Medications and Peripheral Neuropathy
Give A Healthy Person A Drug And It Will Make Them Sick…WHY Then Would We Expect A “Sick” Person To Get Well By Taking A Drug?
Blood Pressure Medications & Insanity
1 in 3 adults suffer from high blood pressure, as reported by the CDC in 2011. This equates to approximately 68 million people in the United States. Blood pressure is the force of blood against your artery walls as it circulates through your body. Blood pressure normally rises and falls throughout the day, but it can cause health problems if it stays elevated for a long time.
It astounds me how Hypertension (High Blood Pressure) is treated as a disease in this country. It is not a disease but merely a symptom of a dysfunction within the body. Imagine one day as you are driving to work, the engine light suddenly comes on in the dashboard of your car. You do the responsible thing any car owner would do…”You ignore it for a week or two in hopes it will disappear”. When it doesn’t turn off after two weeks, you now take it into your mechanic. He pops the hood, looks underneath and states, “I know exactly what the problem is and I can fix it for you.” He then takes a pair of wire cutters and proceeds to cut the wire to the engine light and… “POOF” Presto-Magic! The engine light shuts off. Now, I ask you, “Did that fix the problem?” OF COURSE NOT!!! Yet, everyday this is how we resolve our issues with blood pressure, by cutting the wire to turn off the light or in this case taking medications that cover up the real reason behind the elevation in your blood pressure. Now, I am by no means advocating that you should ignore a blood pressure that is high. What I am saying is that we need to figure out what the problem is within our body that is causing your blood pressure to run high and let’s fix that. Treating only the symptom (blood pressure) is an approach that can have some dire consequences.
A survey published in the British Medical Journal found that 97 percent of patients taking blood pressure medications had suffered from significant side effects, including neuropathy.
One side effect from blood pressure medication is the damage that can occur at the nerve sites for a variety of reasons ranging from decreased blood flow at the extremities, like the feet or hands, to disruption in nerve transmission due to mineral loss or depletion.
High blood pressure medication not only lowers blood pressure, but also reduces the ability of the arterial blood to refill the veins. This creates a tendency for the blood to pool in the lower extremities. As a result, the nerves and synaptic junctions do not have enough of the necessary food and oxygen to maintain their health, leading to nerve cell atrophy, loss of mineralization, and decreased conductivity of the synaptic junctions.
First, let’s address the role that decreased blood flow plays in relation to the health of your nerves. Diminished blood flow to the hands or feet mean diminished oxygenation to the tissues, including the nerves. In order to survive in this oxygen depleted environment, the nerve cells can temporarily contract or shrink (atrophy) in order to conserve oxygen to stay alive. Each nerve cell is separated from the adjacent cell by a gap called the synaptic junction. Shrinkage of each nerve cell, due to lack of oxygen, can increase this gap, thereby enlarging the synaptic junction. The synaptic junctions do not come into contact with each other. As a result, nerve impulses must jump across this gap.
A larger gap makes it harder for the electrical nerve impulse to get across. When the gap gets too big, the electrical impulse can’t make the transition across this gap. What this means for the body is that, the message being delivered along the nerve never makes it to its destination or it has been misdirected to a different part of the body; it will then be misinterpreted as pain. At times, the nerve signals may begin to pile up on one side of the synaptic gap until they can make it across to the other side. Once a collection of these signals gets large enough, a very large signal can be pushed across the widen synapse. When this occurs, the brain will interpret it as sharp, stabbing or shooting pain. This is what is referred to as impaired nerve function.
We must also realize, once this gap inhibits peripheral nerve impulses, the minerals that are dissolved in the synaptic junction’s fluid, like calcium, can leach out making the fluid less conductive. Water alone does not conduct electricity – water needs minerals dissolved in it to make it conductive. A wider gap equals loss of minerals and therefore loss of conductivity.
Some of the most commonly prescribed blood pressure medications are Beta blockers. Beta blockers work by
blocking the effects of the hormones norepinephrine and epinephrine, also known as adrenaline. This occurs
by blocking beta receptor sites on the cell. When you take beta blockers, blood vessels will narrow and
constrict, allowing the heart to beat slower and with less force, thereby reducing blood pressure. The narrowing
of blood vessels also causes a decrease in blood flow to tissues. Any decrease in blood flow will result in
anoxia, so many tissues will be deprived of necessary oxygen and nutrients. This will affect tissues furthest
away, like the extremities, especially the feet and legs, potentially leading to peripheral nerve damage.
A further ensuing problem of beta blocker use is that beta receptor sites are not isolated to the heart. They are
also located on other organs including the pancreas, liver, lungs and kidneys. Any beta blocker that is not
cardio-selective will affect receptor sites outside of the heart and can create narrowing of these arteries. As
a result, beta blockers have been linked with an increased risk for developing diabetes. As reported in the
American Journal of Cardiology, 2007, a meta-analysis of 94,492 patients taking beta blockers resulted in a
22% increased risk for new-onset diabetes. As you will recall, diabetes and peripheral neuropathy go
hand-in-hand. As you will recall, 60-70% of diabetics will develop neuropathy. This same study also revealed
that beta blocker usage resulted in a 15% increased risk for stroke.
Another deleterious effect commonly associated with the use of these drugs is that they can actually worsen
respiratory diseases, including asthma, by way of constricting the blood vessels in the lungs and narrowing of
the walls of the airways. On top of all this, Beta blockers have also been known to worsen preexisting heart
conditions, according to the “Drug Information Handbook 15th edition”.
Examples of beta blockers include Acebutolol (Sectral), Atenolol (Tenormin), Bisoprolol (Zebeta), Metoprolol
(Lopressor, Toprol-XL), Nadolol (Corgard), Nebivolol (Bystolic) and Propranolol (Inderal, Inderal LA). Did
you know that 191.5 million prescriptions were filled in 2010, alone.
Another common blood pressure medication falls into a classification called ACE Inhibitors (Angiotensin Converting Enzyme).
ACE Inhibitors relax blood vessels by preventing an enzyme in your body from producing angiotensin II. This inhibition of angiotensin II not only affects blood vessels of the heart but will also impact other organs, such as, the kidneys, the lungs, and hormones.
For instance, although these drugs preserve the function of the kidneys in people with diabetes whose kidneys are normal, they can be very dangerous for people that have poor kidney function or kidneys that are damaged. In extreme cases, Ace inhibitors have actually been associated with kidney damage. When a person suffers from kidney disease, toxins begin to build up in the blood stream. These toxins have damaging effects on peripheral nerves. Other unfortunate side effects of ACE inhibitors are that they can reduce the moisture in a person’s lungs, and thereby, increase the risk of respiratory infection. They can also cause a non-productive chronic cough. This side effect is quite commonly experienced by a large number of people who have taken Ace Inhibitors. Ace inhibitors have also been known to cause elevated blood potassium levels, a condition referred to as hypokalemia. Potassium is an important electrolyte found both inside and outside of cells. Potassium regulates heart rate and rhythm and also controls both muscle and nerve function. Elevated levels of potassium not only can be life threatening by stopping cardiac function, but also will prevent normal nerve firing. Elevated potassium suppresses the nerve from firing its message. In the beginning this may manifest with typical neuropathy symptoms, however, over time this can result in general paralysis of skeletal muscles.
Several examples of ACE inhibitors are Benazepril (Lotensin), Captopril, Enalapril (Vasotec), Fosinopril, Lisinopril (Prinivil, Zestril), Moexipril (Univasc), Perindopril (Aceon), Quinapril (Accupril), Ramipril (Altace), Trandolapril (Mavik). Take note that 87.4 million scripts are written, per year, for Lisinopril, alone.
Calcium Channel Blockers
Calcium Channel Blockers -CCB’s (also called calcium channel antagonists) are known as the most toxic class of blood pressure medications. They are widely prescribed in the U.S. for conditions such as, hypertension (high blood pressure), heart arrhythmias (irregular heartbeats) and angina (chest pain.) The use of CCB’s has been associated with a large number of deleterious side effects including peripheral neuropathy. Let’s take a look at how this occurs.
We’re familiar with the role calcium plays in healthy teeth and bones but did you know that it is also required
for the healthy function of every cell in the body. It aids in constricting and relaxing blood vessels; it plays a
role in the secretion of hormones, like insulin, for example; and calcium is used for nerve impulse transmission
(moving a signal along nerve pathways) and muscle contractions. For the purpose of this book, we are going to
focus on calcium’s role in nerve transmission.
Cells, such as skeletal muscle and nerve cells, contain calcium channels in their cell membranes. These channels have the ability to open and close, in order to allow for rapid changes in calcium concentrations. For example, a muscle fiber will receive a nerve impulse (signal) that stimulates it to contract. At this occurrence, calcium channels in the cell membrane open to allow a few calcium molecules into the muscle cell. These molecules bind to activator proteins within the cell, releasing a flood of calcium from storage sites inside the cell. The binding of calcium to the protein initiates a series of steps that lead to muscle contraction.
When calcium is not present in sufficient amounts, cellular membranes become irritable, which can lead to neuromuscular spasms that manifest as tremors or muscle cramps.
Now, as you will recall, I promised that I would not attempt to turn you into a neurologist, so this is a very simplified version of how calcium affects nerve cells. I have left out quite a few intermediary steps, but supplied you with the overall ‘meat & potatoes for you get the ‘gist’.
Calcium Channel Blocker medications disrupt the action of these calcium channels. As a result, it will interfere with the flow of calcium and impair nerve function. It is possible for nerves to heal from the damage done to their calcium channels but it can take anywhere from months to years for this to occur.
CCB’s such as Cardizem, Adalat and Procardia lower blood pressure by blocking the entrance of calcium into the arterial wall cells. This causes the vessels to become more relaxed and less constricted. As a result of blocking calcium channels into a cell, over time, the calcium channel will stop functioning, altogether. Initially, symptoms of high blood pressure or chest pain may improve, but later on, these drugs so badly poison the channels that they are known to cause many terrible symptoms, including heart failure, increased risk of cancer and early death. The highly acclaimed ‘Wall Street Journal’ (winter, l996) reported that patients who took calcium channel blockers had 60% increased chance of dying of a heart attack based on a study performed by Bruce Psaty, M.D.
In the Clinical Pharmacy Review, “Calcium is an essential component in a variety of cardiovascular
functions, Susan Ross, M.D. states, “The contractile processes of the heart and smooth muscle, initiation of
action potentials in cardiac conducting cells and the storage and use of energy in the myocardium (heart wall)
are all dependent upon the presence of calcium.” She goes on further to say, “ Therefore, calcium blockers
accomplish the desired effect of lowering high blood pressure by blocking the essential functions of the heart
and blood vessel cells.” What she is articulating is that this is a very ineffective way to lower blood pressure,
not to mention dangerous. Not what we would call a good trade off…you lower your blood pressure only to set
the stage later down the line for other chronic illnesses to take hold due to the calcium disruption that has been
caused by these medications (CCB’s).
This information is nothing new. In the medical community, we have known for a long time that calcium is essential to heart function. The relationship between calcium intake and blood pressure has been investigated extensively over the past two decades. An analysis of 23 large observational studies found a reduction in systolic and diastolic blood pressure when calcium is consumed daily. In these studies, Calcium supplementation ranged from 500-2,000 mg/day, with 1,000-1,500 mg/day being the most common dose. Furthermore, in the DASH (Dietary Approaches to Stop Hypertension) study, 549 people were randomized to one of three diets for eight weeks:
- a control diet that was low in fruit, vegetables, and dairy products;
- a diet rich in fruits (~5 servings/day) and vegetables (~3 servings/day); and
- a combination diet rich in fruits and vegetables as well as low-fat dairy products (~3 servings/day).
The combination diet delivered 800 mg more of calcium per day over the control diet and fruit/vegetable rich diets for a total of about 1,200 mg of calcium/day. Among those participants diagnosed with hypertension, the combination diet reduced systolic blood pressure by 11.4 mm Hg and diastolic pressure by 5.5 mm Hg more than the control diet.
This research indicates that a calcium intake at the recommended level (1,000-1,200 mg/day) may be helpful in preventing and treating moderate hypertension. More information about the DASH diet is available from the National Institutes of Health (NIH).
One can clearly see that blocking the flow of calcium is dangerous since calcium is essential for normal cell life and operation. Without sufficient calcium, you can’t survive. Not only has calcium channel blockers been linked with contributing or creating neuropathies but many previous studies have associated calcium channel blockers with increased heart attacks, increased risk of breast cancer, increased suicide risk, and increased gastrointestinal bleeding. The American Journal of Hypertension published a research article showing a correlation between taking calcium channel blockers and increased risk of cancer. In August, 2000, a report from the “Meeting of the European Society of Cardiology in Amsterdam (Netherlands)” showed that despite lowering blood pressure, calcium channel blockers did not reduce the death rate.
An astounding 57.2 million prescriptions of Norvasc, a popular CCB, was prescribed within one year; and
that’s simply one out of many prescriptions written for a number of CCB’s.
Angiotensin Receptor Blockers
The last class of blood pressure medications is the ARB’s or Angiotensin Receptor Blockers. Angiotensin II receptor blockers inhibit a substance that normally would cause blood vessels to narrow or constrict. As a result of this inhibition, blood vessels relax and widen. This dilation allows the blood to flow through the vessels much easier and in turn, reduces blood pressure. The problem with ARB’s arises from the fact this medication will increase the release of water and sodium into the urine, as well as, acting directly on the hormones that regulate sodium and water balance. Sodium is an electrolyte, which means that it has an electrical charge. Sodium helps control the function of nerves and muscles and it is also important for regulating pressure. Your body needs sodium in certain amounts to function properly. If your sodium levels get too low, you have a condition known as hyponatremia.
Hyponatremia can cause neurological problems and permanent nerve damage. Acute hyponatremia must be treated carefully, as improper treatment can make the nerve damage worse, not better. Sodium levels can
decrease within the body due to medications like ARB’s and diuretics. When your sodium levels in your blood get too low, water travels into your cells to help balance sodium levels. This causes cells to swell, which can result in neuron damage, also known as neuropathy.
ARB’s are prescribed not only to decrease blood pressure but to decrease cardiovascular incidences and
myocardial infarctions (heart attacks), as well. Ironically, it was reported that ARB medications were actually
found to increase the risk of myocardial infarction, according to the research study published in
The Journal of the American Heart Association, “Circulation”,. These medications accounted for $7 billion
dollars’ worth of sales, alone in 2010.
A few of the names of ARB Medications are Advent, Candesartan (Atacand), Eprosartan (Teveten), Irbesartan (Avapro), Losartan (Cozaar), Olmesartan (Benicar), Telmisartan (Micardis) and Valsartan (Diovan).
As alarming as this information may be, I am in no way advocating that a person should abruptly discontinue
their medication. It’s extremely important to realize, for anyone currently taking any of these medications, you
should never abruptly stop taking your blood pressure medication or any medication for that matter.
Discontinuing your medication suddenly may put you at serious health risks and even jeopardize your life.
Any medication must be gradually tapered off, while under your doctor’s supervision.
Cholesterol Medications: What the pharmaceutical companies don’t want you to know…
Cholesterol drugs are the most commonly prescribed types of medication in the United States. In this day and age, cholesterol medications are handed out like candy with blatant disregard for what caused the cholesterol levels to elevate in the first place. In all, more than 255 million prescriptions were dispensed for these drugs in 2010.
The most widely prescribed cholesterol reducing medications are a group of drugs called ‘Statins’. We are all very familiar with them. They are drugs like Advicor, Altoprev, Crestor, Lipitor, Simcor, Vytorin and Zocor. Statin drugs are now prescribed to over 13 million Americans and are responsible for generating over $20 billion dollars in revenue in this country alone. In fact, spending on cholesterol-lowering drugs like statins increased by $160 million in 2010, as reported by the IMS Institute for Healthcare Informatics article named: Use of Medicines in the United States: Review of 2010.
It’s widely published in the research that the same statin drugs that reduce cholesterol can cause peripheral neuropathy—damage to the nerves in your feet, legs, hands and arms. Statin drugs are indeed very good at blocking cholesterol production in the liver. So good, as a matter of fact, that they can cause nerve degeneration or breakdown. As you will recall earlier, nerve cells are surrounded by a protective coating called a myelin sheath. This sheath is made up of protein and fat (cholesterol). When you take a statin drug, otherwise known as a cholesterol inhibiting drug, it can cause a breakdown of the fat in the myelin sheath around the nerve. This breakdown is called demyelination of the nerve, which leads to significant nerve injury.
A researcher from Denmark, David Gaist, M.D., was one of the first to report the link between statin drugs and nerve injury. His study was published in the journal, Neurology, in 2002. His research revealed that people taking statin drugs had a 16:1-fold increased risk of developing neuropathy compared to people not taking statins. Furthermore, people who had taken statins for two or more years had 26.4 times more risk of developing neuropathy. The larger the dose of the drug, the higher the risk. (Neurology 2002; 58;1333-1337.) The study is summarized on the American Academy of Neurology’s website.
Researcher study performed in Fukui Medical University in Fukui Japan revealed that Simvastatin had neurotoxic effects on peripheral nerves, resulting in not only nerve dysfunction but in some cases, nerve death. This type of nerve damage is what’s called direct nerve damage, meaning the drug is directly affecting the nerve, leading to injury and damage and thus leading to polyneuropathy. Let’s also take a look at how statin drugs create indirect damage to the peripheral nerves.
A new study, recently released by the Women’s Health Initiative and published in the Archives of Internal Medicine in 2012, confirms a dangerous statin drug side effect: diabetes. Researchers at Harvard Medical School report women over the age of 45 are much more likely to develop diabetes if they’re taking a statin drug. This information is hardly new to us. There have been several studies in the past years which had reported the same findings: Statin use linked to increased incidence of type II diabetes. Statins have been on the market since the 1980’s but it has taken 20 years for a number of their dangerous side effects to surface, as is typical with most medications. In January 2008, a study was published in the journal Diabetes. This study revealed that statin drugs increased insulin resistancy. Don’t forget…first comes insulin resistancy…next comes diabetes. Later in 2011, findings were published in the Journal of the American Medical Association, revealing that people taking high dose statins were 12% more likely to get diabetes. As all of the evidence was compiling at an astronomical rate, the FDA finally decided to speak out, while still being careful not to offend the pharmaceutical companies.
U.S. Food and Drug Administration (FDA) has issued new labeling guidelines for statin drugs warning users that the medications can cause memory loss, elevated blood sugar levels, and type-2 diabetes, in addition to muscle damage and liver disease. On its website the FDA writes, “The reports about memory loss, forgetfulness and confusion span all statin products and all age groups” and “raised blood sugar levels and the development of Type 2 diabetes have been reported with the use of statins.” More than 20 million Americans are currently taking statin drugs. When looking at the percentages, that equates to approximately 100,000 new cases of diabetes as a result of statin use. As you will recall, diabetes indirectly causes peripheral neuropathy by wreaking havoc with circulation, not to mention the damage that excess glucose in the blood stream causes to neurons.
Still, U.S. doctors have tended to discount these findings, says David Perlmutter, M.D., a neurologist, Fellow of the American College of Nutrition, and director of the Perlmutter Health Center, in Naples, Florida. “These drugs are big money makers, and many doctors turn a blind eye to things they do not want to see,” he says. “These drugs are supposed to be used only after strict diet and lifestyle recommendations have failed, but in this country, the whole message about diet and exercise has been lost and we are paying the price for it. We have medical offices filled with patients with muscle and nerve damage from statin drugs.” And when nerves are damaged, “it can be very challenging to heal the situation,” Dr. Perlmutter says. It can take a year or even longer to see improvement, but it can happen.
Most people have been pounded down by an impending sense of fear or dread by their family doctors if they even consider not taking a cholesterol medication. One well-meaning, albeit ignorant, doctor told one of my patients that she was going to die if she didn’t take her statin drug!
That was literally what this doctor had said. You have been told for decades that if you do not control your cholesterol, chances are high that you will suffer a stroke or heart attack. Because of this, I see people fight to be at the front of the line to receive their statin drugs and consider getting off of them…”Are you insane?!”, is what many would exclaim. In fact, I was treating a nurse for disc problems. She would have bi-annual blood work performed in order to monitor her health levels. She would always supply me with a copy of her blood work. I noticed that her blood work was fantastic, yet she was taking a statin drug, so I asked her why. She replied, “Oh, heart disease is rampant in my family and several years ago my cholesterol was slightly elevated, so my family doctor placed me on it.” Even though I would not have been in agreement with her ever going on any statin drug (based on the current research of all of the damaging effects caused by statins), I, respectfully, asked, “OK, but your lab work for the past year has shown perfect cholesterol levels, so why are you still taking it?”. She confided in me that she had raised this question to her medical doctor, as well, who told her that she needed to stay on as a precautionary measure. He also told her that if she ever were to go off of this medication, given her family history, she would run an extremely high risk of suffering a stroke or heart attack. As you can imagine, there’s no way on this green earth she would even consider going off her statin. Well, after being flabbergasted and disgusted over this doctors ignorance, I began to educate my patient. I provided her with untainted and unbiased research. She was dumbfounded. She asked me, “How come my doctor doesn’t know about this?” What I really wanted to say out of my frustration for these types of closed minded, ill informed doctors is…”Probably because he’s too damn lazy to research it”, but you will be pleased to know…I held my tongue and gave her the politically correct answer. I said, “He’s probably just unaware of the latest research.” Being a nurse of 25 years, she made the decision to wean herself off of her statin drug. She has now been off of them for 2 years and her cholesterol is just fine.
So how could a person even consider discontinuing their statin drugs, even if it is contributing or causing their neuropathy? First you must become accurately informed of the research findings; that is studies that have not been funded by the same pharmaceutical companies that are selling these multibillion dollar profit stream of medications. Let’s begin first by understanding the role cholesterol plays in the body.
Cholesterol is a specialized type of lipid, known as a sterol and is produced in the liver; whereas body fat or dietary fat are from “glyceryl esters”. We won’t delve too deep into this. I don’t want this to turn into an extensive course in physiology for you. The key to remember is that dietary cholesterol is not the same cholesterol as that which is produced in the liver. The cholesterol levels measured on blood work are representative of liver function.
Elevated cholesterol is a symptom of an underlying health problem and nothing more. It is not a disease, in itself. Cholesterol is simply the messenger letting us know there is abnormal or prolonged stress on the liver. It is not the enemy. Research shows that it is a poor predictor for strokes or heart attack. Elevated cholesterol levels predict less than 35 per cent of cardiovascular disease. In fact, research shows us that most heart attack and strokes occur in individuals with normal cholesterol levels.
Did you know that insulin controls the production of fats such as cholesterol and triglycerides. It also controls the packaging of cholesterol and triglycerides into LDL (low-density lipoproteins), VLDL (very low-density lipoproteins), HDL (high-density lipoproteins) and other lipoproteins. The higher your insulin levels, also known as insulin resistancy, the higher your cholesterol production. One very effective way to decrease cholesterol, naturally is by decreasing insulin levels and making your cells more sensitive to insulin. When we consume sugar, processed carbohydrates or alcohol (alcohol is converted to sugar in the body), we produce more insulin hormone.
This, in turn, stimulates more cholesterol and triglycerides to be produced; therefore, people with Type 2 diabetes have elevated fasting insulin (high insulin levels in absence of a meal), as well as, elevated cholesterol. In fact, numerous studies have shown us that elevated fasting insulin is a better predictor of cardiovascular disease than cholesterol. Research has also shown us that the best predictors of increased cardiovascular risk for stroke or heart attack are homocysteine and C-reactive protein (CRP). These are very simple test that can be ordered on your blood work lab panel but seldom are.
Not only is cholesterol not the ‘bad guy’, but it is imperative to good health. There is not one single cell in your body that doesn’t rely upon cholesterol for its healthy membrane structure. Cholesterol is an essential component of cell membranes and plays a critical role in cell communication. Without cholesterol, cell membrane lose their normal function. Cholesterol plays a vital part in both the PNS and CNS and has an essential role in the brain structure and function. Cholesterol is also the foundational material of many essential enzymes, hormones and vitamins, including vitamin D, steroid hormones and the bile acids necessary for digestion. There has even been recent studies showing that cholesterol may have protective properties against cancer.
A 30 year study published in the Journal of the American Medical Association provides evidence that elevated cholesterol in people over the age of 50 does not increase the risk of heart attack.
Cholesterol levels were measured in people that did not have coronary heart disease (CHD) and cancer. The study found that there was no increase in death rate in those with high cholesterol. Research also reveals that elevated cholesterol has protective effects and not harmful on the elderly. A separate study published in the European Heart Journal (1997) found that the risk of cardiac death was the same in groups of people with low
or normal cholesterol levels as those with high cholesterol .
The source of the widespread confusion over whether statin drugs actually help reduce heart attack risk or do more harm comes from the conflicting research. “Most of what we know about statins and their effects (beneficial or otherwise) actually comes directly from the scientific trials themselves, which were funded by, and even coordinated by, the drug companies. The vast majority of these studies were not from long-term, independent, evidence-based observations. As a result, all the information we have received is strongly biased.” (8), as stated by Dr. Peter Dingle, PhD. Dr Dingle is an environmental and nutritional toxicologist and an esteemed Associate Professor in Health and the Environment at Murdoch University.
The major drug companies, as part of marketing scheme, has become quite successful at convincing the public that lower cholesterol levels equal good health. They have been aided by your family doctor, who has unwittingly become the retail arm or dispensary of the pharmaceutical industry. How could your excellent, caring doctor allow this to happen? Most probably, they are not doing their own homework. They are not reading the scientific literature; unbiased research, not funded by the same drug company that is profiting from the sale of the drug it is promoting, all the while convincing both the doctor and the public of the benefits from thaking their drug. They, your doctors, may also be relying upon the pharmaceutical reps to educate them. The goal of these pharmaceutical companies is not your good health; it’s their profits. If everyone were to reclaim their health, the profits on ‘Big Pharma’ would plunge.
Antidepressants- The Epidemic
In this stressful, fast-paced, hectic world, Americans are popping more antidepressants than ever before. These drugs, once only prescribed by psychiatrists, are now being prescribed by family doctors, internal medicine, neurologists and cardiac doctors, to name a few, even in the absence of a mental health diagnosis, to treat normal daily stress, as revealed in one study. The Center for Disease Control (CDC) reported on October 19, 2011 that eleven percent of Americans over the age of twelve take antidepressants. This was based on data in a study compiled by the National Center for Health Statistics. That means that slightly greater than 1 out of 10 people in the United States take antidepressant medication. We have seen an astronomical rise of 400% increased use of antidepressants since the first SSRI (selective serotonin reuptake inhibitor) hit the market in the 1980’s. In fact, Antidepressants like Lexapro, Paxil and Prozac are now the third most widely prescribed group of drugs in the U.S..
So what’s the problem with using antidepressants and how does it relate to neuropathy, you ask? A research study released by the Diabetes Prevention Program Research Group, revealed that continuous antidepressant use was significantly associated with the both an increased risk and cause of developing diabetes. This study found that it wasn’t the depression that caused diabetes but the use of an antidepressant drug that correlated with the outcome of diabetes. Patients without diabetes that suffered from depression but did not use antidepressants did not develop diabetes. This is an astonishing finding, especially in light of the increased use of antidepressant medication by both teens and adults. We discussed in the section on diabetes, how neuropathy is an indirect but potent cause of diabetes. It’s no wonder, in light of this study, that we are seeing ever increasing cases of polyneuropathy develop with people using antidepressants.
Common Tri-cyclic Antidepressants prescribed for neuropathy include: Imipramine (Tofranil), amitriptyline (Elavil), and nortriptyline (Pamelor, Aventyl). Elavil is currently the most commonly prescribed antidepressant medication for peripheral neuropathy. This, by the way, is an off-label use of Elavil.
Another class of antidepressants known as SSRI’s and SNRI’s are commonly prescribed for treating chronic pain. Even though research studies from the Mayo clinic have shown that although these drugs help with some forms of chronic pain, they have minimal results with relieving neuropathic pain. Despite this research there are still quite a few prescriptions written for drugs such as Effexor (venlafaxine) and Cymbalta (duloxetine) –SNRI’s, as well as SSRI drugs such as Paxil (paroxetine) and Prozac (fluoxetine). Studies found that these drugs don’t appear to help relieve pain on their own.
Over-The-Counter (OTC) Pain Killers
Millions of consumers turn to over-the-counter (OTC) pain medications, daily, in order to combat headaches, muscular aches, arthritis, colds and fever. The two most common types of OTC pain relievers used by both adults and children are NSAIDs, (non-steroidal anti-inflammatory drugs), such as aspirin, ibuprofen, naproxen, and Acetominophen, commonly recognized by the brand name, Tylenol. NSAID’s help to reduce inflammation caused by injury or arthritis. They are used to stop muscle aches and pains, headaches and menstrual cramps. They are also used to reduce swelling and stiffness. Acetominophen/Tylenol is used as a general pain reliever and for fever reduction.
OTC pain relievers are amongst the most widely used pain medications. According to a survey from the National Consumers League (NCL) they are used by 175 million Americans, yearly, and are a staple in every medicine cabinet around the country. Fortunately, they are completely safe…or are they? OTC’s can be safe when used sparingly and when label directions are followed closely. Let me ask you, when was the last time you read the label on a bottle of Tylenol or Motrin that you just purchased? If you are like most people, the answer would be that you didn’t. After all, Tylenol and Motrin cannot possibly harm you or else it would not be easily accessible and sold over the counter. Well guess again. The NCL reports that up to 16,500 people die each year from NSAID-related GI bleeding with an additional 107,000 hospitalizations due to NSAID-related complications. The NCL states further, “A third of all consumers take more than the recommended dose of an OTC drug thinking it will increase the drug’s effectiveness. But studies have linked overuse of anti-inflammatories and acetaminophen with kidney and liver problems.” A study published in Archives of Internal Medicine found additional evidence of kidney damage when it discovered that men taking acetaminophen six or seven days a week had a 34% higher risk of hypertension. Those who took NSAIDs six or seven days a week had a 38% higher risk and those who took aspirin six or seven days a week had a 26% higher risk. The cause for alarm with these statistics is that hypertension is often the very first sign of kidney disease and kidney disease has already been linked to the use of all common over-the-counter painkillers.
“Overuse of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aspirin, and naproxen, can cause bleeding ulcers, raise blood pressure, damage the esophagus, and lead to problems with the kidneys,” says Jan Engle, PharmD, a pharmacist at the University of Illinois College of Pharmacy in Chicago and a past president of the American Pharmacists Association. According to the Food and Drug Administration (FDA), acetaminophen can be equally lethal. In fact, overuse of this drug is one of the leading causes of liver failure in the United States, with overdoses resulting in more than 56,000 injuries, 26,000 hospitalizations, and an estimated 458 deaths a year.
Both kidney and liver damage can result in polyneuropathy. A research study done by the Department of Neurology at The Johns Hopkins University School of Medicine found that peripheral neuropathy has a strong association with chronic liver disease. In their study they found that 71% of participants with chronic liver disease were found to have sensorimotor peripheral neuropathy while an additional 48% of the patients had autonomic neuropathy.
‘One aspirin a day will keep the heart-attack away’ is touted by many a doctor and cardiologist. Aspirin is known for its anti-platelet ability. This means that it helps reduce or prevent clotting by decreasing platelet aggregation. In layman’s terms, it keeps the blood thin. However, this comes at a cost and a pretty steep one at that. Aspirin depletes the body of life-saving nutrients. These nutrients include folic acid, iron, potassium, sodium and vitamin C. Depletion of these nutrients and minerals are directly correlated with the development or progression of polyneuropathy as you will see in later chapters. There are much better clinically proven natural alternatives that will give you the same platelet protection but without the risks and side-effects. One such natural alternative is taking vitamin E on a daily basis. Vitamin E not only helps prevent ‘thick’,’sticky’ blood, a problem in cardiovascular disease, but it also offers significant protection against neuropathy and nerve damage.
Symptoms associated with such depletion include: elevated homocysteine (a risk factor for heart disease-oops! What happened to decreasing risk for heart attacks?), headache, depression and suppression of the immune system, to name just a few. Internal bleeding is also a real and present danger, always resulting in anemia.
The side effects of Aspirin are so severe that they can result in death. Each year, a grossly underestimated 7600 deaths and 76,000 hospitalizations occur in the United States from use of Aspirin and other NSAIDS like Motrin, Aleve, and Celebrex. CDC approximates that only 10% of deaths caused by NSAIDS are reported.
Much to my dismay, these drugs are not the only culprits involved in creating peripheral neuropathy. There are many other prescription medications that can cause peripheral nerve damage, thus creating polyneuropathy as a side effect. Even several of the well-known drugs used to treat neuropathic pain have the side effect of creating more nerve damage. Sounds ridiculous but unfortunately it’s very true. I’ve enclosed a list for you.
Medications Known to Cause Neuropathy
The following is a list of medications that have been shown to result in neuropathy as a ‘side effect’
- Neurotin (Gabapentin)
- Phenytoin (Dilantin®)
- Duloxetine hydrochloride
- Allopurinol (zyloprim)
- Amiodarone (Cordarone)
- Amitriptyline (Elavil)
- Metrogl (Metrogel)
- Zyloprin (Allopurinol)
- Levaquin (levofloxacin)
- Ambien (Zolpidem)
- Klonopin (Clonazepam)
- Celexa (Citalopram)
- Cymbalta (Duloxetine)
- Effexor (Venlafaxine)
- Effexor XR
Blood Pressure or Heart Medications:
- Altace, (ramipril)
- Hydrochlorothiazide (HCT)
- Vincristine (Oncovin)
- Carboplatin (Paraplatin)
- Paclitaxel (Taxol),
- Nab-Paclitaxel (Abraxane) Docetaxel (Taxotere)
- Ixabepilone (Ixempra)
- Vinblastine (Velban, Alkaban-Aq),
- Vincasar Pes, (Vincrex), Vinorelbine (Navelbine), Etoposide (Toposar, Vepesid, Etopophos)
- Thalidomide (Thalomid) Lenalidomide (Revlimid)
- Bortezomib (Velcade)
- Eribulin Mesylate (Halaven)
Cholesterol Lowering Drugs:
- Baycol (removed from market d/t death)
- Lescol XL
- Pravigard Pac
Dental Creams: all zinc containing creams including:
- d4T (Zerit)
- ddC (Hivid)
- ddI (Videx EC)
Neuropathy is typically, brought about by the damage caused by toxic effects of many drugs on peripheral nerves. Damage commonly occurs at the axon of the nerves.
A study published by Dr. Louis H. Weimer, M.D. on “Medication-Induced Neuropathies, found, “Numerous medications have been associated with neuropathy, but many more agents (medications) are suspected of causing neurotoxicity, including peripheral neuropathy than have convincing proof. Also, many subclinical or unsuspected cases likely remain undiagnosed”. He further concludes in his research article, “Medication-induced toxicity should be at least considered in new cases of neuropathy including apparent idiopathic forms. Also importantly, patients with existing neuropathy of known or presumed cause should have their current regimen and planned therapy considered for neurotoxicity.” (7)
Prescription medications can not be stopped abruptly. Never discontinue use of a prescribed medication without being instructed to do so by your doctor.