When we think about neuropathy, we often think of diabetes or compression neuropathy. Rarely do we consider that high iron is the most common cause of peripheral neuropathy. Iron in the form of iron filings (that's right! iron filings that will collect on a magnet!) is added to many grocery store foods in the form of "enriched" flour. This isn't limited to wheat flour, but is also added to many packaged foods made from grains. Cereals are a good example.
When the NHANES study was done 1976 - 1980, the average serum ferritin for men was under 100 nanograms per milliliter; now the median is over 200 ng/ml. When our mitochondria produce ATP in the oxidative phosphorylation electron chain transport, oxygen is converted to ATP and metabolic water. In the presence of high iron, however, the Fenton reaction will drive production of the superoxide ion and the hydroxyl free radicals. These will decimate your mitochondrial DNA and cell membranes and your peripheral neurons. When the membranes in your nervous system are damaged they signal that with intense burning.
We can assess iron status with serum ferritin and with the Gamma Glutamyl Transferase test. Serum ferritin will assess our iron stores and the GGT test is a surrogate marker for free iron. For adult men and non-menstruating females, the serum ferritin should be between 20 - 80 ng/ml. Ideal is 40 - 60 ng/ml. GGT range for women is 40 - 45 Units per liter; ideal is 9 U/L. GGT range for men is 65 - 70 U/L; ideal is 16 U/L. Women with GGT > 30 U/L have a higher risk of all cancers and autoimmune diseases.
Other than menstruation and acute or chronic blood loss, we have no way of reducing the toxic iron burden. Therapeutic phlebotomy is a technique that is underused in reducing our iron load. For those with high iron, this is something to think about. I personally remove and discard 40 cc of blood weekly with a butterfly for a monthly total of 160 cc blood removed.
Other than reducing the iron burden for our patients and teaching them to make better dietary choices, we can ameliorate the damage of high iron to some extent with therapeutic doses of Vitamin C delivered as either IV sodium ascorbate or as liposomal C and. Liposomal thiamine, Benfotiamine, has also been shown to be beneficial. In addition, think about supplementing your neuropathy patients with lion's mane mushroom which contains tremendous nerve growth and repair factors.
