Another Cause of Nerve Damage
Nerve Damage from Chemotherapy
Chemotherapy Induced Peripheral Neuropathy (CIPN)
What is CIPN?
How to get relief
Cancer treatment drugs are called chemotherapy. Chemotherapy drugs are toxic chemicals (poisons) that attack fast growing cells (rapidly dividing cells). The theory behind using these toxins is that it will destroy the fast growing cancer cells before it does too much damage to normal cells.
Hair is a quickly dividing, fast growing cell and this is the reason that hair loss is a common side effect of chemotherapy.
Bone marrow produces fast growing cells. Normally, when blood cells wear out in the body, they are replaced by new ones from the bone marrow. When the chemotherapy drugs damage these fast growing cells, it can cause a low blood count, which can result in other side effects such as fatigue, headaches, and chills. It is sometimes even necessary to do a blood transfusion.
Nerve damage from chemotherapy drugs
Chemotherapy is hardest on the nervous system due to the fact that nerve cells are more sensitive than other cells.
The nervous system transmits information between the central nervous system (brain and spinal cord) and the rest of the body. It is designed to transmit feeling such as touch and temperature. It delivers messages from sight; it delivers messages to the muscles to get them to move.
Because nerve cells are more sensitive to these toxins then other cells, they are often affected and can be damaged easily. This may also be the reason for cognitive problems following chemotherapy, also known as "chemo fog" or "chemo-brain".
After exposure to the chemotherapy drugs, the cells that responsible for producing myelin, the fatty substance that helps insulate and protect nerve conducting fibers, can become damaged.
Nervous system changes in chemotherapy patients can develop months or years after treatment. The onset of these symptoms is variable. Some drugs may cause symptoms during or immediately after the first dose, and some have a delayed onset of symptoms, up to several weeks, months, or even years after the last dose.
The severity of these symptoms is related to the amount of chemotherapy drug given. The higher or more frequent the dose of the drug the greater the chance that it will damage the coverings of the nerve and cause nerve damage (neuropathy).
Additionally, someone with pre-existing neuropathy (no matter what the cause) may be at risk for more severe and long lasting neuropathy.
Symptoms of Post Chemotherapy Neuropathy
Chemo (chemotherapy drugs) travels through the whole body, thus can damage different nerves. Symptoms tend to start farthest away from the head, but move in closer over time.
Chemotherapy drugs often strip the coverings from the nerves, damaging the nerves, particularly those of the hands, feet, arms and legs.
Loss of feeling in the hands and feet can make it hard to pick up small objects and cause clumsiness and difficulty walking. Some people with nerve damage first notice a "pins and needles" feeling, not unlike when an arm or leg "falls asleep". Foot nerve damage after chemo is very common which results in stabbing pain and numbness.
As motor nerves are the most sensitive to toxins, this nerve damage may make you feel clumsy and cause difficulty in daily activities such as opening jars, fastening buttons, or even squeezing toothpaste tubes. Loss of balance and coordination is also due to this damage.
Per the American Cancer Society, "Chemo-induced peripheral neuropathy (CIPN) is caused by the chemotherapy drugs used in cancer treatment." (Neuropathy is also sometimes called paraesthesia or even myalgia.)
"The symptoms or signs of CIPN depend mostly on which nerves are involved. The most common symptoms are:
tingling (or a "pins and needles" feeling)
trouble with tripping and stumbling while walking
loss of feeling (numbness)
decreased or no reflexes
increased sensitivity to temperature (usually cold) or pressure, so that things hurt more than usual
trouble passing urine
blood pressure changes
"CIPN often affects both sides of the body the same way; for example, the toes of both feet. It can cause severe pain and can affect your ability to do everyday things like walk, write, button your shirt, or pick up a coin. If it gets very bad it can cause very serious problems like changes in your heart rate, trouble breathing, paralysis, or organ failure"
This is the reason that medical doctors have to keep close watch over their patients when receiving chemotherapy.
Are these long-term side effects of chemotherapy?
When a person develops neuropathy due to chemotherapy, the oncologist will prescribe drugs to cover up the symptoms and the patient will get a pamphlet entitled “Living with Neuropathy”. There is hope that it will get better after the chemo is finished. However, quite often, the damaged cell will continue to deteriorate and the symptoms will get worse. The only way to correctly manage this chronic neuropathy is to address the real causes, not the symptoms.
Is CIPN permanent?
Can this be Reversed?
There are many different treatments for Neuropathy. Making sure that anything might be contributing to the neuropathy needs to be addressed.
CIPN Treatments - most have to do with pain management
Pros: There are several drug treatments for neuropathy. There are medications such as Lyrica and Cymbalta that are given cover up or block the pain. Lyrica, is an anti-seizure medication. It is used for neuropathy as it stops the nerves from talking to each other so you don't feel the pain. Cymbalta is an anti-depressant which is used because it lowers a person's awareness and thus their awareness of the pain. One drug occasionally used is Prednisone and also Elavil.
Cons: You have to continue to take the drugs to get relief.
Prednisone depletes the body of vital nutrients and there is a problem withdrawing from it (see Prednisone)
Amitriptyline (Elavil) it lowers the awareness of the nerve damage but as with all medications, they have side effects that don't enhance your health.
Additionally, Cymbalta as an anti-depressant can very often be difficult to get off without side effects. For info on Cymbalta & Neuropathy
Long term these drugs can cause more damage due to side effects and deficiencies it can create.
If you are taking any mediation that has a side effect of neuropathy, you should talk to your doctor to see if there is an alternative medication.
Pros: This is a drug and like all drugs has side-effects. Medical marijuana is talked about a lot recently with legalization. Up into the 70s, a medical doctor's "okay to prescribe drugs license" listed marijuana. This went out of favor but is now back. Benefits are decreased awareness of pain, relief of pain. As in any drug prescribed for neuropathy, marijuana covers up the symptoms of neuropathy.
There is increased tolerance to the effects of marijuana, meaning that more marijuana is needed to get the same effect.
A big problem with marijuana is that it strips the body of Glutathione, the body's master anti-oxidant that is found in every cell of the body. Thus, marijuana creates nutritional deficiencies. This is the reason for the 60s image of a "druggie" who looks emancipated and out of touch with reality.
Recent studies said that 17% of uses found it was addictive and hard to stop without side effects. Side effects included Anxiety/nervousness; Reduced appetite; Irritability/restlessness; Sleep difficulties including strange dreams. Studies said that users are 4X as likely to develop depression and manic-depression (bipolar) symptoms.
Some of the problems with evaluating this drug are the inconsistent dosing and quality-control issues.
Pros: Combines a footbath with an electrical current. Claims to open up nerve channels and stimulate circulation to the affected area. It claims to stimulate the nearby calf muscles to contract and relax, enhancing the local blood flow to bring fresh nutrients to the nerves and help remove accumulated toxins. No information on how it would address neuropathy in other areas of the body. It also states that it will rebuild nerves, but not how. See Rebuilder
Cons: Cost. The cheapest model is $550. They now recommend going to a doctor to have them use the Rebuilder on you. Inconclusive if this works for everyone or why electric current will "rebuild" nerves except for increasing circulation There are many anti-oxidants which will also increase circulation.. It also states it sends electric current up the foot through the sciatic nerve and down again so it apparently addresses foot neuropathy only.
Pros: The ancient Chinese practice of acupuncture has been known to help with the symptoms of neuropathy. There is apparently an ability to improve circulation with this method that would give similar relief. There is also acupressure which works on the same principles as acupuncture. For more information go to Acupuncture
Cons: Acupuncture sometimes does not help with neuropathy. You also have to continue to get treatments.
Alpha lipoic acid:
Pros: This is as an anti-oxidant which will help protect the nerves so no further damage is done to the body. It can help with the symptoms. In order to help it needs to be taken with Acetyl l-carnitine. There is evidence that they work together well in helping the body use nutrients to repair the nerves, but the vital B vitamins need to be taken with it.
Pros: They will cover up the symptoms of neuropathy similar to drugs and can make you temporarily feel better; you must continue to take them. The body doesn't use them to build healthy nerves.
Cons: There are problems with herbs. They can interact with any other medications that you are taking. They can have side effects. Herbs are similar to drugs in so far as (in therapeutic dosages as found in the herbs that you can buy) they make the body do what it wouldn't normally do. While you can use herbs in your salad and in tea without problems, when you take herbs in a supplement, they are extracts which are far stronger dosages. Herbs should be taken separately as if there is a problem, you can isolate what herb is causing the problem. The combination of herbs found in some supplements prohibits you from doing that.
Remember, herbs are not vitamins. They are natural substances, but they aren't the vitamins, minerals, essential fatty acids & amino acids that the body needs to function, create energy and to repair itself.
Herbs can make your neuropathy feel better, but aren't used by the body to repair the nerves. Thus, you need to keep taking them to continue the relief. There are some herbs which shouldn't be taken more than a few months like Feverfew or Ashwagandha.
When taking any herbs, check with your pharmacist. Pharmacies have databases where they can check for interactions and side effects.
Pros: Infrared light to increase circulation and stimulate production of nitric acid. It is supposed to relax the arteries and eliminate free radicals. Pads are put over the injured areas. Pain is supposed to be relieved with increased circulation and more nitric oxide in the blood. Can treat common injuries.
Cons: Relieves the symptoms but needs to be continued for relief.
Homeopathic Formula: Homeopathy can give temporary neuropathic pain relief without side effects or interactions with drugs. What is homeopathy
Cons: They relieve the symptoms but don't address the cause of the problem, the damaged nerves.
Topical creams: There are many different creams available that will bring relief from neuropathy pain. They can be applied as needed. Capsaicin is a common ingredient. It is used to relieve pain for arthritis, muscle pain, joint pain, as well as nerve pain. It can address the inflammation.
Cons: They relieve the symptoms but you must continue to use it for relief. Doesn't work for everyone.
Cold Laser Treatment or Low Level Laser Therapy: It will give relief from pain. It is non-thermal and won't burn the surrounding area. It is trying to increase cellular activity. The laser delivers electric pulses to the target area which delivers a jolt that matches the pulse at which the body perceives pain. It claims to create a reduction in pain by causing the production of natural pain killer endorphins.
Cons: Again doesn't address the actual cause of the pain, so is relief only.
Various blends of B vitamins and other supplements:
Addressing different "nerve support" vitamins that are brought out from time to time including those supposedly formulated by a medical doctor. There are lots of different ideas about relieving the symptoms of neuropathy. There are many formulations. A lot of them are putting different vitamins together and even do include B1 in the form of benfotiamine and B12 as methyl B12. They even will give mega doses to try and help the nerves. Some have small amounts of B1 & B12 - which are the most important B vitamins for nerve health.
B1 & B12 are important for nerve health. Check that the amount in the formula is not low. One formula even had B12 listed as 1 mg. Not sure what they think that would do for your nerves.
The body needs specific B vitamins working together to build nerves. For instance, folic acid is needed to activate the B12. B6, B9 (folic acid) and B2 are needed for B1 to be absorbed. Some of these blends include both B vitamins and alpha lipoic acid when one needs to be taken with food and the other on an empty stomach. It is valuable to understand why each ingredient was put in the formula and whether it will help or just cover up symptoms, is missing ingredients or are good to take together.
Some brands will tell you that their formula is better because they are in liquid form. Liquid is NOT better. Liquid is variable. When you measure it out its variable and you don't get the exact formula each time you take it.
You want the same dosage every time you take it.
Tablet or capsule is very specific and is a superior delivery for building nerves.
If the problem is taking a pill, get capsules which can be emptied into food or drink.
Other treatments Listed above will not build healthy nerves. These other treatments are attempting to manage the nerve damage. You can cover up the symptoms and you can increase circulation and you can make a person feel less pain, etc., but you want to build healthy nerves.
We always recommend building health and nerves are no different.
Building Healthy Nerves:
Pros: Healthy sensory nerves mean that they are not painful. Healthy nerves means that they communicate and don't send wrong signals such as burning, hot and cold, tingling when there is no reason for it. Healthy motor nerves mean that they relay messages from the brain to the muscle so that they move correctly. Nerves need to be healthy to function properly.
The body needs specific nutrients (vitamins) to be able to build healthy nerves.
Cons: It occasionally doesn't give immediate relief, but it does address the actual problem and creates healthy nerves.
We have used our best judgment in compiling this information. The Food and Drug Administration may not have evaluated the information presented. Any reference to a specific product is for your information only and is not intended to diagnose, treat, cure, or prevent any disease