124 replies to this topic

[fishinghat]

I will add a check of the NovoRapid and Tresiba insulin as well as the Levothyroxine to see if the liver processes them using the CYP 3A4 enzyme. 

 

I fully agree with your assessment of the statins. If the cholesterol is only slightly high then I wouldn't go on them in your case. Just one high cholesterol meal the day before your blood tests can elevate your levels test results. Always watch your diet the day before your blood tests.

[fishinghat]

Well, some good reports on its use to treat neuropathy BUT bad news on that it is NOT to be used if hypothyroidism is present. It also has an interaction with ssri and snri by increasing serotonin levels which can cause anxiety and even possible serotonin syndrome (a possibly fatal disease). 

 

Acetyl L Carnitine 

 

https://www.webmd.co...tyl-l-carnitine

Under-active thyroid (hypothyroidism): There is some concern that acetyl-L-carnitine might interfere with thyroid hormone. Don't use acetyl-L-carnitine if you have an under-active thyroid.

Acetyl-L-carnitine might decrease how well thyroid hormone works in the body. Taking acetyl-L-carnitine with thyroid hormone might decrease the effectiveness of thyroid hormones.

 

https://pubmed.ncbi....h.gov/15591013/

Effects of carnitine on thyroid hormone action

"we validated the concept that L-carnitine is a peripheral antagonist of thyroid hormone action. In particular, L-carnitine inhibits both triiodothyronine (T3) and thyroxine (T4) entry into the cell nuclei."

 

https://pubmed.ncbi....h.gov/11502782/

Usefulness of L-carnitine, a naturally occurring peripheral antagonist of thyroid hormone action, in iatrogenic hyperthyroidism: a randomized, double-blind, placebo-controlled clinical trial

Studies in a few hyperthyroid patients suggested that L -carnitine is a periferal antagonist of thyroid hormone action at least in some tissues. This conclusion was substantiated by our recent observation that carnitine inhibits thyroid hormone entry into the nucleus of hepatocytes, neurons, and fibroblasts. 

 

https://www.ncbi.nlm...les/PMC6982704/

" On the other hand, it was revealed that Acetyl-l-carnitine in the long term could even increase taxane-induced neuropathy in women undergoing adjuvant breast cancer therapy. "

 

https://pubmed.ncbi....h.gov/31118753/

Acetyl-L-carnitine in painful peripheral neuropathy: a systematic review

Acetyl-L-carnitine (ALC) has shown a neuroprotective effect in patients with peripheral neuropathies of different etiologies. Preclinical studies demonstrated a central anti-nociceptive action, both in neuropathic and nociceptive pain models. Compared to placebo, ALC produced a significant pain reduction equal to 20.2% with respect to baseline. Clinical trials also showed beneficial effects on nerve conduction parameters and nerve fiber regeneration, with a good safety profile.

 

https://pubmed.ncbi....h.gov/28534301/

Effects of acetyl-L-carnitine in diabetic neuropathy and other geriatric disorders

ALC has demonstrated cytoprotective, antioxidant, and antiapoptotic effects in the nervous system. It exerts an analgesic action by reducing the concentration of glutamate in the synapses. It facilitates nerve regeneration and damage repair after primary trauma: its positive effects on metabolism promote the synthesis, fluidity, and functionality of neuronal membranes, increase protein synthesis, and improve the axonal transport of neurofilament proteins and tubulin. It also amplifies nerve growth factor responsiveness, an effect that is believed to enhance overall neurite growth. 

 

https://www.salubrai...for-neuropathy/

Acetyl-L-Carnitine (ALCAR) For Neuropathy: Research & Dosage

Summarizes the recent research on the use of Acetyl-L-Carnitine to treat neuropathy with links to individual research articles.

 

https://pubmed.ncbi....h.gov/17696591/

Acetyl-L-carnitine in neuropathic pain: experimental data

In these models, prophylactic administration of ALC has proven to be effective in preventing the development of neuropathic pain. In addition, ALC is known to produce a strong antinociceptive effect when given after neuropathic pain has been established. ALC can also improve the function of peripheral nerves by increasing nerve conduction velocity, reducing sensory neuronal loss, and promoting nerve regeneration. Analgesia requires repeated administrations of ALC, suggesting that the drug regulates neuroplasticity across the pain neuraxis. 

 

https://www.webmd.co...tyl-l-carnitine

When taken by mouth: Acetyl-L-carnitine is likely safe for most people. It can cause some side effects including stomach upset, nausea, vomiting, dry mouth, headache, and restlessness. It can also cause a "fishy" odor of the urine, breath, and sweat.

 

Underactive thyroid (hypothyroidism): There is some concern that acetyl-L-carnitine might interfere with thyroid hormone. Don't use acetyl-L-carnitine if you have an under-active thyroid.

 

Serotonergic drugs interacts with ACETYL-L-CARNITINE

Acetyl-l-carnitine might increase a brain chemical called serotonin. Some medications also have this effect. Taking acetyl-l-carnitine along with these medications might increase serotonin too much. This might cause serious side effects including heart problems, seizures, and vomiting.

 

Thyroid hormone interacts with ACETYL-L-CARNITINE

Acetyl-L-carnitine might decrease how well thyroid hormone works in the body. Taking acetyl-L-carnitine with thyroid hormone might decrease the effectiveness of thyroid hormones.

 

https://pubmed.ncbi....h.gov/34500063/

Acetyl-L-carnitine (ALC) is an endogenous molecule that plays a role in modulating brain neurotransmitters such as acetylcholine, serotonin and dopamine, and acts on neurotrophic factors such as nerve growth factor (NGF). 

 

Note because it changes serotonin levels in the brain it should not be used with an ssri or snri (like Cymbalta). It may cause serotonin syndrome.

 

https://pubmed.ncbi....h.gov/22549035/

Chronic acetyl-L-carnitine alters brain energy metabolism and increases noradrenaline and serotonin content in healthy mice

ALCAR [Acetyl-L-carnitine' supplementation increased the levels of the neurotransmitters noradrenaline in the HF [hippocampus] and serotonin in cortex.

 

https://pubmed.ncbi....h.gov/26365406/

Opposing effects of ketamine and acetyl L-carnitine on the serotonergic system of zebrafish

 

https://pubmed.ncbi....h.gov/12225698/

"A 7-day administration of ALCAR in rats increased dopamine and serotonin output in the nucleus accumbens shell"

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[fishinghat]

I see no reason to consider the L-Citrulline. I could find no information on any effects on the thyroid or neuropathy and the dose seems fine.

 

L-Citrulline 

 

https://health.cleve...lline-benefits/

Start at the smallest dose to see how your body reacts. Side effects may include:

Bloating.

Cramping.

Diarrhea.

Sweating.

 

L-Citrulline lowers blood pressure.

[fishinghat]

Vitamin D - 4000ui along with vitamin K2 

 

If taking vit D3 you should have your calcium and D3 levels checked every 6 months. Long term use can cause hypercalcemia (too high calcium levels). 

 

https://www.mayoclin...-d/art-20363792

The recommended daily amount of vitamin D is 600 IU for people ages 1 to 70 years,

 

Children age 9 years and older, adults, and pregnant and breastfeeding women who take more than 4,000 IU a day of vitamin D might experience:

Nausea and vomiting

Poor appetite and weight loss

Constipation

Weakness

Confusion and disorientation

Heart rhythm problems

Kidney stones and kidney damage

 

Use vitamin D cautiously if you're taking drugs processed by Cytochrome P-450 3A4 (CYP3A4). It may interfere with the uptake of those medicines.

 

Note -One study found that taking vitamin D with dinner rather than breakfast increased blood levels of vitamin D by about 50%.. Considering you are only borderline deficient I would go to 600 to a 1000 UI perday and in the morning only (That is when your serum vitamin D is the lowest). You could just take 1/4 or your current tablet each AM. 

[fishinghat]

L-Theanine - 400mg

 

Relatively safe but research and member experience shoiw that your body can build up tolerance to it and loose its effectiveness. Most use it at 100 mg two to 4 times a day for 4 or 5 days, two or three days off and repeat. 

I can find no references to any effect on the thyroid or neuropathy.

[jc619]

Again, thanks Fishinghat. Extensive as always and very much appreciated. Sorry I've not been on to say thanks - got stuck on a training thing at work for the last few days. But I'm back now. 

 

I'll take a look at all this over the weekend and try and work out what I'll be taking going forwards. My feet, tingling, etc have actually been better over the last few days, so I'm hopeful some of these supplements are having an effect. Not perfect but much better. So fingers crossed as always. 

 

And... it's now 8 days since my last Duloxetine. No extra side effects from the withdrawal. Still a bit of skin crawling, but that seems to be easing so hopefully that was as much to do with the Duloxetine as it was the neuropathy. Still go tinnitus, but am sleeping like a baby. Looks to be going well, so thanks guys for all the help. 

 

JC619.

[fishinghat]

That is great news JC. Your very welcome for all the info. Not a problem. Still a few more to go.

[fishinghat]

Like all fish oil salmon and other seafood the primary concern is contamination.

 

Krill oil

 

Webmd

Krill oil is similar to fish oil and Omega 3. Krill oil seems to be absorbed a little more than fish oil and in addition it contains astaxanthin (a very effective antioxidant). Krill oil reduces blood clotting. 

 

Side effects might include stomach upset, decreased appetite, heartburn, fishy burps, bloating, diarrhea, and nausea.

Krill oil might lower blood sugar levels. Taking krill oil along with diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely. See the research below...

https://pubmed.ncbi....h.gov/26016867/

https://pubmed.ncbi....h.gov/25315197/

https://pubmed.ncbi....h.gov/34296449/

 

Krill oil has most often been used by adults in doses of 1-4 grams by mouth daily for up to 6 months. 

 

Note - I found no research articles relating to the effect of Krill Oil to either the thyroid or neuropathy.

 

Contamination in Krill Oil

https://pubmed.ncbi....h.gov/32846889/

 We identified a few potential food safety issues regarding high levels of fluoride in Northern krill,

 

https://pubmed.ncbi....h.gov/20006111/

The high total As [Arsenic] concentrations found were comparable with a previous study on mesopelagic organisms, where crustaceans, such as krill and shrimp, were found to contain elevated concentrations of total As 

 

https://pubmed.ncbi....h.gov/20006111/

The As speciation data obtained for the certified reference material MURST-ISS-A2 (Antarctic krill) showed that arsenobetaine, dimethylarsinate, trimethylarsoniopropionate, and oxo-arsenosugars were the major arsenical compounds found in the Antarctic krill sample.

 

https://scholar.goog...007/bf00239849

Antarctic krill Euphausia superba from the Western Antarctic Peninsula contains contained higher values of Cd  (Cadmium) (0.29 mg/kg d.w.), and also other historical measurements have approved this trend.

 

https://royalsociety...098/rsos.221421

Artic Krill absorb and collect microplastics in their bodies.

 

https://www.research...n_in_Krill_Oils

Their research found mercury, cadmium and lead in Krill.

[jc619]

Hey guys, 

 

Thanks again for all your help. I'm on day 9 since my last capsule. Tomorrow is day 10. All going well so far.

 

In summary, for my neuropathy I'm now taking the following doses, some are split through the day:

 

R-Alpha Lipoic Acid - 600mg

Benfotiamine (B1) - 600mg

Folate (B9) - 400mg

Evening Primrose Oil - 1000mg

L-Theanine - 800mg

Vitamin D3 + K2 - 4000ui

 

I've dropped B6, B12, L-Citrulline and Acetyl-L-Carnitine on your advice.

 

And still to consider a few others I hear good things about:

• Krill oil / Omega oil
• Turmeric
• Berberine
• N-acetyl Cysteine  - NAC
• Resveratrol

[fishinghat]

The info on Krill oil is about done. You will see it tomorrow. Doing great JC.

[fishinghat]

Turmeric (Active ingredient - Curcumin )

 

https://www.drugs.co...c.html#warnings

Long-term use of turmeric may cause serious side effects. Stop using this product and call your healthcare provider at once if you have:

 

unusual bruising or bleeding;

any bleeding that will not stop; or

high blood sugar--increased thirst, increased urination, dry mouth, fruity breath odor, headache, blurred vision.

 

Common side effects of turmeric may include:

nausea, upset stomach;

diarrhea; or

dizziness.

 

 

 

https://www.sps.nhs....dverse-effects/

 

General safety considerations

When taken orally, turmeric (Curcuma longa) is usually well tolerated but most studies have been short.

 

In human studies, doses of up to 8000 mg a day of turmeric have been used for eight months without toxic effects. Curcumin doses of up to 8000 mg a day have been used for three months without toxic effects.

Giving curcumin with piperine enhances the absorption of curcumin which may have safety implications.

 

Gastrointestinal

Use caution if taking turmeric and have a gastrointestinal condition.

 

Evidence

Of all the adverse reactions reported to the UK Medicines and Healthcare Products Regulatory Authority (MHRA) for curcuma, the most common (around 16%) were for gastrointestinal effects, including:

diarrhoea

constipation

abdominal distension

flatulence

dyspepsia

nausea

 

Other gastrointestinal effects seen commonly in clinical trials are:

gastroesophageal reflux

vomiting

yellow stool

stomach ache

Often, these common gastrointestinal effects are mild and occur at a similar rate with placebo and turmeric in clinical trials.

 

Liver

Avoid turmeric and curcumin in individuals with bile duct obstruction, cholangitis (bile duct inflammation), liver disease, gallstones, or any biliary disease.

 

Evidence

Turmeric extracts can trigger biliary colic (abdominal pain) in people with gallstones. About 7% of the adverse reactions reported to the MHRA for curcuma were for hepatobiliary disorders or abnormal liver function test results.

 

In people taking turmeric as a medicine, there have been reports of:

 

hepatitis

autoimmune hepatitis (case 1, case 2)

drug-induced liver injury

In four published cases of hepatitis or liver injury, turmeric had been taken for three to ten months before the adverse effects were identified, and liver function returned to normal or was greatly improved within a month of discontinuing the turmeric.

 

Cardiovascular

Turmeric or curcumin-containing preparations may cause heart rate or rhythm disorders.

 

Evidence

Cardiovascular disorders, including rate and rhythm disorders of the heart, account for nearly 7% of the adverse effects that have been reported to the MHRA for curcuma.

 

A person experienced atrioventricular heart block a month after starting to take 1500 to 2250 mg of a multi-ingredient supplement containing turmeric. Their heart rhythm normalised three days after stopping the supplement, but the side effect returned when the supplement was restarted.

The supplement was discontinued and no further heart rhythm disturbances were noted in the six months that followed.

 

Blood

Curcumin may have antiplatelet (blood thinning) effects.

 

Advice for surgical procedures

If taking turmeric orally as a medicine, stop taking it at least two weeks before elective surgical procedures.

 

Skin

Pitting oedema and itching are uncommon with turmeric but have been reported in people who took turmeric orally.

 

Allergic contact dermatitis, contact urticaria and itching have been reported when turmeric was used topically.

 

Other effects

Until more is known, use turmeric and curcumin with caution if you have a hormone-sensitive condition such as breast cancer or endometriosis.

 

Turmeric may have weak oestrogen-like actions.

 

Note - Medical research articles cited are listed in the article.

 

 

diabetes

https://pubmed.ncbi....h.gov/31398884/

Curcumin has different pharmacological and biological effects that have been described by both in vitro and in vivo studies, and include antioxidant, cardio-protective, anti-inflammatory, anti-microbial, nephro-protective, anti-neoplastic, hepato-protective, immunomodulatory, hypoglycaemic and anti-rheumatic effects. In animal models, curcumin extract delays diabetes development, improves β-cell functions, prevents β-cell death, and decreases insulin resistance. The present review focuses on pre-clinical and clinical trials on curcumin supplementation in T2DM and discusses the peculiar mechanisms by which curcumin might ameliorate diabetes management.

 

https://www.ncbi.nlm...les/PMC8126655/

The Effects of Curcumin on Diabetes Mellitus: A Systematic Review

The results showed that curcumin’s anti-diabetic activity might be due to its capacity to suppress oxidative stress and inflammatory process. Also, it significantly reduces fasting blood glucose, glycated hemoglobin, and body mass index. Nanocurcumin is also associated with a significant reduction in triglycerides, VLDL-c, total cholesterol, LDL-c, HDL-c, serum C reactive protein, and plasma malonaldehyde.

 

https://pubmed.ncbi....h.gov/36367124/

Studies on diabetic humans and animals have revealed that curcumin may have positive effects on oxidative stress and inflammation and may reduce fasting blood glucose levels, increase insulin sensitivity/secretion and regulate the lipid profile. Thus, it may prevent and treat diabetes by affecting various molecular targets.

 

https://pubmed.ncbi....h.gov/29624265/

The main cause of blocking the broadly extended pharmacological and clinical investigations of curcumin is its extremely low solubility in water and in organ fluids. This feature consequently limits its systemic bioavailability and makes use of curcumin as a therapeutic remedy (to date) difficult. 

 

https://pubmed.ncbi....h.gov/24348712/

Curcumin and diabetes: a systematic review

Note - Do not take turmeric with alpha-lipoic acid as it also lowers blood sugar.

 

Reduces blood-clotting

 

https://pubmed.ncbi....h.gov/29052850/

We also presented molecular mechanisms associated with the antiplatelet and anticoagulant activities of curcumin 

 

https://pubmed.ncbi....h.gov/22531131/

Therefore, these results suggest that curcumin and BDMC possess antithrombotic activities and daily consumption of the curry spice turmeric might help maintain anticoagulant status.

 

https://pubmed.ncbi....h.gov/30098070/

This review is aimed to summarize available evidence on the antiplatelet activity of curcumin and related molecular mechanisms for this activity.

 

https://pubmed.ncbi....h.gov/21071923/

Curcumin treatment resulted in an increase in fibrinolytic activity and cell migration towards the wound area.

Note - Do not take turmeric with Evening primrose oil as both interfere with blood clotting.

 

Interfers with iron absorption

 

https://pubmed.ncbi....h.gov/30899609/

We report here a possible case of iron deficiency anemia in a human taking turmeric. It binds to ferric iron in the gut and causes iron deficiency in mice.

 

https://pubmed.ncbi....h.gov/33005455/

https://pubmed.ncbi....h.gov/28801864/

https://pubmed.ncbi....h.gov/34681908/

https://pubmed.ncbi....h.gov/33388858/

All of the above research show that turmeric inhibits iron uptake.

 

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[fishinghat]

Turmeric (cont.)

 

Neuropathy

https://pubmed.ncbi....h.gov/30767224/

Combining all the factors together, the plant can be utilized in the treatment of diabetic neuropathy.

 

https://pubmed.ncbi....h.gov/35538560/

curcumin at 150 mg/kg had the best efficacy in increasing protein expression of NGF in sciatic nerves and serum NGF level. Our work demonstrated that curcumin has neuroprotective effects for the treatment of DPN.

 

https://pubmed.ncbi....h.gov/33023197/

This review provides for the first time an overview of curcumin in the treatment of PN. Finally, because PN are associated with numerous pathologies (e.g., cancers, diabetes, addiction, inflammatory disease...), this review is likely to interest a large audience.

 

https://pubmed.ncbi....h.gov/26113793/

Taken together, our findings suggest the favorable effects of curcumin on both functional and structural abnormalities in cisplatin neuropathy. 

 

https://pubmed.ncbi....h.gov/23250879/

Curcumin derivatives promote Schwann cell differentiation and improve neuropathy in R98C CMT1B mice

 

https://pubmed.ncbi....h.gov/20838516/

An overview of curcumin in neurological disorders

 

and many other articles as well.

 

Thyroid

https://pubmed.ncbi....h.gov/26904486/

Turmeric use is associated with reduced goitrogenesis: Thyroid disorder prevalence in Pakistan

 

https://pubmed.ncbi....h.gov/12587721/

Effect of antioxidants (vitamin C, E and turmeric extract) on methimazole induced hypothyroidism in rats

 The data suggest the positive effect of antioxidants on thyroid gland which could be due to direct involvement of antioxidants on thyroid gland.

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Next - Berberine

[jc619]

Thanks Fishinghat, food for thought there...

[fishinghat]

Berberine

 

https://medlineplus....ural/1126.html 

National Library of Medicine

It's been used safely in doses up to 1.5 grams daily for 6 months. Common side effects include diarrhea, constipation, gas, and upset stomach.

 

Cyclosporine (Neoral, Sandimmune) interacts with BERBERINE

Berberine might decrease how quickly the body breaks down cyclosporine. This might increase the effects and side effects of cyclosporine.

 

Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates) interacts with BERBERINE

Some medications are changed and broken down by the liver. Berberine might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

 

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) interacts with BERBERINE

Berberine might slow blood clotting. Taking berberine along with medications that also slow blood clotting might increase the risk of bruising and bleeding.

 

Medications for diabetes (Antidiabetes drugs) interacts with BERBERINE

Berberine might lower blood sugar levels. Taking berberine along with diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely.

 

Medications for high blood pressure (Antihypertensive drugs) interacts with BERBERINE

Berberine might lower blood pressure. Taking berberine along with medications that lower blood pressure might cause blood pressure to go too low. Monitor your blood pressure closely.

 

Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates) interacts with BERBERINE

Some medications are changed and broken down by the liver. Berberine might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

 

Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates) interacts with BERBERINE

Some medications are changed and broken down by the liver. Berberine might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

 

Dextromethorphan (Robitussin DM, others) interacts with BERBERINE

Berberine might decrease how quickly the body breaks down dextromethorphan. This might increase the effects and side effects of dextromethorphan.

 

Note - This website lists the medical research associated with these statements.

 

 

Lowers Blood Sugar

https://pubmed.ncbi....h.gov/30393248/

https://pubmed.ncbi....h.gov/18442638/

https://pubmed.ncbi....h.gov/31545226/

https://pubmed.ncbi....h.gov/33359679/

 

 

Lowers Testosterone

https://pubmed.ncbi....h.gov/35209140/

 

Reduces Blood Pressure

https://pubmed.ncbi....h.gov/28515053/

 

Decreases Hemoglobin

https://pubmed.ncbi....h.gov/18442638/

https://pubmed.ncbi....h.gov/31545226/

 

Thyroid

 

https://pubmed.ncbi....h.gov/26996367/

As far as thyroid profile is concerned, T3 level of berberine chloride (50 mg/kg) treated groups (prophylactic+ treatment) showed a significant rise compared to hypothyroid group. TSH level in prophylactic groups was far higher than the rest of the groups (3.002±0.0192, 1.051±0.0008 against the solvent control, 0.308±0.008). SGOT, SGPT levels were significantly higher with the therapeutic group than that of the normal and hypo-thyroidal group.

 

Neuropathy

 

https://pubmed.ncbi....h.gov/35153744/

Berberine Alleviate Cisplatin-Induced Peripheral Neuropathy by Modulating Inflammation Signal via TRPV1

 

https://pubmed.ncbi....h.gov/31338248/

Berberine Alleviates Paclitaxel-Induced Neuropathy

 

https://pubmed.ncbi....h.gov/29121795/

Berberine Ameliorates Diabetic Neuropathy: TRPV1 Modulation by PKC Pathway

 

https://pubmed.ncbi....h.gov/31360147/

Ameliorative Effect of Berberine on Neonatally Induced Type 2 Diabetic Neuropathy via Modulation of BDNF, IGF-1, PPAR-γ, and AMPK Expressions

 

https://pubmed.ncbi....h.gov/26849937/

Neuroprotective effect of berberine is mediated by MAPK signaling pathway in experimental diabetic neuropathy in rats.

 

https://pubmed.ncbi....h.gov/36054436/

The therapeutic potential of berberine chloride against SARM1-dependent axon degeneration in acrylamide-induced neuropathy

 

https://pubmed.ncbi....h.gov/35121005/

"Given all the findings, it was concluded that BBR (berberine ) exhibits protective qualities in the sciatic nerve and spinal cord induced by BTZ."

 

https://pubmed.ncbi....h.gov/31079200/

Berberine ameliorates diabetic neuropathic pain in a rat model: involvement of oxidative stress, inflammation, and μ-opioid receptors

 

https://pubmed.ncbi....h.gov/23954465/

Berberine, a natural antidiabetes drug, attenuates glucose neurotoxicity and promotes Nrf2-related neurite outgrowth

Reactive oxygen intermediates production and apoptotic damage induced by high glucose are major causes of neuronal damage in diabetic neuropathy. Berberine (BBR), a natural antidiabetes drug with PI3K-activating activity, holds promise for diabetes because of its dual antioxidant and anti-apoptotic activities. Furthermore, BBR markedly enhanced nerve growth factor (NGF) expression and promoted neurite outgrowth in high glucose-treated cells.We are the first to reveal this novel mechanism of BBR as an Nrf2 activator against glucose neurotoxicity, providing another potential therapeutic use of BBR on the treatment of diabetic complications.

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[jc619]

Hey guys, 

 

Thanks for the Berberine info Fishinghat. Some of that does look extremely promising, especially around the increased nerve growth factor! I think I may add this to my supplements. 

 

So by my calculations, I'm now over 10-days since I last took duloxetine. Other than the occasional thing that could be down to withdrawal, things have pretty much gone to plan. A bit of extra anxiety & pain now and again, tinnitus still persists, but no brain-zaps or any of the more extreme things I've read about, nor the need to reach for the emergency capsules.

 

Do you reckon I'm through this now?

 

JC619.

[fishinghat]

I believe so (he says with fingers crossed).

 

Tomorrow info on NAC.

[jc619]

Once again, thanks Fishinghat. Your research has been absloutely brilliant. I think we'll be able to find a really good combination of supplements that will help me out and others with peripheral neuropathy. Already, I feel my pain isn't as bad as it was. 

 

JC619. 

[fishinghat]

Great to hear. Glad to help. I think you will like this review.

 

This is one of my favorite supplements to recommend. It has been widely studied and is one of 3 antioxidants that has been shown to extend life and improve quality of life. It's used by healthcare providers to treat acetaminophen (Tylenol) poisoning. It works by binding the poisonous forms of acetaminophen that are formed in the liver.It is GDA approved for that purpose. It is most commonly taken by mouth in doses of 600-1200 mg daily. Most side effects are noted in doses of 600 mg or more. 

 

https://www.drugs.co...de-effects.html

Potential Side effects

Difficulty with breathing or swallowing

fever

hives or itching

nausea

rash with or without a fever

reddening of the skin, especially around the ears

severe or ongoing vomiting

swelling of the eyes, face, or inside of the nose

unusual tiredness or weakness

Mild nausea

stomach upset

vomiting

 

 

https://www.webmd.co...yl-cysteine-nac

Bleeding disorder. N-acetyl cysteine might slow blood clotting. N-acetyl cysteine might increase the risk of bruising and bleeding in people with bleeding disorders.

Surgery. N-acetyl cysteine might slow blood clotting. This might increase the risk of bleeding during and after surgery. Stop taking N-acetyl cysteine at least 2 weeks before a scheduled surgery.

 

 

 

NAC - N-acetylcysteine - Strong antioxidant.

 

https://www.ncbi.nlm...pubmed/18534556

NAC appears a safe and effective augmentation strategy for depressive symptoms in bipolar disorder.

 

https://www.ncbi.nlm...pubmed/25004186

the study provides only limited support for the role of NAC as a novel adjunctive therapy for MDD. 

 

https://www.ncbi.nlm...pubmed/21719110

These open label data demonstrate a robust decrement in depression scores with NAC treatment

 

https://www.ncbi.nlm...pubmed/22891797

There were no significant between-group differences in recurrence or symptomatic outcomes during the maintenance phase of the trial;

 

https://www.ncbi.nlm...pubmed/27725170

The anxiolytic effects of NAC were comparable to diazepam. 

 

https://www.research...stematic_review

https://www.ncbi.nlm...pubmed/29045497

modulation of Glu transporter expression may restore Glu (Glutamate) homeostasis.

 

https://www.ncbi.nlm...pubmed/24676047

These studies evaluated the role of NAC (N-acetylcysteine) in cocaine dependence (three studies), c******* dependence (two studies), nicotine dependence (two studies), methamphetamine addiction (one study), and pathological gambling (one study). Five of these trials were double-blind, randomized, and placebo-controlled.

The studies analyzed suggest a potential role for NAC in the treatment of addiction, especially of cocaine and c******* dependence. These results are concordant with the hypothesis of the involvement of glutamatergic pathways in the pathophysiology of addiction.

 

https://www.ncbi.nlm...pubmed/27179791

Furthermore, NAC was able to rescue changes in key glutamate receptor proteins related to excitotoxicity in HD, including NMDAR2B. Thus, we have shown that baseline reductions in cysteine underlie glutamatergic dysfunction and depressive-like behavior in HD and these changes can be rescued by treatment with NAC. These findings have implications for the development of new therapeutic approaches for depressive disorders.

 

https://www.scienced...278584613000420

https://www.ncbi.nlm...antidepressants

Interactive effects of N-acetylcysteine and antidepressants

 

https://www.research..._Adjunctive_N_-Acetylcysteine_in_an_Adolescent_with_Selective_Serotonin_Reuptake_Inhibitor-Resistant_Anxiety

Treatment with Adjunctive N -Acetylcysteine in an Adolescent with Selective Serotonin Reuptake Inhibitor-Resistant Anxiety

 

https://www.ncbi.nlm...les/PMC4938103/

The effect of N-acetylcysteine on oxidative serum biomarkers of hemodialysis patients

"The study period was set at 6 months, during which time patients received oral 600 mg of NAC, twice daily before meals. "

"Administration of NAC was correlated with significant changes in haemoglobin levels (p=0.029), a decrease in leukocyte count (p=0.002), in particular, neutrophil percentage (p=0.001) while lymphocytes rose (p=0.008). "

 

In addition, the FDA database states that 1.4% of those taking N-acetycysteine develop leucopenia within a month.

 

Members Comments

 

FH - You know, something you may try is this N-Acetylcysteine at 500 or 600 mg twice a day. I have been impressed with its help (benzo withdrawal). Not a huge improvement but a consistent and noticeable improvement. I notice some relief starting around an hour after taking it and it lasts for about 3 or 4 hours.

 

Freeme - I have been taking milk thistle to detox the liver and zertex. I put benadryl spray on my arms at night. I am taking also x3 NAC which cleanses the liver too. These both will calm down my itchy to nothing. 

 

Dr. xxxxxxx - This may be an issue as the blood parameter changes noted in this study resemble my changes in blood chemistry. I am currently taking 600 mg once daily.

 

FH - The main factor has been the 600 mg of N-acetylcysteine(NAC) I have been using every other day (for benzo withdrawal). On the day I use it I can feel a noticeable improvement of around 50% in my symptoms. I would like to mention to everyone that my symptoms are minimal at this slow a drop rate, not comparable to Cymbalta withdrawal. As soon as I feel stable I will go to taking the NAC daily and then if stable I will drop a little faster again. The main factor has been the 600 mg of N-acetylcysteine(NAC) I have been using every other day. On the day I use it I can feel a noticeable improvement of around 50% in my symptoms. I would like to mention to everyone that my symptoms are minimal at this slow a drop rate, not comparable to Cymbalta withdrawal. As soon as I feel stable I will go to taking the NAC daily and then if stable I will drop a little faster again.

One thing I wanted to point out from the research is that it has a direct effect on Glutamate, the main excitatory neurotransmitter. It modulates its blood concentration. Modulates means that if levels are high it lowers them and if levels of glutamate are low it raises them. So essentially the glutamate levels are keep in a relatively stable middle of the road concentration. This is important because glutamate control GABA production. GABA is the main calming neurotransmitter that does the primary blocking of synapses when not in use. So by stabilizing the glutamate production you also stabilize the GABA production.

 

DThiessen - forgot to mention I am also taking NAC OTC 600mg daily. Really seems to help with basically every withdrawal symptom. 

 

Mxpro - I've been taking nac for a few days and it seems to really be helping. I swear it's helping me to ruminate less and my mood seems better.

 

https://www.research...stematic_review

https://www.scienced...278584613000420

https://www.research...sistant_Anxiety

 

-----------------------------------------------------------------------------------------------------------------

Reverse/minimize DNA damage from sun and radioactive imaging as well as extending life span

 

DNA damage is important. We have often discussed the gene mutations that are associated with anxiety/depression but you may not have been born with those mutations. They may have developed due to the agingf process, sun exposure, radiation, etc. Being able to reverse some of that damage is a great asset. 

 

600-1200 mg N-Acetyl Cysteine per day or 500 mg of Vitamin C per day. Shown to reverse significant damage done by aging and radioactive imaging/sun and slow the aging process.

 

Nicotinamide mononucleotide is an effective anti-aging intervention that could be translated to humans, recommended dose 100 to 200 mg/day. 

 

Astaxanthin at 12 to 18 mg/day significantly reduces DNA damage from radiation/sun and is anti-aging.

 

Coenzyme q10, while not helping with DNA damage it does have anti-aging effects. 

 

Quercetin has anti-aging effects and also improves BDNF levels but it does not show signs of repairing DNA. 

 

L-Theanine slows the aging process and increases BDNF.

 

https://www.ncbi.nlm...les/PMC4328591/

Full article

 

--------------------------------------------------------------------------------------------

Neuropathy

 

https://pubmed.ncbi....h.gov/16214382/

Role of oxidative stress in pathophysiology of peripheral neuropathy and modulation by N-acetyl-L-cysteine in rats

This study identifies antioxidants superoxide dismutase and reduced glutathione, and oxidative stress as important determinants of neuropathological and behavioural consequences of CCI-induced neuropathy, and NAC may be a potential candidate for alleviation of neuropathic pain.

 

https://pubmed.ncbi....h.gov/19840221/

N-acetylcysteine inhibits hyperglycemia-induced oxidative stress and apoptosis markers in diabetic neuropathy

 

https://pubmed.ncbi....h.gov/32009537/

N-Acetylcysteine causes analgesia in a mouse model of painful diabetic neuropathy

 

https://pubmed.ncbi....h.gov/35799894/

The nociceptive behavior was reversed, respectively, by AMD3100 at the early phase and by the antioxidant N-acetyl-L-cysteine (NAC) at the late phase. 

 

https://pubmed.ncbi....eine neuropathy

Myelinated fibre regeneration distance, determined electrophysiologically, was reduced by 12.2% with diabetes; this was prevented by N-acetyl-L-cysteine treatment. Thus, the data stress the importance of free radical-mediated changes in the aetiology of experimental diabetic neuropathy.

 

https://pubmed.ncbi....h.gov/31751619/

N-acetylcysteine (NAC) alleviates the peripheral neuropathy associated with liver cirrhosis via modulation of neural MEG3/PAR2/ NF-ҡB axis

 

https://pubmed.ncbi....h.gov/31819599/

https://pubmed.ncbi....h.gov/21824100/

https://pubmed.ncbi....h.gov/24687190/

https://pubmed.ncbi....h.gov/25317247/

https://pubmed.ncbi....h.gov/32601973/

The reserch listed above as well as many more atricles note the benefits of NAC on neuropathy.

[fishinghat]

NovoRapid and Tresiba insulin are both eliminated by the kidneys and are not effected by liver enzymes.

 

Levothyroxine is slowly degraded by the body into its metabolites and unused metabolites are usually discharged in the feces. They are not affected by the CYP 3A4 enzyme. 

 

The only supplement left for me to check will be Resveratrol and I should have it done tomorrow.

[jc619]

That's awesome, thanks Fishinghat. I'll put NAC on my list. 

[fishinghat]

Resveratrol 

 

https://www.webmd.co...307/resveratrol

Side effects

Resveratrol supplements are possibly safe when taken by mouth in doses up to 1500 mg daily for up to 3 months. Higher doses of up to 2000-3000 mg daily have been used safely for 2-6 months. But these higher doses are more likely to cause stomach upset.

 

Bleeding disorders: Resveratrol might slow blood clotting and increase the risk of bleeding in people with bleeding disorders.

 

Surgery: Resveratrol might increase the risk of bleeding during and after surgery. Stop using resveratrol at least 2 weeks before a scheduled surgery.

 

Medications changed by the liver (CYP3A4. CYP1A1. CYP1A2. CYP1B1. CYP2C19 and CYP2E1 substrates) interacts with RESVERATROL.

 

https://www.ncbi.nlm...es/PMC7139620/ 

Potential Adverse Effects of Resveratrol: A Literature Review

 Indeed, toxicity and adverse effects were reported following consumption of RE; therefore, extensive future studies on the long-term effects, as well as the in vivo adverse effects, of RE supplementation in humans are needed. Furthermore, data on the interactions of RE when combined with other therapies are still lacking, as well as results related to its absorption and bioavailability in the human body. In this review, we collect and summarize the available literature about RE toxicity and side effects. In this process, we analyze in vitro and in vivo studies that have addressed this stilbenoid. These studies suggest that RE still has an unexplored side.

 

Note - See document for detailed list of possible side effects.

RE Metabolites Can Exhibit Cytotoxic Effects

Resveratrol Cytotoxic Mechanisms Can Induce DNA Breaks

Resveratrol Cytotoxic Mechanisms Can Induce Oxidative Stress

Resveratrol Suppresses the Expression and Activity of COX-1 and COX-2

Resveratrol Interacts with and Attenuates the Action of Other Drugs

Resveratrol Alters the Redox State of Endothelial Human Cells

Resveratrol Chemotherapeutic Doses Are Cytotoxic to Normal Healthy Cells

Resveratrol-Associated Toxicity in Rodents

Resveratrol Can Lead to Hypersensitivity and Alteration of Human Cytokine, Blood, and Liver Parameters

Resveratrol Can Increase DNA Damage and Proteolysis [Breakdown of proteins]

 

Thyroid

 

https://pubmed.ncbi....h.gov/28668442/

Resveratrol has anti-thyroid effects both in vitro and in vivo

 

 No clinical signs of hypothyroidism were seen, although the treated rats showed significant increase in thyroid size. Serum TSH and thyroid hormone levels were in the normal range, with significantly higher TSH seen in resveratrol-treated rats, compared with control rats. Histological and immunohistochemical analyses confirmed increased proliferative activity in the thyroid from resveratrol-treated rats. These data suggest that resveratrol acts as a thyroid disruptor and a goitrogen, which indicates the need for caution as a supplement and for therapeutic uses.

 

https://pubmed.ncbi....h.gov/21946130/

Resveratrol and its impact on aging and thyroid function

Finally, resveratrol also influences thyroid function by enhancing iodide trapping and, by increasing TSH secretion via activation of sirtuins and the phosphatidylinositol- 4-phosphate 5 kinase γ (PIP5Kγ) pathway, positively affects metabolism.

 

https://pubmed.ncbi....h.gov/25251397/

Resveratrol inhibits sodium/iodide symporter gene expression and function in rat thyroid cells

Furthermore, resveratrol decreased cellular iodide uptake after 48 h of treatment. The inhibitory effect of resveratrol on iodide uptake was confirmed in vivo in Sprague-Dawley rats. This study demonstrates that with longer-term treatment, resveratrol is an inhibitor of sodium/iodide symporter gene expression and function in the thyroid. These data suggest that resveratrol can act as a thyroid disruptor, which indicates the need for caution as a supplement and in therapeutic use.

 

Neuropathy

 

https://pubmed.ncbi....h.gov/31982401/

Attenuation of diabetic retinopathy and neuropathy by resveratrol: Review on its molecular mechanisms of action

 

https://pubmed.ncbi....h.gov/24206125/

Neuroprotection by resveratrol in diabetic neuropathy: concepts & mechanisms

 

https://pubmed.ncbi....h.gov/33770763/

Anti-inflammatory effect of resveratrol attenuates the severity of diabetic neuropathy by activating the Nrf2 pathway

 

https://pubmed.ncbi....h.gov/31090224/

Resveratrol alleviates nuclear factor-κB-mediated neuroinflammation in vasculitic peripheral neuropathy induced by ischaemia-reperfusion via suppressing endoplasmic reticulum stress

 

https://pubmed.ncbi....h.gov/30988737/

The combined effect of mesenchymal stem cells and resveratrol on type 1 diabetic neuropathy

Following the administration of therapy, the levels of blood glucose and C-peptide in mice in the MSCs + RSV group were significantly improved when compared with the other diabetic groups, and the dosage of insulin therapy required was the lowest among the six experimental groups (P<0.05). 

 

https://pubmed.ncbi....h.gov/20211601/

NF-kappaB inhibitory action of resveratrol: a probable mechanism of neuroprotection in experimental diabetic neuropathy

Resveratrol treatment produced significant decrease in nerve MDA levels in treated animals which may also be contributing to reduction in neuro-inflammation. This study confirms the NF-kappaB inhibitory activity and anti-inflammatory activity of resveratrol which may contribute to neuroprotection in diabetic neuropathy apart from its antioxidant effect.

 

Note - There are many more articles on the benefit of resveratrol on neuropathy.

 

Diabetes

 

https://www.clinical...l&referrer=null

It is recently gaining scientific interest for RES in controlling blood sugar and fighting against diabetes and its complications properties in various types of diabetic models. These beneficial effects seem to be due to the multiple actions of RES on cellular functions, which make RES become a promising molecule for the treatment of diabetes and diabetic complications. Here, we review the mechanism of action and potential therapeutic use of RES in prevention and mitigation of these diseases in recent ten years to provide a reference for further research and development of RES.

 

https://www.ncbi.nlm...les/PMC6984411/

Resveratrol for adults with type 2 diabetes mellitus

Oral resveratrol not combined with other plant polyphenols was administered at 10 mg, 150 mg, or 1000 mg daily for a period ranging from four weeks to five weeks. Due to the short follow‐up period, HbA1c results have to be interpreted cautiously. Similarly, resveratrol versus placebo showed neutral effects for fasting blood glucose levels (MD 2 mg/dL, 95% CI ‐2 to 7; P = 0.29; 2 studies; 31 participants), and resveratrol versus placebo showed neutral effects for insulin resistance (MD ‐0.35, 95% CI ‐0.99 to 0.28; P = 0.27; 2 studies; 36 participants).

 

https://pubmed.ncbi....h.gov/25445538/

Anti-diabetic action of resveratrol has been extensively studied in animal models and in diabetic humans. In animals with experimental diabetes, resveratrol has been demonstrated to induce beneficial effects that ameliorate diabetes. Resveratrol, among others, improves glucose homeostasis, decreases insulin resistance, protects pancreatic β-cells, improves insulin secretion and ameliorates metabolic disorders. 

 

https://pubmed.ncbi....h.gov/31486447/

Four-week supplementation of resveratrol in patients with T2DM and CHD had beneficial effects on glycemic control, HDL-cholesterol levels, the total-/HDL-cholesterol ratio, TAC and MDA levels.

 

https://pubmed.ncbi....h.gov/35240291/

Role of resveratrol supplementation in regulation of glucose hemostasis, inflammation and oxidative stress in patients with diabetes mellitus type 2: A randomized, placebo-controlled trial

Resveratrol supplementation contributes in improvement of glycemic control by reducing insulin resistance. It has significant beneficial impact on chronic inflammation, oxidative stress and associated microRNA expression in diabetic patients. Thus, supplementation of resveratrol along with oral hypoglycemic agents may be useful in the reduction of diabetic associated complications.

 

https://pubmed.ncbi....h.gov/33480264/

We conducted a meta-analysis to evaluate the effects of resveratrol supplementation on fasting blood glucose, insulin resistance, and glycated hemoglobin. Thirty studies were included in the review. Almost 60% demonstrated at least one significant effect of the resveratrol supplementation related to diabetes. In the meta-analysis, there was a significant effect on the reduction of insulin resistance [SMD: -0.34; CI 95%: -0.64, -0.04; p = 0.01; I2 = 70%] and glycated hemoglobin [SMD: -0.64; CI 95%: -1.22, -0.07; p = 0.01; I2 = 90%]. For fasting blood glucose, the results were significant only for individuals with diabetes [SMD: -0.85; CI 95%: -1.49, -0.21; p = 0.01; I2 = 90%]. This systematic review with meta-analysis demonstrated that resveratrol supplementation has protective effects on diabetes parameters.

 

and more articles too numerous to mention.

[fishinghat]

Let me know if there are any more issues you wanted to be checked out.

 

I will also be posting a small list of comments shortly with some suggestions.

[jc619]

Thanks Fishinghat. Amazing as always. I really can't thank you enough.

 

I'm tryin to make a plan myself, it will be good to hear what you would do. 

 

JC

[fishinghat]

These are some things you need to carefully consider when making decisions on supplements. 

 

1) All supplements (as well as prescription meds) have potential side effects even if it is just an upset stomach. Consider using what is called the teacup/teaspoon method when starting and supplements or meds. Basically, what my drs have had me do is start with a 10 to 20% dose for 3 or 4 days, go to a 50% dose for 3 or 4 days, then 75% dose for 3 to 4 days and then if no issues go to a full dose. This has helped my wife and I avoid many severe reactions in the past. If you develop any side effects at a low dose it will be much less distressful and recovery will be quicker.

 

2) Supplements that slow bleeding is a serious risk to take. Ask any paramedic, emergency room doctor or surgeon and they will tell you that taking a supplement that reduces your ability to clot and stop bleeding is taking a big risk. There are two main time this typically occurs.:

 

      a) An accident (automobile, falls, etc...) can cause a major wound that would normally clott over and slow bleeding, especially              if pressure is applied often becomes life threatening if a person is on a supplement that reduces clotting. Instead of the blood clotting it continues to bleed until the person bleeds out.

 

      Secondly any emergency surgery that would normally be considered routine now becomes a serious threat to your life.                    Bleeding during surgery will be a lot more difficult to control and risk will be more pronounced. 

 

          Supplements you are considering that effect clotting include;

          Turmeric (Active ingredient - Curcumin )

          Berberine

          Resveratrol 

          Evening Primrose Oil

          Krill oil

 

3) Most long-term effects of supplements have not been studied.

 

4) Many companies that produce supplements do not do quality analysis. Try to find suppliers that will provide independent third party testing of their products. This especially applies to krill oil.

 

5) Many supplements interfere with the liver CYP enzymes and drastically effect how much of a medication may be absorbed. It is fairly common that supplements will cause absorption of meds to drastically increase or decrease. The data on which CYP is involved with a specific prescription med is easily found in the drug inserts BUT the data on the effects of supplements on the CYP meds is not required to be determined or even published and involves a detailed search of medical research journals. 

 

6) If you decide to take the Vitamin D - 4000ui please consider getting a blood vitamin D analysis every 6 months. Vitamin D toxicity is a fairly common thing these days due to high dose supplements.

 

7) Caution - Do not rely too heavily on research involving lab animals., especially in the case of diabetes. Many animals do not have the same biological mechanisms in controlling body functions, especially sugar.

 

I hope you have success in the control of your various medical conditions. If there is anything else I can help with let me know. 

[jc619]

Hi guys,

 

I think I owe you all an update. 3 weeks off duloxetine now. Other than foot pain, everything seems pretty good. Thanks again! For anyone using the forum, you couldn't be in better hands. Fishinghat and IUN have given me amazing advice that allowed me to stop using Duloxetine in a safe manner. Going cold turkey in the early days, even though I hadn't been on the for very long, really wasn't pleasant. I'm not sure what I'd have done without them during what has been a pretty worrying time.

 

A few days ago I had a bit of a recurrence of not being able to go to the loo, but it was fine the next morning. It did freak me though. When folks come off duloxetine do they often get patchy withrawal symptoms like that? I'm also hoping the pain is 'bounce-back' to an extent and will settle down. 

 

I'm currently putting a plan together which involves a mixture of nerve-protecting/regenerating supplements (some of which anecdotely also help with pain), and some stretches and nerve glides that will hopefully help to take the pressure off my feet. I'm also trying red-light therapy as it's non-invasive and some are seeing positive results. I'm trying not to over-do the supplements, but the list is quite long. With your advice I've managed to rationalise it down to about 10, but most are uncontentious. In some cases, I have opted to take a half-dose of some, so I don't accidentally overload my system with the wrong things, cause clotting issues, etc. It's not going to be a quick process at all, so in my darkest hours I do wonder if I'm desperately wasting my time though. I saw a podiatrist last week, and she said that in her opinion what I'm going through isn't related to my diabetes, it's likely a problem in my back. Different diabetic nurses have also said they're surprised if it is indeed Diabetes-related, so fingers crossed - I seem to be saying that a lot lately! It's just my doctors who don't seem open-minded to other causes.

 

Again, it just amazes and annoys me that my doctors have taken a route-1 diagnosis and threw some harsh tablets at me and pretty much told me to get used to it without further investigation. I have convinced them to send me for a electric nerve conductivity test this week, which will hopefully shed some light. In the meantine I figure if supplements could potentially afford me a little nerve protection and prevent permanent damage then I'll try that.

 

Another quick question as I continue my quest for neuropathy relief, and can concentrate a bit more on this as duloxetine disapears nto my rear-view mirror. Vitamin E seems important for nerve function. Do you think I should add that to my supplements?

 

Thanks in advance,

 

JC619.

[fishinghat]

Thank you very much for the kind words JC. I am glad I could help even if in a small way. So many others have helped me on this site I am glad to pass the help on anytime I can. You should be proud of yourself as well. You have really stepped up and done your research and asked the right questions of your drs, 

 

Periodic episodes of withdrawal symptoms is standard. They will slowly subside with time. In addition the rebound pain should subside some over the next few weeks as well. You may still have some residual pain in the long-run but it should be similar to your pain before you started Cymbalta.

 

I am glad you are going slow and wisely with the supplements. When I have a medical issue and try and evaluate what supplements to use I start with one at a time and try it for several months. If it doesn't help it goes in the trash and I try the next one on the list. The problem with that is it requires a lot of patience (which I have little of. lol). It does keep me from wasting a lot of money on supplements though. 

 

The back issue the one dr speculated about is something to consider. With it being your feet that are hurting then the issue would have yo be in the lumbar area as that is where the nerves to the feet originate.  An MRI could answer that question and maybe save you a lot of issues with trying supplements that may not even help. 

 

Vitamin E - Slows blood clotting, high doses linked to prostate cancer, interferes with cyp3A4 and interferes with vitamin K absorption.   

[jc619]

Hi everyone,

 

I wanted to provide an update as I've been off Duloxetine for around 6 weeks now, after fantastic advice from Fishinghat and IUN. I'm currently free of pretty much all withdrawal symptoms other than a bit of nerve pain now and again (more on that later), and still have tinnitus. Hopefully that will go away.

 

Also an update on my original condition that bought me here. You may remember I was told out-right that I had diabetic peripheral neuropathy, which is why duloxetine was given to me. Accept it, go home and take these tablets was the advice. I continued to push doctors on this, but they were insistant, refusing any further investigation, that diabetes was the cause. I eventually manged to convince my doctors to send me for a nerve conductivity test, but when the results came in they still insisted diabetic neuropathy and wouldn't refer me on or investigate further. Go home and take tablets was still their advice. 

 

This morning I've seen an amazing Neurologist Consultant privately. She's an expert in her field. After a much more thorough examination she's concluded that my pain isn't anything to do with diabetes. Instead she believes a Covid infection I had before Xmas '22 has lead to an inflammatory response that is causing my nerve pain. The good news is that there is a chance this may clear, maybe even on it's own. I'm being sent for more tests, and potentially I'll need immunoglobulin treatment, although for now none is needed as symptoms don't seem to be getting worse. 

 

My efforts now are to look at all things anti-inflammatory to aid my potential recovery. I'm still taking my handful of supplements - as it happens many of those supplements have antioxident and antiinflammatory properties - maybe that has helped me so far!

 

For anyone out there, hang on in there, you can do it. The support you'll receive here is invaluable and life-changing - thanks guys! Keep hope that even when things seem desperate, the bad times can and will pass.

 

JC619

[fishinghat]

Ahhh, the "wars" associated with modern medicine. Drs do many beneficial things and we would be in bad shape without them... BUT they just go with standard medicine and many don't consider anything else as a possibility. If a dr won't work with me then I will, and have, fired them and went on to another dr. I have had to do that many times for sure. 

 

I know that many of the long-covid symptoms seem to slowly resolve over a 6 to 12 month period. many of my family members and people i know have had associated long-covid symptoms and that pattern normally holds. I would really like to thank you for the update and please continue to keep us posted.

[invalidusername]

How I wish I was living in the US!!! Here in the UK, we can't "fire" a doctor - we are stuck with what we can get - or we don't get one at all.

 

I haven't seen my doctor in months... simply because he knows the square root of sh!t about what he should do.

 

Hat has said exactly what I would say... long-covid. I too know a number of people that have suffered the same thing with very similar symptoms. It is such a nasty situation and I don't like to get caught up in the covid debate as it has sparked so much animosity all over the globe. But I remain in my position that I have never been "jabbed" and I have never contracted covid. Think of that what you will. Most people I know who have had covid have had the jabs. But I will not open this can of worms. Much as is often the case, there are arguments for and against. It is up to the individual to decide on their own.

 

I am so glad that you managed to get an appointment with such a good expert in your field. I really hope that things will sort out for you in due course.

 

Again, as Hat said, please keep us posted....

 

IUN

[jc619]

Cheers guys - great to be back in touch. 

 

I must admit I've been very frustrated by my doctors. I had to go full on 'House MD' to do my own research and push for an answer. It always seemed very coincidental that my neuropathy pain began after an infection and while I had developed a bad back. These things apparently could all be related, as I first thought. And never made sense this is diabetes related - I'm well controlled, moderately young(ish!) and have always been healthy. I'm strangely proud that the Consultant came to the same conclusions as me.

 

I initially thought the infection in December wasn't Covid - but I may have tested too soon. I've since done a test to see if I've had a Covid infection in the last 6 months, so I assume that is it. I caught Covid before, in May 2020, a very mild infection that caused a year's worth of long-covid with breathing difficulties. So it looks like I'm prone to an exaggerated inflammatory/immune response. I also have type 1 diabetes and hypo-thyroidism, again auto-immune conditions. 

 

So be it long-covid, or just a post-viral response, the issue looks to be inflammatory. 

 

My plan now is to try and find the best anti-inflammatory supplements, alongside an anti-inflammatory diet. Fishinghat, your help last time was amazing. I don't suppose you're aware of the best anti-inflammatory supplements off the top of your head are you?

 

JC619