced foods (meat, poultry, seafood, dairy).
1 McCarty, M.F. Favorable impact of a vegan diet with exercise on hemorheology: implications for control of diabetic neuropathy. Med Hypotheses. 2002 Jun;58(6):476-86. Doi: 10.1054/mehy.2001.1456. PMID: 12323113.
4 Crane, MG., Sample, C. Regression of Diabetic Neuropathy with Total Vegetarian (Vegan) Diet. Journal of Nutritional Medicine; 4(4); 1994.
5 Storz, M.A., Küster, O. Plant-based diets and diabetic neuropathy: A systematic review. Lifestyle Med. 2020; 1:e6. https://doi.org/10.1002/lim2.6.
6 Callaghan, B.C., Cheng, H.T., Stables, C.L., Smith, A.L., Feldman, E.L. Diabetic neuropathy: clinical manifestations and current treatments. Lancet Neurol. 2012 Jun;11(6):521-34. Doi: 10.1016/S1474-4422(12)70065-0. Epub 2012 May 16. PMID: 22608666; PMCID: PMC4254767.
7 Rose, S. and Strombom A. Preventing and Treating Diabetic Peripheral Neuropathy with a Plant-Based Diet. Journal of Neurology and Neurosurgery. March 2021. 15(1). Doi: 10.19080/OAJNN2020.15.555901
8 Rizzo, N.S., Sabaté, J., Jaceldo-Siegl, K., Fraser, G.E. Vegetarian dietary patterns are associated with a lower risk of metabolic syndrome: the Adventist health study 2. Diabetes Care. 2011 May;34(5):1225-7. Doi: 10.2337/dc10-1221. Epub 2011 Mar 16. PMID: 21411506; PMCID: PMC3114510.