Best Diet for Diabetic Neuropathy

Neuropathy, or damage to the nerves, is a debilitating disorder, and diabetes is by far the most common cause. Up to 50 percent of people with diabetes will eventually develop neuropathy during the course of their disease. It can be “very painful, and the pain is frequently resistant to conventional treatments.” In fact, currently, there is no effective treatment for diabetic neuropathy. Clinicians rely on steroids, opiates, and antidepressants to try to mediate the suffering.

But, as I discuss in my video Curing Painful Diabetic Neuropathy, a remarkable study was published 20 years ago on the regression of diabetic neuropathy with a plant-based diet. There are two types of diabetic neuropathy: a “relatively painless type characterized by numbness, tingling and pins-and-needles sensations” and a second form, which “is painful with burning or aching sensations to the point of excruciating, lancinating [or stabbing] pain.” This study concentrated on the painful type of diabetic neuropathy.

Twenty-one diabetics suffering with moderate or worse symptomatic painful neuropathy for up to ten years were placed on a whole food, plant-based diet along with a half-hour walk every day. Years and years of suffering and then complete relief of the pain in 17 out of the 21 patients within days.

Years and years of suffering and then complete relief of the pain in 17 out of the 21 patients within days.

Numbness noticeably improved, too, and the side effects were all good. They lost ten pounds, blood sugars got better, and insulin needs dropped in half. And, in five of the patients, not only was their painful neuropathy apparently cured, so was their diabetes. Their blood sugars were normal, and they were off all medications. Their triglycerides and cholesterol also improved, as did high blood pressure. In fact, it was gone in about half the hypertensives—an 80 percent drop overall in need for high blood pressure medications within three weeks.

Now, this was a live-in program, where patients’ meals were provided. What happened after they were sent home? The 17 folks were followed for years, and the relief from the painful neuropathy continued or improved even further for all except one person. How did they get that kind of compliance? According to the researchers, “Pain and ill health are strong motivating factors.”

Diabetic neuropathy is one of the most painful and frustrating conditions to treat in all of medicine, and 75 percent of patients were cured within days with a natural, nontoxic, and, in fact, beneficial treatment: a diet composed of whole, plant foods.

How could nerve damage be reversed so suddenly? It wasn’t necessarily the improvement in blood sugar control, since it took about ten days for the diet to control the diabetes, whereas the pain was gone in as few as four days. “There are several mechanisms by which the [‘total vegetarian diet’]…works to alleviate the problem of diabetic neuropathy as well as the diabetic condition itself.” The researchers’ most interesting speculation was that it could be the trans fats naturally found in meat, dairy, and refined vegetable oils that could be causing an inflammatory response. They found a significant percentage of the fat found under the skin of those who ate meat or dairy consisted of trans fats, whereas those on a strictly whole food, plant-based diet had none.

The researchers stuck needles in the buttocks of people eating different diets and found that nine months or more on a strict plant-based diet appeared to remove the trans fat from their bodies (or at least their butts). Their pain, however, didn’t take nine months to get better—it got better in days.

More likely, it was due to an improvement in blood flow. “[N]erve biopsies in diabetics with severe progressive neuropathy…have shown small vessel disease within the nerve.” There are blood vessels within our nerves that can get clogged up too. The oxygen levels in the nerves of diabetics were found to be lower than even the levels of de-oxygenated blood. This lack of oxygen within the nerves may arise from blockages within the blood vessels depriving the nerves of oxygen, presumably leading them to cry out in pain.

Within days, though, improvements in blood “rheology,” or the ease of blood flow, on a plant-based diet may play a prominent role in the reversal of diabetic neuropathy. Plant-based diets may also lower the level of IGF-1 inside the eyeballs of diabetics and decrease the risk of retinopathy (diabetic vision loss) as well. But, “the most efficient way to avoid diabetic complications is to eliminate the diabetes, and this is often feasible for those type 2 patients who make an abiding commitment to daily exercise and low-fat, whole-food vegan diet.” 

Why didn’t we learn about this in medical school? The “neglect of this important work by the broader medical community is little short of unconscionable.”


What about reversing diabetic vision loss? See my video Can Diabetic Retinopathy Be Reversed?.

Did you think trans fats were only in partially hydrogenated junk food? See Trans Fat in Meat and Dairy. Ideally, we’d reduce our intake as low as possible, which I discuss in Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero.

The best way to prevent diabetic complications is to prevent the diabetes in the first place:

And then to reverse it:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

How to Treat Dry Eye Disease Naturally with Diet

One of the most common eye disorders, dry eye disease, causes irritation or discomfort, and can decrease functional vision, sometimes causing a dramatic deterioration in the quality of life. About five million Americans over age 50 suffer from moderate-to-severe dry eyes, and tens of millions more have mild or episodic manifestations of the disease, at a cost of more than $50 billion.

In terms of treatment, there are several drops and drugs that can help. We spend hundreds of millions of dollars on things like artificial tears, but currently there is no therapy available to actually fix the problem. If drugs don’t work, doctors can try plugging up the outflow tear ducts, but that can cause complications, such as plugs migrating and eroding into the face, requiring surgical removal. Alternatively, surgeons can just cauterize or stitch up the ducts in the first place.

There has to be a better way.

What about prevention? Dry eyes can be caused by LASIK surgery, affecting about 20-40% of patients six months after the operation. With a million LASIK procedures performed annually, that’s a lot of people, and sometimes the long-term symptoms can be severe and disabling.

There’s a long list of drugs that can cause it, including antihistamines, decongestants, nearly all the antidepressants, anticonvulsants, antipsychotics, anti-Parkinson’s drugs, beta-blockers, and hormone replacement therapy, as well as a few herbal preparations.

In the developing world, vitamin A deficiency can start out as dry eyes and then progress to becoming the leading cause of preventable childhood blindness. Vitamin A deficiency is almost never seen in the developed world, unless you do it intentionally. There was a report in the 1960s of a guy who deliberately ate a vitamin A-deficient diet, living off of bread and lime juice for five years, and his eyes developed vascularization and ulceration of the cornea, which you can see (if you dare) in my Treating Dry Eye Disease with Diet: Just Add Water? video. That was better than what happened to an unfortunate woman who was the member of a cult and tried to live off of brown rice and herbal tea: Her eyes literally melted and collapsed.

There are also a couple case reports of autistic children who refused to eat anything but French fries or menus exclusively comprised of bacon, blueberry muffins, and Kool-Aid, and became vitamin A deficient. A case in the Bronx was written up as vegan diet and vitamin A deficiency, but it had nothing to do with his vegan diet—the kid refused to eat vegetables, consuming only potato chips, puffed rice cereal with non-fortified soymilk, and juice drinks. “His parents lacked particular skill in overcoming the child’s tendency to avoid fruits and vegetables.”

A plant-based diet may actually be the best thing for patients with dry eye disease, those who wear contact lenses, and those who wish to maximize their tear secretions. People with dry eyes should be advised to lower protein, total fat, and cholesterol intake, and do the following:

  • increase complex carbohydrates;
  • increase vitamin A content (by eating red, orange, yellow, and dark green leafy vegetables);
  • increase zinc and folate intake (by eating whole grains, beans, and raw vegetables, especially spinach);
  • ensure sufficient vitamin B6 and potassium intake (by eating nuts, bananas, and beans);
  • ensure sufficient vitamin C intake (by eating citrus);
  • eliminate alcohol and caffeine;
  • reduce sugar and salt intake; and
  • consume six to eight glasses of water per day.

We know dehydration can cause a dry mouth, but could dehydration cause dry eyes? It may seem kind of obvious, but evidently it was never studied until recently. Is the answer to just drink more water? We know that those suffering from dry eye are comparatively dehydrated, so researchers figured that tear secretion decreases with progressive dehydration just like saliva secretion decreases and gives us a dry mouth. And indeed, as one gets more and more dehydrated, their urine concentrates and so does the tear fluid. But one can reverse that with rehydration, raising the exciting prospect that improving whole-body hydration by getting people to drink more water might bring relief for those with dry eyes. The researchers recommend eight cups of water a day for women and ten cups a day for men.


Find more on the importance of proper hydration in my How Many Glasses of Water Should We Drink a Day?, Does a Drink Of Water Make Children Smarter?, and Can Dehydration Affect Our Mood? videos.

To learn more on other topics related to eye health, check out:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

A Dietary Treatment for Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a chronic, episodic intestinal disorder characterized by abdominal pain and altered bowel habits. It affects 1 in 7 Americans, although most go undiagnosed. IBS can have a substantial impact on well-being and health, but doctors underestimate the impact the disease can have, particularly the pain and discomfort. Using some measures, the health-related quality of life of irritable bowel sufferers can rival that of sufferers of much more serious disorders, such as diabetes, kidney failure, and inflammatory bowel diseases. The first step toward successful treatment is for doctors to acknowledge the condition and not just dismiss the patient as just hysterical or something.

Another reason sufferers often don’t seek medical care may be the lack of effectiveness of the available treatments. There is a huge unmet therapeutic need. Since IBS has no cure, treatment is targeted to alleviate the symptoms. Typical antispasmodic drugs can cause side effects, including dry mouth, dizziness, blurred vision, confusion, and fall risk. New drugs now on the market, like Lubiprostone and Linaclotide, can cost up to $3,000 a year and can cause as side effects many of symptoms we’re trying to treat.

Antidepressants are commonly given but may take weeks or even months to start helping. Prozac or Celexa take 4 to 6 weeks to help, and Paxil can take up to 12 weeks. They also have their own array of side effects, including sexual dysfunction in over 70% of the people who take these drugs.

There’s got to be a better way.

Acupuncture works, but not better than placebo. Placebo acupuncture? That’s where you poke people with a fake needle away from any known acupuncture points. Yet that worked just as well as real acupuncture, showing the power of the placebo effect.

I’ve talked about the ethics of so many doctors who effectively pass off sugar pills as effective drugs, arguing that the ends justify their means. There’s actually a way to harness the placebo effect without lying to patients, though. We tell them it’s a sugar pill. Patients with irritable bowel syndrome were randomized to either get nothing or a prescription medicine bottle of placebo pills with a label clearly marked “placebo pills” “take 2 pills twice daily.” I kid you not.

Lo and behold, it worked! That’s how powerful the placebo effect can be for irritable bowel. They conclude that for some disorders it may be appropriate for clinicians to recommend that patients try an inexpensive and safe placebo. Indeed, sugar pills probably won’t cost $3,000 a year. But is there a safe alternative that actually works?

As you can see in my video, Peppermint Oil for Irritable Bowel Syndrome, nine randomized placebo-controlled studies have indeed found peppermint oil to be a safe and effective treatment for irritable bowel syndrome. A few adverse events were reported, but were mild and transient in nature, such as a peppermint taste, peppermint smell, and a cooling sensation around one’s bottom on the way out. In contrast, in some of the head-to-head peppermint versus drug studies, some of the drug side effects were so unbearable that patients had to drop out of the study. This suggests it might be a reasonable approach for clinicians to treat IBS patients with peppermint oil as a first-line therapy, before trying anything else.

The longest trial only lasted 12 weeks, so we don’t yet know about long-term efficacy. The benefits may last at least a month after stopping, though, perhaps due to lasting changes in our gut flora.

The studies used peppermint oil capsules so researchers could match them with placebo pills. What about peppermint tea? It’s never been tested, but one might assume it wouldn’t be concentrated enough. However, a quarter cup of fresh peppermint leaves has as much peppermint oil as some of the capsule doses used in the studies. One could easily blend it into a smoothie or with frozen berries to make something like my pink juice recipe. You can grow mint right on your window sill.

We doctors need effective treatments that “are cheap, safe, and readily available. This is particularly relevant at the present time as newer and more expensive drugs have either failed to show efficacy or been withdrawn from the market owing to concerns about serious adverse events.” Just like it may be a good idea to only eat foods with ingredients you can pronounce, it may be better to try some mint before novel pharmacological approaches, such the new dual mu-opioid agonist delta-antagonist drug with a name like JNJ-27018966.

I have some other mint videos: Enhancing Athletic Performance With Peppermint and Peppermint Aromatherapy for Nausea. Lemon balm is also in the mint family, so check out Reducing Radiation Damage With Ginger & Lemon Balm and Best Aromatherapy Herb for Alzheimer’s.

You can also sprinkle dried mint on various dishes. See Antioxidants in a Pinch.

What else might work for IBS? See Kiwifruit for Irritable Bowel Syndrome and Cayenne Pepper for Irritable Bowel Syndrome and Chronic Indigestion.

Irritable bowel symptoms can overlap with problems with gluten, so make sure your physician rules out celiac disease. These may be helpful:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: