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Dr. Fitz - Nerve Health Nerve pain or neuropathy?

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Normal blood sugar. Weaker nerve signals in the feet anyway. That was the pattern in a study of 1,176 adults published l...
10/18/2026

Normal blood sugar. Weaker nerve signals in the feet anyway. That was the pattern in a study of 1,176 adults published last month.

If your feet burn, tingle or go numb and you've been told your blood sugar is fine, this one is for you.

Researchers in western China ran nerve conduction tests, the electrical test of how well a nerve carries a signal, on 1,176 adults from the community, most in their 50s. They sorted people by two things: blood sugar, and metabolic syndrome.

Metabolic syndrome isn't one number. It's five: blood pressure, triglycerides, HDL cholesterol, waist measurement and fasting blood sugar. You meet the definition with any three. Only one of the five is sugar.

The group that caught my attention had metabolic syndrome with a normal fasting blood sugar, averaging around 90 mg/dL. Compared with people who had neither, the nerves running to their feet carried weaker signals on average, and one sensory nerve on the top of the foot conducted more slowly. Their heart-rate variability, a measure of the automatic nerves that steady your heartbeat, was lower too, about as low as in people with high blood sugar alone.

Why that could make sense: the longest nerves in your body depend on tiny blood vessels for fuel and oxygen. Blood pressure and blood fats are thought to act on those vessels too. Sugar isn't the only thing that can strain a long nerve.

What this does NOT show. These are group averages, not a diagnosis for any one person, and the study didn't report how many individuals had neuropathy. It was a single snapshot in time, so it can't say which came first. It drew on one region of China, mostly women, and nobody recorded medications, which can affect some of these readings. And no one tested whether improving blood pressure or triglycerides changes nerve function. A normal blood sugar is still good news. It just may not be the whole story.

I spent years operating on peripheral nerves. "Your sugar is normal" was often where the search for a cause stopped. This study is a reason it shouldn't.

So, a concrete check. Of those five, blood pressure, triglycerides, HDL, waist and fasting blood sugar, how many of your own numbers do you actually know? Give me a number from 0 to 5.

Educational content, not medical advice. New, worsening or one-sided symptoms deserve a proper evaluation, and don't start or change a medication or supplement without your clinician.

10/18/2026

If you've ever wondered whether damaged nerves can grow back, this new study is worth a minute.

Researchers publishing in Nature identified a protein called AhR. After a nerve injury, it seems to keep nerve cells in "survival mode" instead of rebuilding. Think of it as a brake on repair.

In mice, removing AhR early helped nerves regrow further, and recovery came faster. A drug that blocks it also helped in spinal cord injury.

Here's the honest part. This was mice. It was traumatic injury, not diabetic neuropathy. And timing mattered. It is not a treatment, and nothing here changes anyone's care today.

What it does show is that slow nerve repair may be a switch we can study, not just something to wait out.

If you have numbness, tingling, or weakness that's new, getting worse, or only on one side, that deserves a proper medical evaluation now, not a wait for future research.

What would you want to know if this ever reaches human studies?

I put together a free Nerve Health Blueprint on what supports nerve health today. Link in the first comment.

The shoe can't change your nerve. It can change what your foot is protected from. That's the part "grounding shoes for n...
10/17/2026

The shoe can't change your nerve. It can change what your foot is protected from. That's the part "grounding shoes for neuropathy" gets backwards.

If you've seen them advertised, you know the pitch: thin, flexible shoes with conductive threads or plugs that connect you to the earth's electrical charge, sold to calm burning and tingling feet.

Here's the mechanism that matters. When both feet tingle or go numb starting at the toes, the problem is usually the nerve along its whole length, from near the spine all the way down to the foot. Blood sugar, B12, blood flow, alcohol and some medications act on that whole fiber. Nothing touching the bottom of your foot reaches it.

What the sole does decide is what reaches your skin. A foot that feels less can't warn you about a pebble, a seam, hot pavement or a blister starting. That's why standard foot-care advice for reduced feeling runs the other way: protective, well-fitting shoes, no barefoot walking, and a look at your feet every day. A thin, near-barefoot sole leaves more of that job to feeling you may not fully have.

What this does NOT show. I searched the published research and couldn't find a single randomized trial of grounding or earthing footwear for neuropathy symptoms. That isn't proof it does nothing. It means nobody has tested it. It also doesn't show these shoes are harmful, or that anyone's shoes caused their symptoms. No trial has looked in either direction. And comfort and fit are real reasons to like a shoe.

This isn't a push to buy a different shoe, either. I don't sell footwear. The right shoe for a numb foot is a conversation with your clinician or a podiatrist, who can check your feeling and your skin.

I spent years operating on peripheral nerves. The foot problems that worried me most were rarely the ones people could feel. They were the ones they couldn't.

One thing to do tonight: look at the bottoms of both feet, with a mirror if you need one. Do you check your feet every day? Yes or no?

Educational content, not medical advice. A sore, blister or color change on a numb foot deserves prompt attention, and new, worsening or one-sided symptoms deserve a proper evaluation.

10/16/2026

Eight weeks in, and you can't tell if anything is working.

That's the point where the trend usually starts to show. So line up your weekly averages. Is your burning score drifting down? Are your feet waking you up fewer nights? Can you hold a one-foot stand a little longer? (Do it next to your kitchen counter, and skip it if you feel unsteady.)

If the numbers haven't moved, most people add another supplement or another change. I'd ask a different question first.

Has the reason your nerves are struggling actually been addressed?

Blood sugar. Vitamin B12. Too much B6. Alcohol. A medication. A nerve being pinched somewhere along the way.

Take your log to your doctor. A page of numbers starts a much better conversation than "I think it's about the same."

Have you ever tracked your symptoms on paper? What did you notice?

The full video walks through the four numbers to write down before you start and what to look for at 4, 8 and 12 weeks. That, plus my free 5-minute nerve health risk assessment, is in the first comment.

If you have diabetes and tingling feet, there's a good chance you already take a B vitamin for them. Turn the bottle aro...
10/15/2026

If you have diabetes and tingling feet, there's a good chance you already take a B vitamin for them. Turn the bottle around. The B1 line holds a detail most people never check.

B1 is thiamine. In a 2007 study, people with type 1 and type 2 diabetes had about 75% less thiamine in their blood plasma than healthy volunteers. The researchers linked it to the kidneys, which were clearing thiamine 16 to 24 times faster than normal. So the shortfall may be less about what goes in than how fast it leaves.

Why nerves care. When blood sugar runs high, cells pile up glucose byproducts that can do damage. Thiamine is the helper an enzyme called transketolase needs to steer some of them down a safer route. The longest nerves, the ones that reach your feet, tend to show strain first.

Now the form. Most B vitamins use thiamine salts, listed as thiamine HCl or thiamine mononitrate. They dissolve in water and are absorbed through a transporter that tops out. Benfotiamine is a fat-soluble form. In absorption studies, it produced several times higher blood thiamine than thiamine HCl. In a 6-week trial called BENDIP, people with diabetic nerve symptoms took 300 or 600 mg of benfotiamine a day, or placebo. Symptom scores improved more with benfotiamine among people who completed the trial as planned, and more at 600 mg.

What this does NOT show. It doesn't show benfotiamine treats nerve damage. BENDIP lasted 6 weeks, and when everyone who started was counted, the result just missed statistical significance. A second symptom score didn't differ. A 12-month trial raised blood thiamine clearly but found no difference from placebo in nerve measures, so higher blood levels are not proof of nerve benefit. The 2007 study was small, measured blood rather than nerves, and didn't include prediabetes. B1 isn't on routine blood panels, and there's no agreed cutoff for screening. And nothing here replaces blood sugar control.

Full disclosure: benfotiamine is one of the ingredients in NeuroAxis, the nerve formula Dr Fitz Nutrition sells, so I have a financial interest in this topic. This post makes no claim for it.

I spent years operating on peripheral nerves. With diabetes, the cause looked obvious, and that's exactly when the smaller contributors got skipped.

So check now. What does the B1 line on your B vitamin say: thiamine HCl, thiamine mononitrate, benfotiamine, or no B1 at all? Reply with what you see.

Educational content, not medical advice. Don't start, stop or change any medication or supplement without your clinician, and new, worsening or one-sided symptoms deserve a proper evaluation.

10/15/2026

Most people think of a nerve as a wire. It's actually living tissue with its own blood supply, and it uses a lot of energy.

That matters when you ask how inflammation could affect it.

Researchers point to two routes. One runs through the small vessels that feed the nerve. Chronic inflammation is linked to those vessels becoming stiffer and less responsive, which means less oxygen and fuel reaching the far end of the nerve. The other route is the nerve fiber itself and the support cells that wrap around it.

That fits a pattern many of you know well. Symptoms usually start in the toes and work their way up.

Inflammation is one possible piece, not the explanation for everyone. Burning, tingling and numbness have many causes, and new or worsening symptoms deserve a proper evaluation.

When did you first notice it in your toes?

The free 5-minute Nerve Health Risk Assessment and the full video are in the first comment.

You can build my nerve formula yourself. Here's the shopping list.I mean that. Every ingredient and dose in NeuroAxis is...
10/14/2026

You can build my nerve formula yourself. Here's the shopping list.

I mean that. Every ingredient and dose in NeuroAxis is printed on the label, so you don't need me to get it. To match one month, you'd buy 12 separate products:

R-alpha lipoic acid, 600 mg
N-acetylcysteine (NAC), 900 mg
Acetyl-L-carnitine, 600 mg
Benfotiamine, 300 mg
Turmeric extract (95% curcuminoids), 500 mg
CoQ10, 150 mg
Methylcobalamin (B12), 2,000 mcg
Serrapeptase, 40,000 SU
Bromelain, 600 GDU
Vitamin B6, 10 mg
Vitamin D3, 800 IU
BioPerine (black pepper extract), 10 mg

Priced from quality brands at those daily doses, that comes to $150+ a month. Plus 12 bottles to keep stocked, and a counter full of capsules every morning.

Why put them in one formula? I spent years operating on peripheral nerves, and nerve trouble rarely had one moving part. Energy production inside the nerve, antioxidant defenses, B-vitamin cofactors and the tissue around the nerve all play a role. NeuroAxis is built to support several of those at once, with every dose on the label.

NeuroAxis is that same list in 6 tablets a day, and every order includes the 160-page NeuroAxis Protocol ebook (PDF), my full plan for nutrition, lifestyle and how to track your progress. Twelve separate bottles don't come with a plan.
$69.99 a bottle, or $59.99 a month on subscription.
3-bottle, 90-day supply: $179.99 ($60 a bottle).
Free shipping on 2+ bottles in the US, and on 3+ bottles internationally.

What this does not show: price isn't evidence. Most combination studies, including the two I published on this formula, compared a formula with placebo or no supplement, not with its own ingredients taken separately. If you'd rather buy them one by one, that's a legitimate choice. The rest of the plan matters either way: blood sugar, B12 status, movement and sleep.

Disclosure: I formulated NeuroAxis and Dr Fitz Nutrition sells it, so I have a financial interest here.

How many separate supplement bottles are on your counter right now? Give me the number.

Educational content, not medical advice. Check with your physician before starting any supplement, especially if you take prescription medication. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

10/14/2026

If you or someone you love is starting taxane chemotherapy, this trial is worth two minutes.

Researchers had half of 268 patients wear frozen gloves and socks through every infusion. The idea is simple: cold narrows the blood vessels in the hands and feet, so less drug reaches the small nerves there.

The result: 74% of the cooling group developed neuropathy, compared with 84% on usual care. Ten points apart, but not statistically significant.

What caught my attention is that far more patients dropped out of the comparison group. A gap that size can shape a result. The glove group also reported less tingling and numbness in their hands and did better with fine tasks like buttons. Those were secondary findings in a trial no one could be blinded in.

I spent 20 years repairing injured nerves. Frozen gloves are not proven to prevent this. They are worth asking about.

Before the first infusion, ask your oncology team: "How will we check my nerves, and when?"

Has anyone in your family been offered cold gloves or socks during chemo? Yes or no in the comments.

Link in the first comment.

Study: Lendorf et al., Annals of Oncology 2026 (CryoPac trial)

10/13/2026

If you've changed something for your nerves and you're four weeks in, here's the honest answer about what to expect.

Usually, not much. And that's normal.

If anything has moved at four weeks, it tends to be sleep, or how intense the symptoms feel.

The mistake I see most often is judging progress by how your feet feel today. Look at your weekly average instead. Not your best day, not your worst. One bad night doesn't erase a good week.

The four-week check is mostly a safety check. If anything is clearly getting worse, like new weakness or a wound on your foot you didn't feel, don't wait until week 12. See your doctor.

What changed first for you, if anything?

Links to my free guide and the full 8 and 12 week video are in the first comment.

Bacteria in your gut turn part of the protein you eat into a molecule that, in mice, made injured nerves regrow faster. ...
10/13/2026

Bacteria in your gut turn part of the protein you eat into a molecule that, in mice, made injured nerves regrow faster. For twenty years my work was the nerve itself. I never once looked at the gut.

Here's what the study found. Researchers at Imperial College London crushed a leg nerve in mice and measured how fast it grew back. One group was put on intermittent fasting, and their nerves regrew better. The reason surprised them: the fasting changed the gut bacteria, and those bacteria made more of a molecule called indole-3-propionic acid, or IPA, which bacteria build from tryptophan, an amino acid in food.

Then they tested the link directly. When the gut bacteria couldn't make IPA, regrowth slowed. When they gave IPA after the injury, regrowth sped up and the mice recovered feeling faster. The molecule seemed to work through the immune system, by calling in white blood cells that help clear the way for a regrowing nerve.

Why I care about pace: an injured nerve regrows at about an inch a month. For a nerve that has to reach the toes, that's a very long wait. Anything that changes that pace deserves attention.

What this does NOT show. This was mice with a crushed nerve, not people with neuropathy, and a crush injury isn't the slow loss that happens with diabetes or age. It doesn't show that your gut is behind your nerve symptoms, or that changing your diet will speed anything up in a human nerve. It isn't a reason to start fasting either. Fasting isn't safe for everyone, especially if you take insulin or other glucose-lowering medication. And there's no IPA supplement with human nerve data. I find it interesting precisely because I have nothing to sell you here.

What it does show is that nerve repair may not be decided by the nerve alone, and that's a question worth bringing to your next appointment.

Has anyone looking after your nerves ever asked you about your digestion or how you eat? Yes or no?

Educational content, not medical advice. Don't start fasting or change your diet or medication without your clinician, and new, worsening or one-sided symptoms deserve a proper evaluation.

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