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Ask the Pharmacist
by Ron & Marla Chapleau

May 30, 2016
www.kincardinetimes.com
www.saugeentimes.com

Health

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Q) My feet and hands often feel numb. What is causing this and what can I do about it?

A) There are many potential causes but the two most common involve either poor circulation or injured peripheral nerves.

These nerves are referred to as peripheral because they are located well away from your brain and spinal cord (your central nervous system) and damage to these nerves results in abnormal sensations being experienced in very specific areas of your body. These can range from the numbness mentioned above to feelings of pins and needles, itching, tingling, shock like sensations and numerous others. For some, these sensations can be only intermittent but for an unfortunate many, these symptoms are a constant irritant that threatens their quality of life.

When patients complain of symptoms such as these, they are told they are experiencing peripheral neuropathy.

Poor circulation refers to a lack of blood flow to the affected region and is not really a condition in itself so much as it is a symptom of other medical issues. Possible causes of impaired circulation include peripheral artery disease, blood clots, varicose veins, diabetes, atherosclerosis (which is closely related to peripheral vascular disease), obesity and Raynaudís disease.

Possible causes of peripheral neuropathy are extremely varied and include diabetes, assorted nerve entrapment syndromes (such as carpal tunnel syndrome), various infections (lyme disease, shingles, Epstein-Barr virus...), alcoholism, autoimmune disorders (lupus, rheumatoid arthritis...), exposure to toxins (particularly heavy metals such as lead, mercury and a host of industrial chemicals), injury (where nerves can be compressed as with a herniated disc or damaged such as post surgical pain), systemic diseases (kidney disease, liver disease, hypothyroidism, cancers, benign tumors, connective tissue disorders, blood diseases, prescription medications (chemotherapy, antibiotics, antivirals...), vascular diseases and vitamin & mineral deficiencies (magnesium, vitamins E, B12, B1 and B6 although an overabundance of B6 can also lead to similar symptoms).

Treatment options for poor circulation are usually aimed at treating the underlying medical condition such as blood thinners for clots, drugs known as calcium channel blockers for Raynaudís and medications that increase blood flow to the extremities such as pentoxifylline and cholesterol lowering drugs in peripheral vascular disease.

There are even more options for treatment if the sensations you are suffering from are deemed to be a form of peripheral neuropathy. Options include anti-seizure drugs (gabapentin...), older anti-depressants (amitriptyline...), pregabalin (Lyrica), anti-inflammatories (ibuprofen...), duloxetine (Cymbalta), a number of creams (using ingredients such as capsaicin, menthol, lidocaine and many others) and possibly narcotics although their use in peripheral neuropathy is controversial both in terms of their usefulness and potential side effects.

There are also a number of remedies that may be tried at home that are both same and effective in some. When poor circulation is the root cause, increasing the blood flow to the affected extremity can be accomplished by soaking the area in warm water or using a heating pad for 5-10 minutes multiple times a day. This serves to open up the blood vessels and should provide some relief within a very short period of time. Adding a half cup of Epsom salts to your warm soaks can increase their effectiveness as the magnesium content of this product can raise the levels within your body which can be an underlying cause for some.

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Another quick remedy is to massage the area firmly using circular motions for at least 5 minutes. Doing regular aerobic exercises can improve circulation to all parts of the body and can relieve both the symptoms of poor circulation as well as to help rectify many of its possible underlying causes. Elevating the affected limb for even a few minutes can also help many.

 As always there are a number of lifestyle choices that can greatly benefit this condition such as quitting smoking, increasing your fluid consumption and avoiding caffeinated and alcoholic beverages.

There are also a number of herb and natural products that help some with poor circulation including turmeric (also a powerful natural anti-inflammatory that is gaining popularity in the treatment of assorted auto immune disorders), cinnamon (preferably the cassia form which is not the one usually bought at the grocery store and is also useful in diabetes) and ginkgo biloba (usually 40mg three times a day). Note these products do have the potential for interactions both with other drugs and medical conditions so consult your health care professional before attempting their use.

 Increasing your intake of foods high in magnesium can help improve numbness from either poor circulation or nerve damage. Foods that are high in this include dark green vegetables, nuts, seeds, bananas, cold water fish, peanut butter, dark chocolate and yogurt. Conversely, taking magnesium in a supplement at around 350mg a day can help meet your daily needs.

Natural ways to improve peripheral neuropathy include increasing your intake of vitamin B6 & 12 (foods high in these include fortified cereals, eggs, bananas, fish, beans, meats, dairy and seeds), regular exercise, controlling your blood sugars (if youíre diabetic), increasing your intake of vitamin D (through a supplement), soaking the area in a warm bath, trying an alpha-lipoic acid supplement (600mg daily) or regularly applying (4 times a day) a cream using capsaicin which comes from hot peppers.

There are a number of commercial creams which use this and some pharmacies (including Gordon Pharmasave and Port Elgin Pharmasave) are able to compound much more powerful versions when requested. So while this condition can be a life-long challenge for some, the good news is that there is no shortage of options that can be tried to alleviate your discomfort.

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For more information about this or any other healthcare questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination in Kincardine and Port Elgin Pharmasave.


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