Ad copy

The year my doctor told me my blood sugar was finally under control was the same year the burning in my feet started. I didn't connect those two things for a long time. By the time I did, I was sitting on the edge of my bed at 3:17 in the morning with both hands pressed flat against the bottoms of my feet. Not rubbing. Just pressing. Like enough pressure might convince them to stop for a few hours so I could sleep. My wife was asleep. I didn't wake her. The stinging had turned into something else by then. Bee stings that came out of nowhere. TV static running under the skin. Two weeks earlier, my left foot went so numb in the middle of the grocery store that I had to grab a shelf to keep from going down. Stood there for a full minute while people walked past me. Hoping nobody I knew saw it. I'm 64. My A1C is 6.8. My doctor calls it a good number. But I was sitting there in the dark doing the math on what happens if this keeps going. My father lost two toes at 71. Then the foot. I had watched the whole thing. And now I was sitting in the same dark, in my own house, wondering if I was already on the same road and just hadn't admitted it to myself yet. I had tried everything my doctor suggested. I was taking a B12 supplement from the pharmacy. I was eating better. I had cut back on the things I was supposed to cut back on. When the stinging got bad enough that I finally said something out loud about it, my doctor prescribed a nerve medication that made me feel like I was moving through water. Brain fog so thick I had to write down things I knew perfectly well twenty minutes earlier. I stopped taking it after six weeks because I couldn't tell if I was more afraid of the feet or of what the pills were doing to my head. So I went back to just managing it. That's what I called it. Managing. Which mostly meant not talking about it, not planning anything that required a lot of walking, and waking up at 3am twice a week to press my hands into my feet in the dark. My doctor ran blood work. He said my levels looked fine. He said this was a common complication with diabetes. He said some patients find it gets better on its own. I nodded. I drove home. I did not believe him but I did not know what else to do. My wife would ask me how the feet were and I would say the same thing every time. About the same. I said that for two years. About the same. Because telling her the truth, which was that they were slowly getting worse and I was starting to think they were not coming back, felt like saying something I could not take back once I said it. What nobody told me, and what my doctor may not have known himself, is that Metformin does something specific inside the gut that has nothing to do with blood sugar. There is a receptor in the small intestine. Its job is to absorb B12. Metformin blocks it. Not partially. It closes the door. So every B12 pill I had been swallowing for two years hit that same blocked door and passed straight through without ever reaching my bloodstream. The pharmacy supplement was not failing because it was cheap or because my body did not respond. It was failing because the medication keeping my blood sugar under control had quietly locked the entrance. The nerve damage I was experiencing, the stinging, the static, the numbness, the grab-the-shelf moment in the grocery store, that is what B12 deficiency does to the nervous system when it goes unaddressed long enough. The nerves that run into the feet are the longest in the body. They are the first ones to show it and the hardest ones to recover. But here is what I did not understand about the nerve medications my doctor prescribed. The first one he put me on is one of the most commonly prescribed drugs in the country for nerve pain. When it stopped working well enough he switched me to a stronger version of the same thing. When that one gave me enough brain fog that my wife started asking if I was okay at dinner, he added a third, an antidepressant that some doctors use off-label for nerve pain. I was on all three at different points over about eighteen months. Each one did something. None of them did the thing I needed them to do. And the reason is simple once you understand it. Those medications work on the brain. They turn down the volume on the signal your nervous system is sending. They do not touch the nerve itself. They do not stop the damage. They do not rebuild anything. The stinging goes quieter for a while and you think something is getting better. But underneath that quiet the deficiency is still running and the nerves are still deteriorating. The day the medication stops working, or the side effects get bad enough that you stop taking it, the signal comes back louder than before. Because nothing was ever actually fixed. There is also something that happens when blood sugar first comes under control that nobody warned me about. In some patients, the symptoms get worse before they get better. The nerves, which had been sitting in a high-sugar environment for years, start to wake up as the glucose drops. That waking up feels like more pain. I thought Metformin was making the feet worse. I almost stopped taking it. My doctor did not explain that this was a known response and that pushing through it while addressing the underlying deficiency was the actual path forward. A 2017 analysis published in the journal Diabetes Care looked at long-term Metformin users and found that the longer someone had been on the medication, the lower their B12 levels, regardless of diet or supplementation with standard oral pills. The absorption pathway was blocked. The pills could not fix a problem they could not reach. There is a form of B12 that bypasses the gut entirely. You hold it under the tongue and it absorbs directly through the tissue there, straight into the bloodstream, no gut receptor required. Metformin cannot block a door that was never used. And unlike the nerve medications, it does not turn down the signal while the damage continues. It gives the nerve sheath what it needs to start rebuilding. Slowly. But actually. I want to be honest about what changed and what didn't. The first two weeks I noticed nothing. I was not expecting a miracle and I did not get one. What I got at the end of week three was a morning where I swung my legs off the bed and put my feet on the floor and stood up without thinking about it first. That was the change. Not the sensation. The thinking about it first. For two years I had been doing a small calculation every morning before I stood up. Bracing. Preparing. That morning I just stood up like a person who doesn't have to think about standing up. The burning at night went from something that woke me up to something that was there but quieter. Then quieter again. By week six my wife asked me what was different and I told her I had been sleeping better. She said she knew because I had stopped sitting up in the middle of the night. I walked through the grocery store last Thursday without putting my hand on anything. I went the whole way through, got what I came for, and walked back to the car. I sat in the driver's seat for a minute before I started the engine. Not because my foot was numb. Just because I wanted to sit there for a second and notice that nothing had happened. I am not going to tell you my feet are perfect. They are not. I still have bad nights. I still have mornings that are harder than others. What I can tell you is that for the first time in two years I stopped doing the math. The math about my father. The math about what comes after the toes. I stopped running that calculation because the thing that was driving it, the feeling that this was only going one direction, started going the other way instead. That was enough for me to keep going. If any part of what I just described sounds like your Tuesday morning, or your 3am, or your hand on the shelf in the grocery store, I want to say something directly. It is probably not your fault that the pills didn't work. You were not doing it wrong. The door was locked and nobody told you. That is not a small thing. That is two years, or four years, or however long you have been managing this, of trying something that could not work because of the medication you were already taking. You were not failing the treatment. The treatment had a structural problem that nobody explained. The sublingual B12 I use is called Nuvel. It dissolves under the tongue in about thirty seconds. There is no gut involved. No blocked receptor. It gets into the bloodstream the way it needs to and goes to work on the nerves the way oral supplements never could. I am not a doctor. I cannot tell you what your feet will do. What I can tell you is that I was 64 years old, two years into something I thought was permanent, and I was wrong about that. The nerve sheath can rebuild. The research says so and my 3am says so. If you want to look at what I found, the link is below. Not because you should rush. Because you have probably already waited long enough. trynuvel.com/products/b-essence-complex