Neuropathy’s Hidden Causes: What Labs and Protocols Often Miss

What’s Inside This Episode?

• The metabolic mechanisms linking insulin resistance to nerve damage

• The three types of neuropathies every practitioner should recognize

• Functional labs that detect root causes

• The hidden role of vitamin deficiencies and genetics in nerve symptoms

• Clinical clues that distinguish neuropathy from carpal tunnel, fibromyalgia, or toxicity

• Functional interventions: diet, exercise, supplements, and antioxidant therapies that restore nerve health

• Nutrients that accelerate repair

• Lifestyle and stress‑management strategies that promote regeneration and protect mitochondria

Resources and Links:

• Download our FREE Metabolic Health Guide here.  

• Download our FREE Guide to for Lab Test Recommendations

• Join the Next-Level Health Practitioner Facebook group here for free resources and community support
• Reserve your spot for our Reinvent Healthcare Online Event Nov 7-9! It’s the event of the year for practitioners serious about root-cause healing. 
• Visit INEMethod.com for advanced health practitioner training and tools to elevate your clinical skills and grow your practice by getting life-changing results. 
• Check out other podcast episodes here

Transcript

Dr Ritamarie  

Most people believe that neuropathy is a later complication of diabetes. But the surprising truth is that nerve pain and numbness in the extremities may actually be some of the earliest signs of insulin resistance. I've seen it in practice many times. And in today's episode, we're going to uncover the mechanisms behind neuropathies and explain why addressing them early on is crucial to preventing nerve damage, permanent nerve damage. 

Today, we're diving deep into the connection between insulin resistance, blood sugar, and neuropathies. You're going to gain valuable insights into how these metabolic disruptions can lead to nerve damage and what you can do to help your clients prevent, halt, or even reverse the progression of neuropathies. So let's get started. 

Neuropathies, or nerve damage, are a growing concern among those dealing with metabolic health issues like insulin resistance and blood sugar imbalances, but neuropathies aren't just limited to insulin resistance. 

We'll discuss the different causes and how they relate to metabolic dysfunction, and then we'll go into how insulin resistance and metabolic dysfunction lead to neuropathies. 

Understanding the connection between metabolic health and neuropathies is crucial for us as practitioners, because we can then better help our clients to navigate these challenges and make informed decisions about their health.

Dr Ritamarie (01:55 )

Let's get started with an overview of neuropathies, what they are and what kinds of underlying conditions can cause them. 

Neuropathies refer to a group of disorders that involve nerve damage or dysfunction leading to various symptoms,  how they affect the nervous system, and how it communicates with the body.

Neuropathy or neuro-pathy, right? The pathological effect on the nerves can affect all kinds of nerves, sensory, motor, or autonomic. And it can be categorized into several types, including one, the one we're most familiar with actually, and the one most common, and the one we see most often in metabolic dysfunction is peripheral neuropathy. It causes symptoms of things like numbness and tingling and pain, and lack of sensation that causes damage when we're injured. 

It's often associated with diabetes, especially insulin resistance. And this happens in the peripheral, peripheral neuropathy. So it can happen in the hands, it can happen in the feet. 

Autonomic neuropathy affects the autonomic nervous system that controls involuntary functions like heart rate, blood pressure, and digestion. So symptoms of this can include dizziness and digestive issues and problems with regulating body temperature. 

Clues, clues, clues, right? We're looking for clues. 

Focal neuropathy, unlike the other two, affects specific nerves or groups of nerves that often lead to sudden localized pain or weakness, such as in the face or torso. So careful history taking will help you to determine what kind of neuropathy they have and what some of the underlying causes may be. So what are the symptoms?

The symptoms of the neuropathies can vary based on the type and the severity of nerve damage. The common symptoms include numbness or tingling described as pins and needles. The official name is paresthesias. This can begin in the toes, fingers, or legs. Pain, sharp or burning, or stabbing pain. Oftentimes it worsens at night. Weakness, loss of muscle strength leading to difficulty with movement or performing tasks that require dexterity or strength.

Balance issues in cases of autonomic neuropathy, problems with coordination and dizziness can occur. 

So while insulin resistance is a major player, neuropathies can also be triggered or exacerbated by any number of other conditions. 

So some of them include autoimmune conditions like rheumatoid arthritis, lupus, Guillain-Barre, and they cause the immune system to attack the nerves and that leads to inflammatory neuropathies. 

Infections, so certain viral and bacterial infections, particularly herpes zoster known as shingles, Lyme disease, HIV can directly affect the nerves leading to neuropathy. 

Toxins, exposure to heavy metals like lead or mercury or certain medications. Certain chemotherapy drugs, for example, can lead to toxic neuropathy by damaging nerve fibers. 

Hereditary conditions can be at the heart of these. Something like Charcot-Marie-Tooth disease can lead to progressive neuropathy, and that oftentimes runs in families.

Insulin resistance and blood sugar dysregulation can be the cause of neuropathies on their own or in combination with some of these other conditions. And when they're combined, it leads to an exacerbation of symptoms. Insulin resistance contributes to neuropathy in several ways.

Dr Ritamarie (05:24 )

One, chronic high blood sugar damages the small blood vessels that supply the nerves and that leads to reduced oxygen, which impairs nerve function. The damage can be especially profound in the extremities. That's where we usually see peripheral neuropathies, because the blood flow is already quite limited there. 

High blood sugar can lead to the formation of ages, advanced glycation end products, which build up in tissues and cause structural damage to the nerves. They bind to the nerve proteins and lead to reduced nerve conductivity and function. 

Insulin resistance and elevated blood sugar levels increase oxidative stress and inflammation, which can accelerate nerve damage by stimulating the release of inflammatory cytokines. These compounds can lead to nerve cell degeneration and inhibit nerve cell regeneration. 

Prolonged exposure to high blood sugar also promotes oxidative stress, which causes direct damage to nerve cells by creating these unstable free radical molecules that impair the nerve's ability to transmit signals effectively. 

Mitochondria are particularly sensitive to oxidative stress. In insulin resistance, mitochondrial function is compromised, reducing the energy available to nerve cells and impairing their ability to repair and regenerate.

Accurate assessment is key to differentiating neuropathy from other conditions with similar symptoms. Like nerve conduction studies are often done to measure how well the electrical signals move through the nerves and help to identify the location and extent of nerve damage. 

We can test for markers of insulin resistance, obviously, to see if the potential of this neuropathy is related to blood sugar. So we want to look at not just fasting blood sugar, but we want to look at hemoglobin A1C, fasting insulin, and also C peptide levels to reveal the underlying metabolic dysfunction. 

Other tests like C-reactive protein, ESR, and homocysteine, also interleukins and cytokines, can assess the inflammation levels or the presence of autoimmune markers. There are techniques like MRI or ultrasound that can assess nerve structure and identify compression by other factors like physical factors, like problems with a neck or vertebrae or compression of the spinal cord by stenosis.

Dr Ritamarie (07:47 )

So how do we differentiate neuropathy from other conditions, right? Conditions such as carpal tunnel syndrome, fibromyalgia, or vitamin deficiencies. They all can mimic neuropathy. 

Blood tests and nerve conduction, as we talked about, can differentiate by identifying underlying causes and the severity of nerve damage. Of course, like I said, fasting glucose and A1C and insulin are all going to help us to identify if there is an underlying metabolic dysfunction.

C-peptide levels are not often tested in people unless they're already diabetic, but that can indicate that insulin resistance is present and that also helps us to identify if the body is losing pancreatic function. 

 Vitamin B12 needs to be assessed, because vitamin B12 deficiency can lead to what‘s called stocking and glove paresthesias, which means that it's just in the hands and the feet, so gloves and stockings, right? And that can be B12, and it could mimic diabetic neuropathy. So we want to look at indicators of B12 status. 

We want to look at things like MCV and homocysteine and, of course the gold standard, is methylmalonic acid. We also want to look at genetic predispositions. If a person has some of the SNPs that predispose to B12 deficiencies potentially or imbalances like MTRR and FUT2, then that would help us to identify that maybe that's where this is. 

When neuropathy is caused by insulin resistance, it can be severe, and it's possible to prevent further progression and even reverse the damage through combination of lifestyle changes, targeted supplementation, and of course, supportive therapies. 

So let's talk about some of those. Before we do, I just want to give you an example. I had a client years ago who was experiencing neuropathies. And he was an intelligent person, and he went and started researching. And he asked the doctor, could this be from diabetes? 

And she said, ”No, you don't have diabetes. Your fasting blood sugar is 98. Why would you be thinking you have diabetes?” Well, he went on to thinking about that, and he saw at a health fair that they were testing hemoglobin A1C. And he said, oh, that's related to diabetes or early diabetes. Let me get that checked, because my doctor never checked it. He checked it, and his A1C was 10 point something. It should be 5.2, 5.0, right? And he went, whoa, that's way too high.

Now, those neuropathies were an early sign for him. He wasn't diagnosed with either insulin resistance or with diabetes, and probably, because he was having a balance, a shift up and down of his glucose, and it was going very high, but it was also coming very low or coming down quickly, because he had some insulin, excess insulin happening. 

I don't really know what the cause was, but he started to follow an insulin resistance reversal program, one of the programs that we do called the sweet spot. And he was able to get his A1C down in the 5s, like 5.2, right? But he, in the meantime, developed some eye issues. He started to have difficulty and his vision was blurred. And so he went and got that checked out, and it turned out he had diabetic retinopathy.

Mind you, he was not yet diagnosed with diabetes and probably never will be, because he got it under control. But all those years of having that imbalance in the blood sugar that no one was testing on a deeper level led him to have the neuropathies and the retinopathies. 

So really be careful with people. Don't discount and think this can't be retinopathy, neuropathy, nephropathy, because this person doesn't have diabetes.

Fasting blood glucose, which is what's used to diagnose diabetes. It is one of the last things to change. We need to be looking early on at the insulin levels, the A1C levels, C-peptide levels, maybe that's more of a later sign, because of pancreatic dysfunction as time goes on, but at least insulin and A1C, and then looking at inflammatory markers. 

So we can help people to reverse diabetes, before they even get diagnosed with diabetes, and that's really exciting. So let's look at some of the diet and lifestyle.

So we want to look at reducing the glycemic load. Obviously a low glycemic diet, anti-inflammatory diet can lower those blood sugar levels and reduce the reduction of ages, which play a key role in nerve damage. Anti-inflammatory foods and including omega-3 rich fatty foods, right? So flax and chia and sea vegetables, algae and sea foods that are high, like high omega-3 foods.

Dr Ritamarie (12:41 )

We want to look at antioxidants like vitamins A, C, and E, and polyphenol-rich foods such as berries and leafy greens to help reduce systemic inflammation.  Inflammation causes all of these conditions. Supplementation can be used, but I'm a big fan of starting with food, but most people need supplementation from the start,  especially if you're testing their homocysteine and their MCV,  the methylmalonic acid. If you're doing a more advanced functional test and seeing they have imbalances here, by all means, get them to do the food, but also supplements, so you can reverse some of the damage that's been done. 

The ones that are most important for nerve health are B1, B6, and B12.

Dr Ritamarie (13:23 )

Supplementation can help improve nerve function and reduce symptoms of neuropathy. So by all means, work with this. B6 has been shown to do this. Alpha lipoic acid is a powerful antioxidant that can help repair the nerve damage by reducing oxidative stress and improving nerve conduction.

Acetyl L Carnitine is another supplement that's been shown to support mitochondrial function, which can help to reduce pain and improve nerve regeneration. 

Exercise, of course, regular physical activity helps improve insulin sensitivity, reduce inflammation, promote blood flow to the extremities, and all of these are essential for nerve health. And of course, stress management and sleep hygiene. 

Chronic stress and elevations of cortisol and poor sleep where we don't get to regenerate can all affect nerve damage, and we want to help reverse that. Relaxation techniques like deep breathing and meditation, yoga, adequate rest are critical for reversing neuropathy progression.

Dr Ritamarie (14:23 )

One other thing that can be utilized is capsaicin cream on the feet or the hands. The place where that is happening helps increase the circulation and in some cases has been shown to at least do some reduction in the pain and the paresthesia. 

So to summarize, insulin resistance can lead to serious nerve complications, but the good news is we can reverse, manage and prevent further progression with the right interventions.

It's all about addressing root causes, right? That's exactly what we're trained to do. We are the future of healthcare. Those of us committed to going beyond symptom suppression, it's outdated, and addressing root causes of imbalances and all these conditions that are related to insulin resistance. That's a great place to start. 

So whether you're a practitioner, a health seeker, it's time to empower yourself with the knowledge that can transform lives. If you want to deepen your understanding of insulin resistance, neuropathies, and how to address them through food, lifestyle, and functional insights, visit our inemethod.com site for more tools and resources. 

We even have an insulin resistance practitioner training that can help you with all of this. And if you want to explore this topic even further, go check out the show notes in the description, and I put some valuable links and powerful tools and additional trainings.

Together, let's continue the movement to reinvent healthcare. And until next time, shine on.