What Can Actually Happen To You If You Have Neuropathy

Today's post from neuropathytreatmentgroup.com (see link below) is actually an article attached to an advertisement for a neuropathy treatment and this blog does not support the treatment offered, nor any other form of advertising for so-called curative neuropathy products. Neuropathy is with you for life I'm afraid and all you can do is reduce the severity of the symptoms using chemical drugs or various alternative treatments and supplements. It can't be cured (at the moment), so please don't believe any website that tells you it can. HOWEVER, this article is packed with such useful and accurate information, I can only applaud the author and recommend the content to readers of this blog. It explains simply and clearly what can happen to you if you have neuropathy. Worth a read.

What No One Tells You About Neuropathy and Muscle Control
2016
 
Have you noticed your muscles acting a little strange since developing neuropathy? Perhaps they affect your ability to walk? Or maybe you find it difficult to use your fingers to pick something up? While we normally associated peripheral neuropathy with symptoms like pain, numbness and tingling – there are other symptoms as well.

The peripheral nervous system is made up of three different kinds of nerves: motor, sensory and autonomic. Each type of nerve controls different functions. Motor nerves send signals from the brain and spinal cord to your muscles – controlling motor functions like walking, dexterity and more. Sensory nerves do the opposite – relaying signals like temperature, pain, etc. from the muscles back to the brain and spinal cord. Finally, the autonomic nerves control involuntary or semi-voluntary functions like heart rate, digestion, blood pressure and more.

Peripheral neuropathy can affect some or all of these nerves. The symptoms you experience will depend entirely upon the type of nerve(s)that have been damaged as a result of your neuropathy. If your sensory nerves have been damaged you will experience symptoms such as pain, numbness, tingling or burning. Damage to the autonomic nerves can lead to problems with dizziness, sweating (either too much or too little), nausea, vomiting, diarrhea, constipation, difficulty urinating and more.

If your motor nerves fall victim to nerve damage – various motor functions can be affected. Lets take a look at five possible symptoms you might experience if your neuropathy has damaged your motor nerves:

Loss of balance and difficulty walking

Damage to the motor nerves can make walking difficulty. Your legs may feel heavy and difficult to move or you may feel constantly off balance. Since damage to the motor nerves disrupts the signals from your brain and spinal cord to the muscles – telling them what to do – even something as simple as walking can become a difficult task.

Damage to the sensory nerves can exacerbate this problem. The pain or numbness usually associated with damage to these nerves often affect the feet – making walking even more problematic.

For those suffering from symptoms related to motor nerve damage – extra caution should be used when walking on stairs or other areas where a fall risk is greater. Allowing extra time and avoiding rushing to perform tasks can also help limit your risk of falling.

Loss of Dexterity

Do you find it difficult to pick things up or use your hands to perform certain tasks? If so, that’s a sign your neuropathy has affected your motor nerves. Damage to the motor nerves can affect the ability of your brain to send signals properly to the muscles in your hands. You may notice somewhat delayed reactions in your hands or the muscles in your hands may feel weak – inhibiting your ability to perform even normal tasks like picking something up or moving your fingers.

Some common difficulties associated with loss of dexterity are inability to grip objects, loss of hand strength, difficulty writing or typing, difficulty performing tasks that require small movements, decreased reflexes and more. While you may not be able to restore complete control or strength to the hands – doing regular hand exercises can help you rebuild and maintain muscle strength and improve dexterity control.

Muscle Weakness; Deterioration

As damage to your motor nerves inhibits the ability of your brain and spinal cord to transmit messages to your muscles – you may find yourself limiting the use of your arms, legs, hands and feet. For many, this decrease in physical activity results in muscle deterioration and weakness. As the muscles deteriorate, you lose muscle mass and tone (this is often referred to as muscle atrophy).

Muscle weakness further contributes to the loss of dexterity, balance and difficulty walking previously mentioned. While exercise is often difficult and pain for those with neuropathy – there are low-impact exercises that will help you retain muscle mass and prevent muscle deterioration.

Try these 5 Low Impact Exercises for Neuropathy if you’re experiencing muscle weakness or deterioration!

Cramps; Spasms

The deterioration of muscle mass and the disruption of signals from the brain to the muscles can also lead to painful cramps, muscles spasms and twitches. For many, the cramping strikes at night and can range in severity from mild to extremely painful. In addition to cramping, many experience uncontrollable spasms or muscle twitching – which is visible just below the skin. While not as painful as cramps, they can be quite bothersome.

Loss of Muscle Control

As we’ve already touched on with the sections on loss of balance and dexterity – damage to the motor nerves affects your ability to control your muscles properly. The motor nerves carry messages from the brain and spinal cord to the muscles – telling them what actions to perform. As this line of communication is disrupted – the ability to control muscles is diminished. This is made manifest in loss of reflexes, inability to move hands or feet quickly, difficulty with fine motor tasks (i.e. buttoning a shirt, writing, etc) and more.

While the most common symptoms associated with peripheral neuropathy are pain, numbness, burning or tingling in the hands or feet – they are not the only symptoms. When the motor nerves fall victim to neuropathy the symptoms can go far beyond pain or numbness. They can affect your ability to control muscles and perform otherwise simple physical tasks. Though you may not be able to completely reverse these negative effects, alternative approaches like exercise can help you build and maintain muscle mass – thus helping to minimize the impact of motor nerve damage.

http://www.neuropathytreatmentgroup.com/what-no-one-tells-you-about-neuropathy-muscle-control/

Dont Worry If Your Pain Is Also Emotionally Based Its A Chicken And Egg Situation

Today's post from thelightmedia.com (see link below) doesn't seem to be directly related to neuropathy as such but if any group of pain patients understands the correlation between emotional states and their physical pain, it's nerve damage patients. They are also frequent victims of pain stigma; where outsiders accuse them of having a psychosomatic problem and in effect...faking it. You don't need telling that this makes the problem so much worse. However, if psychosomatic pain is pain that is 'created' and not 'real', then nerve pain is exactly that because nerve pain stems from faulty nerve cell signals moving to and from the brain cells. People living with neuropathy can also have other forms of pain that are nociceptive (stemming from injury and physical damage) and not neuropathic and this can cause all sorts of confusion, both for the patient and the concerned onlooker. This article takes a look at forms of pain that are influenced by and influence, emotions. If nothing else, it may help you sort out what you're feeling en help you better deal with it.

10 Types Of Pain That Are Directly Linked To Your Emotions
2017

“Psychosomatic means mind (psyche) and body (soma). A psychosomatic disorder is a disease which involves both mind and body. Some physical diseases are thought to be particularly prone to be made worse by mental factors such as stress and anxiety.”

(A quick note before we begin: it is extremely important that any severe physical symptoms must be attended to by a licensed medical professional, such as a physician.)

If there is a mental aspect to virtually every type of disease, isn’t it then rational to assume there is a mental aspect to virtually every type of physical pain? The simple truth is that mental states affect physical states and vice-versa.

Traditional medicine has labeled this the psychosomatic effect. Interestingly, the specialty of psychosomatic medicine is the latest sub-specialty in psychiatry to become board-certified. Board-certified physicians comprise the “best of the best” in 24 different medical specializations (e.g. neurology, dermatology, psychiatry, etc.) As important, these medical specialties are universally recognized by the medical and scientific communities as vital to public health.

Indeed, pain can be caused by emotional and mental states. In science, it has been demonstrated that both mental/emotional and physical pain activates the same areas of the brain: the anterior insula and the anterior cingulate cortex. So – a physiological connection between brain and body exists as well.

Here we are going to discuss 10 different types of pain that are directly linked to feelings, emotions and thoughts. Equipped with this knowledge, one can begin to make whatever adjustments necessary to feel better (we’ll also provide some recommendations).

Here are 10 types of pain caused by feelings/emotions/thoughts:

1. Back pain

Areas of the back and shoulders are arguably where we feel muscle tension the most. Chiropractors, osteopaths and other medical professionals have been explaining the stress/anxiety connection between back pain and mental/emotional health for years.

Making matters worse, this type of pain is cyclical. We begin to stress and worry about back pain, which tenses back the muscles; the muscles tense, and then we begin to feel things like frustration and anger.

2. Headaches and migraines

Dr. Christina Peterson, a board-certified physician, writes: “Stress comes in many varieties, including time stress, emotional stress, and the stress of physical fatigue…and (these) emotions pack a wallop for the migraine sufferer.” Furthermore, emotions like anger, anxiety, crying/sadness and depression trigger headache pains.

The good doctors recommend practicing relaxation techniques, meditation, and to seek the help of a counselor in the event that this pain doesn’t subside.

3. Neck pain

The buildup of emotions; more specifically, negative emotions, can affect virtually every area of the body. Neck pain, according to Calm Clinic, is one of the most common complaints of people suffering from anxiety-related disorders.

It’s nearly impossible to explain every one of the multitude of ways that anxiety can manifest. Financial problems/worries, relationship problems, sadness, fatigue, etc.

4. Shoulder pain

Many kinesiologists believe that our shoulders are the area of the body most prone to feeling the adverse effects from pressure. Ever wonder where the axiom “Carrying the weight of the world on your shoulders” comes from?

Us too. But it turns out there is a whole lot of truth to it.

5. Stomach aches and/or cramps

Our poor stomach is where we house most of our worries, fears, and anxieties. Experiencing these emotions repeatedly, without surprise, can cause stomach aches and pains. In fact, as it turns out, chronic stress can develop into stomach ulcers.

6. Elbow pain and/or stiffness

Dr. Alan Fogel, in a piece published by Psychology Today, writes, “All emotions have a motor component.” The elbow is no different. While medical conditions such as arthritis and others may be the reason for pain or stiffness; mental states such as anxiety and depression can also manifest in strange areas…including the elbows.

7. Pain in hands

Similar to the elbows, pain in the hands can arise from legitimate medical conditions. Some even say that hand pain may result from feelings of isolation or confinement. As Dr. Fogel said, every one of our emotions manifests into a physical symptom…so, anything is possible, right?

8. Hip pain

Aside from a documental medical condition, some type of emotional trigger is almost assuredly the cause of hip pain. The human body has more nerve connections in the hip than we would think; so distress can manifest into physical pain in this area as well.

9. Knee pain

The rationale given for knee pain experienced from emotions is pretty much the same as that given for hip pain. Of course, there are many nerve endings in the knee; hence, more of a brain/body connection. As such, it is perhaps more likely that emotional triggers such as anxiety, fear, depression, etc. will manifest into knee pain than other, less sensitive areas, such as the hip.

10. Foot pain

Here’s what one podiatrist says about the relationship between mental/emotional states and foot pain: “Stressed people present with a wide range of biomechanical issues. I am not trying to be a guru…but I am convinced there is an anecdotal connection between lower limb and foot presentation and their emotional status.”

Experts at Columbia University admit that “there’s some evidence that there are psychological conditions that may be associated with physical symptoms,” and that treating the real cause of the pain may be the answer.

Related article: This Simple Mind-Body Exercise Reduces Negative Thoughts and Improves Health

After investigating the physical pain or stress, it’s worthwhile to do the same with any emotional state(s). What are you feeling?

Relaxation techniques (e.g. progressive muscle relaxation), controlled breathing, meditation, guided imagery, and many other techniques and practices exist to help people who are experiencing both physical and/or emotional pain.

http://thelightmedia.com/posts/55199-10-types-of-pain-that-are-directly-linked-to-your-emotions

What happens if Neuropathy causes Erectile Disfunction

This subject has been covered once already on the blog but the fact is, that under the physical and mental stresses of having both HIV and neuropathy, the likelihood that men will be affected by ED is so much greater than normal. All the more reason to find out what exactly happens in that process and why it can go wrong. This article from the Official Foundation of the American Urological Association (see link below) gives an extensive description of how and why, although it doesn't talk at length about neuropathy, it is mentioned as a recognised cause. Given that we know that ED can be a problem, especially for sufferers of autonomic neuropathy, this article will provide lots of useful information.

Non-Surgical Management of Erectile Dysfunction (ED)

Erectile dysfunction (ED) is a medical term that describes the inability to achieve and or maintain an erect penis adequate for sexual function. This condition is one of the most common sexual problems for men and increases with age. It is estimated between 15 to 30 million American men suffer from ED, although not all men are equally distressed by the problem.

Most men have difficulty with erections from time to time, yet in some men, it is a regular and more severe problem. It can cause low self-esteem, performance anxiety, depression and stress. ED may affect the quality of a marriage or intimate relationships. However, there are many safe and effective ED treatments available.

What happens under normal conditions?

Achieving a normal erection is a complex process involving psychological impulses from the brain, adequate levels of the male sex hormone testosterone, a functioning nervous system, and adequate and healthy vascular tissue in the penis.

The simplest way to describe the process of erection is to think of a washing machine. The "on-off" switch (the brain) initiates the process; the wires in the washing machine (the nerves) carry the electrical signal to the pipes (the blood vessels); when an appropriate signal arrives a valve opens to allow water to flow in (the arteries carry blood into the penis); and the drain shuts (the penile veins close). Water flows in and fills the tank (the penis fills with blood and becomes erect) and the wash cycle begins (enjoys sexual activity). At the end of the wash cycle this process reverses; the switch goes to the off position (the brain terminates erection); the valve closes (the arteries markedly decrease blood inflow); and the drain opens draining the wash tank of water (the veins open, blood leaves the penis and erection subsides).

How do erections occur?

When a man is not sexually aroused, his penis is soft, limp or flaccid. During sexual arousal, nerve messages release chemicals that increase blood flow into the penis. The blood flows into two erection chambers made of spongy tissue (the corpus cavernosum) in the penis. The “smooth muscle” in the erection chambers relaxes, which allows blood to enter and remain in the chambers. The pressure of the blood in the chambers makes the penis firm, producing an erection. After a man has an orgasm, the blood flows out of the chambers and the erection subsides.

What are the risk factors for ED?

The most common risk factors for ED are:

• Age over 50

• Diabetes

• High blood pressure

• High cholesterol

• Smoking

• Cardiovascular disease


These conditions over a period, can lead to a degeneration of the penile blood vessels, leading to restriction of blood flow through the arteries and to erectile tissue damage, which allows leakage of blood through the veins during erection.

Abnormally low levels of circulating testosterone may cause ED, although low testosterone is found in a minority of men who develop ED. Low levels of sexual desire, lack of energy, mood disturbances, loss of muscle strength and depression can all be symptoms of low testosterone. A simple blood test can determine if the testosterone level is abnormally low. Low levels of testosterone can be replaced by using a number of different delivery systems (e.g., shots, skin patches, gels, sub-dermal implants).

The choices made in life can lead to degeneration of the erectile tissue and the development of ED. Smoking, drug or alcohol abuse, particularly over periods of time, will compromise the blood vessels of the penis. Lack of exercise and a sedentary lifestyle also contribute to the development of ED. Modifying these risk factors may contribute to overall health and in some individuals correct mild ED.

Patients undergoing surgery or radiation therapy for cancer of the prostate, bladder, colon or rectum are at high risk for the development of ED. Drugs used to treat these risk factors listed above may also lead to or worsen ED.

Another cause of ED is peripheral neuropathy in which the nerves leading to the penis fail to send coordinated signals to the penis. Peripheral neuropathy can be caused by diabetes, HIV infection, certain medications and other less common conditions.

What causes ED?

ED can result from medical, physical or psychological factors. ED may be caused by a combination of factors that could also include medicine, alcohol or drugs. The physical and medical causes of ED include three basic problems:

• Not enough blood flows into the penis. Many conditions can reduce blood flow into the penis, examples include heart disease, diabetes and smoking.

• The penis cannot store blood during an erection. A man with this problem, called venous leak or cavernosal dysfunction, cannot maintain an erection because blood does not remain trapped in the penis. This condition can occur to any man regardless of age.

• Nerve signals from the brain or spinal cord do not reach the penis. Certain diseases, injury or surgery in the pelvic area can damage nerves in the penis.

Sexual activity requires the mind and body to work together. Psychological, emotional or relationship problems can cause or worsen ED; and include but are not limited to:

• Depression

• Relationship conflicts

• Stress at home or work

• Anxiety about sexual performance

Many prescription and over-the-counter medications may have side effect often causing erection difficulties. Drugs such as marijuana, heroin, cocaine and alcohol can lead to sexual problems.

If your ED is due to a hormonal problem, such as low testosterone or diabetes, you may be referred to an endocrinologist. Your healthcare provider may also refer you to a mental health professional. These specialists treat psychological or emotional causes of ED. Even if your ED is not caused by these factors, it may contribute to them. It may be helpful to get counseling, alone or with your partner, in addition to getting medical therapy for ED.

Who gets ED?

Studies show about one-half of American men over age 40 have some degree of ED. At one time, health care providers thought that psychological problems, such as stress and anxiety, were the main causes of ED. Recent studies show most ED cases have a physical cause. While ED becomes more common as men age, growing old is not the cause of the problem. Though sexual function may decrease with age, many men enjoy sexual activity well into their senior years.

ED can be an early warning sign of a more serious illness, such as heart disease, high blood pressure or diabetes mellitus. Diagnosing and treating the condition that causes ED can improve your overall well being, as well as help restore your sexual health.

How is ED diagnosed?

ED is diagnosed by an urologist or another medical professional and for most patients the diagnosis will require a simple medical history, physical examination and a few routine blood tests.

Medical History exam requires health care providers to ask about you, and your ED experience. The doctor will also want to know if you have any other conditions that might affect your ED, such an any endocrine problems or depression. They may ask questions about your sexual history and performance, which may be very personal but necessary to understand the root cause of the problem. The important thing to remember is not to be embarrassed while speaking with your physician and to be very open to allow for the best treatment options for you. Other questions the physician is likely to ask are the following:

• Your current sexual function

• When you started noticing changes

• Any past medical or sexual problems

• Surgery or injury to the pelvic area

• Current and past medication usage

• Lifestyle and personal habits (i.e. smoking, drinking, use of illicit drugs, etc.)

• Relationship with current and past partners

Physical Examinations means the doctor will check your overall health and physical condition. They will look for signs of problems with your circulatory, nervous and endocrine systems. This includes checking your blood pressure, penis and testicles, and you may need to have a rectal exam to check the prostate. These tests are not painful and may provide valuable information about the cause of ED. Most patients do not require extensive testing before beginning treatment.

The choice of testing and treatment depends on the goals of the individual. If erection returns with simple treatment like oral medication and the patient is satisfied, no further diagnosis and treatment are necessary. If the initial treatment response is inadequate or the patient is not satisfied, then further steps may be taken. In general, as more invasive treatment options are chosen, testing may become more complex.

What are some non-surgical treatments?

The first line of therapy for uncomplicated ED is use of oral medications known as phosphodiesterase-5 inhibitors (PDE-5):

• sildenafil citrate (Viagra®),

• vardenafil HCl (Levitra®),

• tadalafil (Cialis®)

Men with ED take these pills before beginning sexual activity and the drugs boost the natural signals that are generated during sex, thereby improving and prolonging the erection itself. The medication works by relaxing the muscle cells in the penis, allowing for better blood flow and production of a rigid erection. These medications are often effective, and nearly 80% of men show improvement once they begin use. The drugs are effective regardless of race and age. Although studies have shown these medications can be used by heart patients, men taking nitrates should speak with their physician before use to understand the possible drug interactions or effects on their other health conditions.

The side effects of PDE-5 inhibitors are mild and usually transient, decreasing in intensity with continued use. The most common side effects are headache, stuffy nose, flushing and muscle aches. In rare cases, sildenafil can cause temporary blue-green shading of vision. There is no long-term risk and decreases as the amount of the drug in the body decreases. It is important to follow the medication instructions in order to get the best results. Tests have shown 40 percent of men who do not respond to sildenafil will respond when they receive proper instruction on the medications' use.

For men who do not respond to oral medications another drug, alprostadil, is approved for use in men with ED. This drug comes in two forms: injections that the patient places directly into the side of the penis and an intraurethral suppository. Success rates in achieving a firm erection useful for sexual intercourse with self-injection can reach 85 percent. Modifying alprostadil to allow intraurethral delivery avoids the need for a shot, but reduces the likelihood of successful treatment. The most common adverse effects of alprostadil use are a burning sensation in the penis and a prolonged erection lasting over four hours, requiring medical intervention to reverse the erection.

For men who cannot or do not wish to use drug therapy, an external vacuum device may be acceptable.

This device combines a plastic cylinder or tube that slips over the penis, making a seal with the skin of the body. A pump on the opposite end of the cylinder creates a low-pressure vacuum around the erectile tissue, which results in an erection. To keep the erection once the plastic cylinder is removed, a rubber constriction band goes around the base of the penis, which maintains the erection. With proper instruction, 75 percent of men can achieve a functional erection using a vacuum erection device.

Some men who have severe penis tissue degeneration do not respond to any of the treatments listed above. While this is a small number of men, they usually have the most severe forms of ED. Patients most likely to fall into this group are men with advanced diabetes, men who suffered from ED before undergoing surgical or radiation treatment for prostate or bladder cancer and men with deformities of the penis called Peyronie’s disease. For these patients reconstructive prosthetic surgery (placement of a penile prosthesis or "implant") will create an erection, with patient satisfaction rates approaching 90 percent. Surgical prosthetic placement normally can be performed in an outpatient setting or with one night of hospital observation. Possible adverse effects include infection of the prosthesis or mechanical failure of the device.

What can be expected after treatment?

All of the treatments, with the exception of prosthetic reconstructive surgery, are temporary and meant for use on demand. The treatments compensate for but do not correct the underlying problem in the penis. It is important to follow-up with your doctor and report on the success of the therapy. If your goals are not reached, if your erection is not of sufficient quality or duration and you are still distressed, you should explore the alternatives with your doctor. Because the medications used are not correcting the problems leading to ED, your response over time may not be what it once was. If such should occur again, have a repeat discussion with your physician about the remaining treatment options.

http://www.urologyhealth.org/urology/index.cfm?article=60

Advice For If Your Pain Brings Depression Vid

Today's animated video produced by the World Health Organisation is both cute and extremely helpful for people driven to depression by chronic pain. There's no direct reference to neuropathy but people living with neuropathy symptoms day in, day out can become depressed over a period of time, sometimes without realising what's happening to them. This video gives a gentle reminder that there's no shame in asking for help and ignoring it, or repressing the feelings of serious depression can lead to problems just as serious as the cause itself. Worth a watch for everybody.

Living With a Black Dog
World Health Organization Published on 4 Sep 2014

Millions of people around the world live with depression. “Living with a black dog” is a guide for partners, carers and sufferers of depression. It advises those living with and caring for people with depression on what to do, what not to do, and where to go for help.

“Living with a Black dog” is a follow-up to “I had a black dog, his name was depression”, which offers practical advice for coming to terms with and overcoming depression.

Both videos were produced by writer and illustrator Matthew Johnstone, in collaboration with WHO, and were based on books of the same name.

For “I had a black dog, his name was depression” 

 
https://www.youtube.com/watch?v=XiCrniLQGYc&feature=youtu.be

Simple Genetic Cheek Swab Tells You If A Drug Is Suitable Or Not

Today's fascinating post from wsj.com (see link below) looks at how tiny genetic variations can significantly change the way we absorb common and not-so-common drugs. This has far-reaching implications for many neuropathy patients, who need to be on a cocktail of drugs to control their main condition and the neuropathy caused by it. There is a simple genetic test (cheek swab) that can alert doctors as to how well, or not, a drug will be absorbed. Sometimes, your genetic make up can make even a single dose of a common drug toxic, or create the need for higher than normal doses to achieve the right effects. Experienced neuropathy patients who have already been through the mill regarding neuropathy drugs ( originally intended for other conditions) will be very much aware that certain drugs work well and others not at all. How much simpler would life be, if a genetic test could predict how you will react to a certain drug before taking it! Worth a read.

Is Your Medicine Right for Your Metabolism? By Melinda Beck Updated March 14, 2016   

More genetic tests aim to help predict how people might respond to many common medications

Medications don’t work the same way for everyone--depending in part on genetic factors that influence metabolism. 

People can respond to drugs very differently. A medication that brings relief for some patients might show no benefit at all in others, or even cause harmful side effects.

A growing array of genetic tests is designed to help predict how people are likely to respond to many common medications, from antidepressants and antihistamines to pain relievers and blood thinners. The tests, which are controversial, look for tiny variations in genes that determine how fast or slow we metabolize medications.

Because of such gene variations, codeine, frequently prescribed to relieve pain, has little effect on as much as 20% of the population, while 2% of people have such a strong reaction that a normal dose can be life-threatening. About 25% of people can’t effectively absorb Plavix, a clot-busting drug, putting them at increased risk for a heart attack or stroke.

Even everyday drugs such as Advil and Motrin, for pain relief, and Zocor, to lower cholesterol, can have widely varying effects.

The speed at which people metabolize medications can dramatically influence a drug’s effectiveness. Illustration: Jason Mecier for The Wall Street Journal

Testing patients for gene variations could avoid some of the 700,000 serious drug reactions in the U.S. each year, some experts say. Proponents of the tests, which are done with a cheek swab, say they also could help doctors rely less on trial and error in choosing the right drug and the right dosage for individual patients.

The Food and Drug Administration has included cautionary information for people with certain gene variations on the labels of more than 100 prescription medications. As yet, only about 20% of doctors order such tests, according to a survey by the American Medical Association, and many patients don’t know they exist.

Some major medical associations, including the American College of Cardiology and the American Psychiatric Association, have been slow to endorse the testing, mainly because there are no large, randomized controlled trials showing the technique significantly improves patient care. And the tests, which range from $500 to $2,000, are only covered by some insurers in some cases.
Alan Pocinki, an internist in Rockville, Md., says he orders gene testing for patients who have a history of unexplained symptoms or who haven’t gotten relief from drugs in the past. In many cases, he is able to find a better treatment based on their DNA, he says. “It makes a huge difference clinically among people I see every day.”

How people’s genes affect their response to medications is called pharmacogenetics. One of the first such drug-gene interactions was identified at the Mayo Clinic in Rochester, Minn., in the 1970s. Researchers discovered that about 1 in 300 children being treated for childhood leukemia had a gene variation that made the drug thiopurine destroy their bone marrow. Now, children are routinely tested before undergoing treatment with the drug.

Scientists have since discovered that about 75% of prescription and over-the-counter drugs depend on a handful of liver enzymes to be absorbed and eliminated from the body. Minor variations in the genes that regulate those enzymes are very common—95% of people have at least one.

People who get two impaired copies of an enzyme gene—one from each parent—are likely to be “poor metabolizers” and absorb drugs so slowly that even a normal dose can become toxic. “Intermediate metabolizers”—with one impaired and one normal gene—allow drugs to build up in the body and over time can cause side effects. People sometimes get extra copies of enzyme genes, which can make them “ultrarapid metabolizers” of some drugs and flush them out of the body so fast they have little effect.

Gene variations that affect drug metabolism tend to run in families and ethnic groups. Other factors, including alcohol and dietary supplements, can also affect how a person reacts to a drug. Some medications, such as Plavix and the acid-blocker Prilosec, shouldn’t be taken together because they can impair each other’s ability to be absorbed. Cigarette smoking speeds up the absorption of the schizophrenia drug clozapine, so patients who smoke need a higher dose.

Some people say learning they have drug-gene sensitivities explains a lifetime of health mysteries. Elise Astleford, 75, a retired Episcopal priest in Vancouver, Wash., says she experienced hallucinations, a deep depression and symptoms of dementia while taking various drugs over the years. After spotting a newspaper ad for gene testing, she convinced her primary-care doctor to order it. She learned she has variations in three key liver enzymes that make her an intermediate metabolizer of dozens of common drugs.

Ms. Astleford still takes a variety of medications for thyroid, blood pressure and other conditions, but she makes sure they all use different enzyme pathways. “Now, whenever I get a new prescription, I check with the pharmacist to see how they are metabolized,” she says.

Dr. Mark Dunnenberger heads the pharmacogenomics clinic at NorthShore University HealthSystem in Evanston, Ill. The clinic, which opened last year, offers a panel of 14 gene tests aimed at predicting how a patient will respond to various medications, for as little as $500. Photo: Photo by Jonathan Hillenbrand

Some tests for gene reactions to individual drugs have been available for years. More lab companies, including Assurex Health Inc., in Mason, Ohio, and OneOme LLC, in Minneapolis, offer panels of tests aimed at advising patients with psychiatric, cardiac or chronic-pain conditions what medications would be the best fit based on their genes. Genelex Corp., in Seattle, says its YouScript software program analyzes how multiple medications, over-the-counter drugs and supplements react with each other and with patients’ DNA. The testing and analysis costs roughly $1,000. “Your results don’t change; you’ll have that information the rest of your life,” says Genelex Chief Executive Kristine Ashcraft.

Medicare pays for pharmacogenomic tests in some cases, such as before patients take certain antidepressants and anticoagulant drugs, but stopped covering many others last year after one company was investigated for allegedly making improper payments to doctors. Private-insurance coverage is spotty but costs for the tests are dropping. NorthShore University HealthSystem in Evanston, Ill., opened a pharmacogenomics clinic last year that offers a panel of 14 gene tests for less than $500.

More top medical centers—including those at Vanderbilt University, the University of Pittsburgh, the Mayo Clinic and St. Jude Children’s Research Hospital—are testing patients’ DNA and studying whether gene-based drug targeting makes a difference in their care. Insurers sometimes cover the cost of testing for such research trials; other times grants or the hospitals themselves provide the funding.

In many cases, hospitals are incorporating the information into patients’ electronic-medical records, so it can help doctors choose the most useful drugs and dosages for them in the future.

“Pharmacogenomics is never going to be a crystal ball to tell you which medications will work and which won’t. Too many other factors come into play,” says Dr. Mark Dunnenberger, who heads the NorthShore University clinic. “But we can take advantage of a patient’s DNA and say, ‘You have a high likelihood of a suboptimal response from these drugs, so let’s try another medication that works a different way.’” 





Not Right for Everyone

Many common medications can affect people differently depending on minor variations in the genes that regulate key enzymes. The variations can make people metabolize certain drugs either more slowly or rapidly than normal. 

Some examples:
DRUGS
Pain relievers codeine or oxycodone, including Tylenol 3 and Percocet
ENZYME PATHWAY AT WORK
CYP2D6
IMPACT
A standard dose can have little effect in up to 20% of people, while as many as 2% can have a life-threatening reaction. 

DRUGS
Blood thinner Plavix (clopidogrel) and acid reducers Prilosec (omeprazole) and Prevacid (lansoprazole)
ENZYME PATHWAY AT WORK
CYP2C19
IMPACT
Up to 15% of people metabolize these drugs very slowly, resulting in a higher effective dose and greater risk of side effects.

DRUG
Blood thinner Coumadin (warfarin)
ENZYME PATHWAY AT WORK
CYP2C9
IMPACT
People with some gene variants have twice the risk of severe bleeding, but other factors are involved and population percentages are unclear.

DRUG
Cholesterol reducer Zocor (simvastatin)
ENZYME PATHWAY AT WORK
SLCO181
IMPACT
Up to 40% of people have impaired ability to metabolize this drug, giving them increased risk of muscle pain and other side effects.
 
Source: Clinical Pharmacogenetics Implementation Consortium
Write to Melinda Beck at HealthJournal@wsj.com

http://www.wsj.com/articles/is-your-medicine-right-for-your-metabolism-1457982384

What To Do If You Think You Have Neuropathy

Today's post from gobeyondrelief.com (see link below) is a compact article giving advice to people who begin to feel the unique symptoms of neuropathy and are worried what they should do about it. It's true; in order to climb onto the medical windmill, you need to get some sort of evaluation from your doctor or neurologist. If that person is sympathetic and sensible, most neuropathic symptoms will give a pretty clear idea of what's wrong. However, you may have to go through a whole raft of tests before an official conclusion can be reached. Most of the time, a patient's story should be enough. His or her background; other medical conditions and life style; combined with the symptoms he or she describes, will lead to a pretty quick and certain diagnosis. At that point, you may be put onto the treatment treadmill, according to the severity of your symptoms and then it's a question of finding the treatment that works for you. Be warned; this can take some time, as everybody with neuropathy reacts differently to different treatments and finding something that calms your symptoms down enough to make your quality of life better, is no easy task. Whatever happens, if someone claims to be able to cure your neuropathy - they can't - medical science is not there yet. The best they can do is treat the symptoms. Good luck. 

Think that you may have Peripheral Neuropathy – What to do Now?

by Dr. Cohen February 13, 2015

If you are experiencing any of the symptoms of peripheral neuropathy, you should seek medical evaluation and treatment immediately. This could be pain, numbness, or a “pins and needles” feeling in your legs or feet. It might show up as muscle weakness or a loss of coordination. If you are concerned, especially if you have diabetes, you should schedule a medical evaluation.

Peripheral Neuropathy Medical Treatment

Doctors will prescribe treatment that will vary depending upon the source of the condition and the amount of pain or discomfort. Medications are commonly prescribed to help alleviate pain and discomfort.

These are some typical medications prescribed for this condition:
* Pain relievers: Doctors will often prescribe medication that could range from over-the-counter anti-inflammatory pain relievers like aspirin to prescription opiates. The type and strength of medication depends upon the amount of pain or discomfort and other treatment options.
Anti-seizure medication: Some drugs that have been developed to treat epilepsy can also help relieve pain.
Capsaicin: This substance is found in hot peppers, and it is included in some topical treatments that are often used in combination with other medications. The patient will be given a cream or ointment. In some patients, this causes some skin irritation, but that usually goes away after a few days.
Antidepressants: Certain kinds of antidepressants seem to interfere with the ability to feel pain and provide relief.

Of course, doctors also try to treat the underlying causes of this disorder. For example, when diabetics are able to control their blood sugar, they can minimize nerve damage and give their body a chance to heal. In the case of carpal tunnel syndrome or a tumor, surgery may be called for to relieve pressure on nerves.

Alternative Medicine Treatments for Peripheral Neuropathy

In some cases, a physical therapist or chiropractor may be able to treat symptoms of nerve discomfort. Some patients prefer to try alternative treatments instead of relying upon prescription medication or surgery. Many doctors are open to trying them to see if they are effective on a case-by-case basis.

Chiropractors may offer these treatments:
TENS: Also called Transcutaneous electrical nerve stimulation, this involves nerve stimulation with adhesive electrodes that are placed upon the skin.
Physical therapy and physical manipulation: Certain movements and exercises may help combat muscle weakness and numbness.
Support and aids: In some cases, the patient may also need foot and hand braces, a wheelchair, or a walker.

Acupuncture is another alternative therapy that is used to treat this condition. This science originated in China, but it has gained more credibility in the U.S. and other Western countries over the last few decades. An acupuncture therapist uses needles to attempt to improve blood circulation, eliminate nerve blockages, and sometimes to try to treat the underlying causes of the condition.

Treatment at Home

Doctors and alternative therapists will also suggest good home care for patients. For example, people with numbness in their extremities may be advised to protect their hands and feet and frequently check them for injuries.

Of course, people who have an underlying disease that causes this condition will be advised to follow their treatment regimen to control the condition. In any case, healthy meals, a reasonable exercise program, and avoiding alcohol and smoking are also suggested.

Most patients should check with their doctor before beginning an exercise routine, but walking, yoga, and tai chi are frequently suggested as very beneficial. Of course, patients should ease themselves into a new exercise routine gradually if they have been sedentary before.

What’s the Next Step?

Anybody who experiences the symptoms of numbness, tingling, weakness, and pain should seek help from a medical professional as soon as possible. Your doctor will take your medical history, diagnose the condition, and suggest treatment options or suggest a specialist or therapist for certain conditions. If you prefer to try alternative treatments instead of medication, that should be discussed with the physician.

Since there is no way to be certain that the problem is Peripheral Neuropathy until it is properly diagnosed, people should not try to diagnose and treat this condition on their own. These symptoms could have other causes. The most important key to recovery may be treating the underlying cause of the symptoms, and this is what your physician is trained to do.

In conclusion, if you are experiencing any of the symptoms associated with Peripheral Neuropathy, there is hope. Proper diagnosis is the key to getting relief from this painful and debilitating condition.

http://gobeyondrelief.com/peripheral-neuropathy-natural-treatment-options/