Key takeaways
Neuropathy has many linked factors, and more than one can be present at once.
Commonly linked factors include blood sugar, nutrient levels such as B12, some medications, injury or nerve compression, thyroid concerns, alcohol and autoimmune conditions.
Laboratory testing and functional lab testing look at these contributing factors.
A naturopathic assessment brings the results together into a personalized, supportive plan.
When people ask why numbness or tingling is happening, the honest answer is usually "it depends." This post explains the factors that are commonly linked to nerve changes and how a naturopathic assessment looks at them.
Ready to talk it through? Book a naturopathic assessment at Nature Doctors or call 204-943-6079.
Why are so many factors linked to neuropathy?
Neuropathy is a description of what is happening in the nerves, not a single disease. NINDS lists diabetes, injury, infections, chemotherapy, autoimmune conditions, nutritional deficiencies, alcohol and toxin exposure and inherited conditions among the factors, and notes that in some people no clear cause is found. That is why a good question is rarely about the feet or hands alone, and why a whole-person look is useful.
How does blood sugar relate to nerves?
The NIDDK explains that diabetic neuropathy is nerve damage caused by diabetes, and that high blood glucose and high fat levels over time can progressively affect nerves. Mayo Clinic notes that diabetes and metabolic syndrome are among the most common reasons. Laboratory testing such as fasting glucose and HbA1c, which reflects average blood sugar over about three months, is how this part of the picture is looked at.
What about B12 and other nutrients?
The NIH Office of Dietary Supplements notes that low vitamin B12 can cause neurological changes, including numbness and tingling in the hands and feet, even without anaemia, and that symptoms may take years to appear because the body stores B12. Groups at higher risk include older adults, people with gastrointestinal disorders, people who have had stomach surgery and people who follow vegan or vegetarian diets.
B12 status is looked at through laboratory testing, and Mayo Clinic lists B vitamin shortfalls in general as a contributor. Absorption depends on digestion, which is where the clinic's interest in digestive health fits in.
What other factors are linked to neuropathy?
Chemotherapy and some medications. NINDS and Mayo Clinic both list chemotherapy as a possible contributor.
Injury and nerve compression. Past injuries, repetitive strain and pressure on a nerve can disrupt signals.
Thyroid concerns. Thyroid function is commonly checked as part of a thorough look at metabolic factors.
Alcohol. Heavy long-term alcohol use is linked to nerve changes and to lower nutrient levels.
Autoimmune conditions. Mayo Clinic lists conditions such as rheumatoid arthritis and lupus.
Infections and toxin exposure. NINDS lists shingles, Lyme disease and exposure to certain toxins.
How do laboratory testing and a naturopathic assessment look at these factors?
A naturopathic assessment looks at your history, symptoms, food, medications and lifestyle, and then may use laboratory testing and functional lab testing to fill in gaps. The Nature Doctors testing page describes metabolic and nutritional testing, gut testing, hormone testing and environmental testing, and recommends beginning with an initial consultation so tests are chosen for a reason.
Markers that may be discussed include glucose and HbA1c, vitamin B12 and other nutrient levels, thyroid function and inflammation. Results are reviewed together at a follow-up visit so you hear what they mean in plain terms.
What should I bring to a first visit?
A note on when symptoms started and what changes them
A simple written list of what you take, including anything prescribed
Any recent laboratory results you already have
Notes on food, alcohol and sleep over a typical week
What does the research say about nutrients and nerves?
The NIH Office of Dietary Supplements reports that vitamin B12 is needed for healthy nerve function, and that neurological changes linked to low B12 can occur even without anaemia. NINDS adds that lifestyle changes like quitting smoking, avoiding toxins (like alcohol and drugs), exercising, eating healthfully and maintaining a healthy weight can all support healthier nerves. These are general, everyday habits that your naturopathic doctor can help you plan around.
What else does the clinic offer?
Nature Doctors offers a range of services that your naturopathic doctor reviews with you in a personalized plan, including nutritional guidance, laboratory testing, acupuncture with Juyin Lu, R.Ac, massage therapy with Jennifer Weidemann, RMT and counselling with Jocelyn MacLeod, CCC. Virtual naturopathic appointments are available across Manitoba.
If you notice sudden weakness, numbness that spreads rapidly or loss of bladder or bowel control, call 911 or go to the nearest emergency department right away.
Frequently asked questions
Can low B12 be linked to tingling in the feet?
It can be. Laboratory testing shows B12 status.
Does high blood sugar always lead to neuropathy?
No, but it is a well-known linked factor.
What is HbA1c?
A laboratory test that reflects average blood sugar over roughly the past three months.
Can more than one factor be present?
Yes, and sorting this out is the point of a thorough assessment.
Can I have testing arranged if I live outside Winnipeg?
Nature Doctors offers virtual appointments across Manitoba. The testing page does not describe how tests are arranged at a distance, so ask the clinic at 204-943-6079.
Ready to look at the whole picture?
Start with a naturopathic assessment at Nature Doctors. Book online with Nature Doctors, call 204-943-6079, or visit us at 7-1200 Waverley Street, Winnipeg.
Sources
NINDS, Peripheral neuropathy: https://www.ninds.nih.gov/health-information/disorders/peripheral-neuropathy
Mayo Clinic, Peripheral neuropathy: https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061
NIDDK, Diabetic neuropathies: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies
NIH Office of Dietary Supplements, Vitamin B12: https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/
Nature Doctors, Functional lab testing: https://www.thenaturedoctors.ca/testing