GLP-1s, weight loss, and Neuropathy

@elwtonykt Im so glad you asked this and hope you get some feedback. I’m planning to ask my Dr for this in hopes that I can lose weight and to see if it will help my neuropathy and ME/CFS. I don’t have diabetes. There’s been quite a bit of discussion on Health Rising’s forum about it helping with CFS .

Being overweight is generally unhelpful, and it's one of those things that can be remedied without medication and at no cost.
So whether or not it helps with PN - and we all seem to have different PN - go for it.
At the risk of being obvious, no cake no donuts no fizzy drinks no crisps no beer no sweets no choc (other than one daily square of Plain) no ice cream no sugary stuff no sugar in tea or coffee no microwave meals no second and third helpings blah blah etc.

Even at my weight - 6ft/140lb - I eat little or nothing of this stuff. After a while you don't miss it, but I do miss cheese & onion crisps.

@v8auto

Actually, many overweight people can’t easily remedy their situation by cutting back on food intake alone. There are several factors that play into obesity, and advice like this only furthers the notion that overweight people over-consume and under-exercise, which is a dangerous idea when talking about medical issues.

I was just discussing this idea with my primary care doctor, and she shared that GLP-1s seem to help with neuropathy in some patients, regardless of the degree of their overweightness, for reasons that the medical community hasn’t been able to figure out yet. They think it may be linked to inflammation, and autoimmune-related neuropathy that may be getting improperly diagnosed.

@tsinnc this is encouraging. I’m definitely planning on trying after Medicare starts covering it.

@tsinnc
It does seem to run in some families, but if one looks back to the 70s for instance, or at least photos from that time, it is apparent that there were few overweight people.
The modern rise in obesity tracks the widespread availability of fattening foods, and the decline in what one might term 'proper' cooking, that is to say cooking from scratch. This began a good few years ago, so we now have a generation where their parents never cooked nor ate well, and lacking a good example people have grown up (and outwards) not knowing any better. I was fortunate that this was not the case for me, and my wife has always cooked from scratch, I was and am lucky.
As regards exercise, I'm sure it's harder to exercise when one is carrying more weight. I would never wish to deter anyone from exercising, it's good for the heart and general muscle tone, but its role in weight loss is overstated, perhaps because of a reluctance to point to someone's diet as a cause of their weight.
To burn off the calories of one slice of bread for instance, one has to walk briskly for around 20 minutes or run 12 minutes. How long to burn off a slice of cake or a few biscuits... it's not going to happen.
Exceptions apply, as you say, but for most people the route to weight loss is to eat less and eat better. We should be glad that it is something most people can remedy without medical intervention.
Whether that helps with PN is another matter of course, but it would at least help with the leg weakness that often arises from PN.

@v8auto and @tsinnc, Mayo Clinic's opening paragraph recaps what you are both saying quite nicely and with understanding.
- Obesity https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742

EXCERPT
"Obesity is a complex disease involving having too much body fat. You might think of obesity as a cosmetic concern. But it's a medical condition that increases the risk of many other diseases and health conditions. These can include heart disease, diabetes, high blood pressure, high cholesterol, liver disease, sleep apnea and certain cancers.

There are many reasons why some people have trouble losing weight. Often, obesity results from inherited, physiological and environmental factors, combined with diet, physical activity and exercise choices.

The good news is that even modest weight loss can improve or prevent the health conditions associated with obesity. A healthier diet, increased physical activity and behavior changes can help you lose weight. Prescription medicines and weight-loss procedures are other options for treating obesity."

To bring this discussion back on topic:
@elwtonykt asks about the possible effect of GLP-1 medications on diabetic-related neuropathy. GLP-1 medications (like Ozempic, Wegovy) have a dual relationship with neuropathy: they have been reported by some patients to have improved existing diabetic neuropathy symptoms, possibly due to anti-inflammatory and neuroprotective effects (as @tsinnc mentioned, thank you). However for some people, these same medications have been reported to increase the neuropathy symptoms.

Researchers are studying these effects. Here's one study that is underway:
- A Research Study to Investigate the Effects of CagriSema Compared to Placebo in People With Type 2 Diabetes and Painful Diabetic Peripheral Neuropathy https://www.clinicaltrials.gov/study/NCT06797869

As always, it it best to talk to your doctor about your specific risks factors related to you. And that you and your doctor watch for new nerve pain or weakness, or improved neuropathy symptoms while on GLP-1 medication.

@elwtonykt, have you started treatment? Did you notice any changes in your neuropathy?

@db72 Medicare covers it if you have Diabetes. Not for weight loss.

I was diagnosed with severe, bilateral peripherial neuropathy approximately 15 years ago.

About 2 years ago, I started into remission and am, now, receiving IVIG treatments every 3 weeks.

Turns out, I was improperly diagnosed.

What I do appear to have is CIDP, which typically has PN symptoms, but can go into remission, with or without medication.

In my case, the remission coincided, exactly, with: (1) daily consumption of cashews and (2) a weekly routine that included standing on thick carpet (which has an exertion effect similar to using an exercise waffle board).

Take your pick, but neither (1) or (2) were casual in nature.

Interesting. I went and read about CIDP.
How did you finally receive the correct diagnosis?
How did you decide the disciplines that you utilized that resulted in remission?