Chris Kresser: What Causes Neuropathy & How To Treat It (incl B12 Deficiency) | If Elevated Hcy, Suspect B12 Or B9 Folate Deficiency

really glad to have found this super insightful simple compilation of gems that speaks to everything i'm dealing with, so worth sharing..

takeaway (from cited source)

• not a lot of great information out there in the conventional medical world on how to troubleshoot neuropathy
  
• methylmalonic acid MMA is a good marker of active b12.  
• serum methylmalonic acid is not accurate in cases of intestinal bacterial overgrowth and urine is more sensitive
• holotranscobalamin holoTC is a more sensitive marker of active b12
  
• if you see elevated Hcy, suspect b12 and/or b9 folate deficiency 
• if MMA is elevated, then there's not enough active b12
• if pernicious anemia or sibo or low stomach acid, you'll have issues digesting b12, so best to use sublingual form.   jarrow sublingual methycobalamin.  studies show higher dose sublingual b12 are as effective as injections
  
• stage 4 of b12 deficiency is when you see symptoms of neuropathy, anemia, severe fatigue, etc.  
• impaired methylation can cause b12 deficiency or interfere with b12 metabolism
• higher dose sublingual b12 are as effective as injections
  
• make sure you’re eating enough protein
• make sure you’re getting enough exercise, particularly high-intensity exercise and strength training, can be helpful for improving metabolic health.  
• get enough sleep
• manage your stress
• reduce your intake of all of the highly-processed and refined foods

https://www.youtube.com/watch?v=sHOUnFbnJzA

RHR: What Causes Neuropathy—and How To Treat It | Chris Kresser  21m

Chris Kresser, L.Ac
Published on Nov 19, 2014

In this episode of Revolution Health Radio (RHR) we discuss "What Causes Neuropathy—and How To Treat It." There are a number of potential causes of neuropathy. Find out how to address the underlying cause of the problem for the most effective and longest-lasting change. This is an important topic and something that's fairly commonly experienced. There's not a lot of great information out there in the conventional medical world on how to troubleshoot neuropathy if you're experiencing it.

In this episode, we cover:

• Potential Causes of Neuropathy
• Testing for B12 Deficiency
• Four stages of B12 Deficiency
• Five Potential Causes of B12 Deficiency
• Treating B12 Deficiency

READ FULL ARTICLE: http://chriskresser.com/what-causes-n...   

the transcript:  https://chriskresser.com/what-causes-neuropathy-and-how-to-treat-it/

2:30 causes: b12 deficiency is most common, diabetes (usa), toxic exposure, mold toxicity, chronic inflammatory response syndrome, liver/kidney disease, infections ex. lyme disease, sleep apnea (can worsen neuropathy), and rx incl blood pressure meds. 4:30 if it's due to blood sugar, then the ketogenic diet can reverse it.

5:35 if b12 deficiency, 6:20 serum b12 not a reliable biomarker as you may still not have enough 'active' b12 or convert it. use more sensitive markers: methylmalonic acid MMA (urine/serum). 8:40 if MMA is elevated, then there's not enough active b12 to convert it into succinic acid. 8:50 urine more sensitive/concentrated but not good marker if you have kidney disease, and serum MMA test not good in cases of intestinal bacterial overgrowth (which is far more common than kidney disease).

9:50 another biomarker more sensitive is holotranscobalamin holoTC 10:35 stage 1+2 of b12 deficiency is when plasma/cell stores are depleted and TC reduced and only holoTC test will see it. 11:05 in stage 3 characterizes function b12 imbalances involves elevated homocysteine Hcy and urinary/blood MMA. 11:55 if you see elevated Hcy, suspect b12 and/or b9 deficiency. 12:25 stage 4 of b12 deficiency is when you see symptoms of neuropathy, anemia, severe fatigue, etc. most won't end up at clinics until stage 3+4.

13:10 if you run Hcy or MMA test in stage 3 you'll detect it before stage 4 even if all blood work look 'normal'. 13:30 so why not test holoTC since it can detect stage 1+2 deficiency? unfortunately not readily available to SF bay area labs, but for now, we can use MMA and Hcy tests to spot stage 3 b12 deficiency when neuropathy are still reversible.

14:40 causes: pernicious anemia PA (autoimmune) when cells in the stomach can't bind to b12 so that it absorbs in small intestines so you can't absorb b12 orally. 15:30 b12 deficiency is way more common in 83% vegans 68% vegetarians vs 5% omnivores (but omni with PA can have sibo or low stomach acid). glutathione deficit can lower b12 since one of G9's role is to protect b12. 16:30 oxidative stress incl exercise imbalance can deplete glutathione levels. 16:45 impaired methylation can cause b12 deficiency or interfere with b12 metabolism. 17:00  inadequate dietary b12 intake. 17:25 if it i b12 deficiency, adding animal foods good shellfish, organ meats, red meats. 17:50 if supplementing best with active: methylcobalamin best form.

18:00 if pernicious anemia or sibo or low stomach acid, you'll have issues digesting b12, so best to use sublingual form. 18:30 jarrow sublingual methycobalamin. 18:35 there are studies that show higher dose sublingual b12 are as effective as injections, but some patience do better with injections. so if you have serious neuropathy and sublingual high doses aren't working, talk to doctor about injections, but you'll have to ask/press for the active form.

19:25 supportive nutrients incl active forms of b9 methylfolate, trimethylglycine, b6 active: p5p, b2 active: r5p. 19:45 to put the brakes on oxidative stress: antioxidants/vitamins AEC, CoQ10, G9...