What can you do for neuropathy in your feet? My brother-in-law kept the answer on a list on his fridge, and the most important line was the one that was missing

"What can you do for neuropathy in your feet?" My brother-in-law Walt has asked that question to every doctor, pharmacist, neighbor and church friend he has run into for three years. And because he is a careful man, he wrote down every single answer. They live on a yellow legal pad stuck to his refrigerator with a magnet shaped like a mailbox. By the time I went through it with him, it was four pages long.

Walt is 70. He carried mail in our town for thirty-one years, eleven miles a day, and he will tell you with real pride that he wore out a pair of shoes every four months. So there is something hard about watching a man who walked for a living hold the porch rail to get down two steps. The burning started on the soles about three years ago. Then the toes went quiet, "like they're wrapped in a dish towel," he says. Now, some nights, there are little electric zaps that make him jump in his recliner.

That Sunday, after the burgers, he took the pad off the fridge and handed it to me. "You were a bookkeeper," he said. "Audit it."

Column one: the things you really should do

I want to start with the good news, because there is some. A few lines on Walt's list are not optional, and I'd tell anyone with numb or burning feet to do them this week.

• Look at your feet every night. With numb feet, a blister or a splinter can go unnoticed for days. Walt bought a long-handled mirror for it. It isn't glamorous. It matters.
• Get your numbers checked. Blood sugar, B12, thyroid. A surprising number of people with tingling feet have never had their B12 looked at, and it's a simple blood test.
• Shoes that fit, socks without seams. His podiatrist put that one on the list. Thirty-one years of good shoes, and now he has to buy them a half size wider.
• Keep moving. Short, flat walks. Circulation to the feet matters more, not less, when they go numb.

None of that will make the burning go away. But it keeps a bad situation from becoming a dangerous one, and nobody should skip it.

Column two: the things that buy you an hour

This was most of the pad. A warm Epsom salt soak. A cream with capsaicin, the hot pepper stuff. A menthol rub. An ice pack in a dish towel. A vibrating foot massager his daughter got him for Christmas. Compression socks. A TENS unit from the drugstore with the sticky pads. And from a lady at church, the sincere suggestion of sleeping with his feet outside the covers.

I'm not here to make fun of any of it. Walt tried almost all of it, and some of it truly helped him get to sleep on a bad night. The soak bought him maybe half an hour. The capsaicin cream worked for a week and then felt, in his words, "like rubbing a campfire on a campfire." The massager is still by his chair.

But when we went down that column with a pen, I noticed something you notice when you spend a career reconciling accounts. Every single item was about the feeling. Cool it down, warm it up, numb it, distract it. Not one line on four pages said a word about the nerve itself. "It's like I've been answering complaints about the mail," Walt said, "and nobody ever went and looked at the truck."

The line that wasn't on the pad

The nerves that run to your feet are the longest ones in your body. Every one of them is wrapped in a protective coating, a little like the rubber on a lamp cord. The medical name for it is myelin. While that coating is whole, signals travel clean: you feel the carpet, the cold tile, the dog. When the coating wears thin, the signal leaks. Too weak and you get numbness. Too loud and you get burning and zaps. And because the longest wires have the most coating to lose, it starts in the toes and climbs.

So the question that should have been at the top of Walt's list, before the soaks and the creams, was this one: what is wearing that coating away? Night after night, in a man who takes his pills and watches his sugar?

The first person who ever gave Walt an answer to that question was not on his list at all. His niece sent him a short presentation from a doctor who has spent the better part of three decades with neuropathy patients. As Walt explained it to me, the doctor believes there's a slow process happening around the nerve, one that eats at the coating the way rust works on metal and leaves a kind of buildup behind it, and that most home remedies stop short of it because they're aimed at the skin. He also talks about a cheap morning recipe made from things in a kitchen cabinet, and he is very particular about which kind of one ingredient and what hour of the day. Walt wouldn't tell me the details. "Watch it yourself," he said. "It's his to explain."

I'm a retired bookkeeper, so let me be careful. That is one doctor's view, not the whole medical profession's. But it was the first thing in three years that explained what Walt was feeling instead of telling him how to feel less of it. And it changed what he went looking for.

The bottle on the dashboard

Here's the part I didn't see coming. A few weeks after that, Walt was at his old post office for a retirement lunch, and he got to talking with a carrier he trained twenty years ago, a fellow named Ray, who's 58 now and has had burning feet since his forties. Walt told him about the pad and the rust and the coating. Ray walked him out to the parking lot, opened the door of his truck, and took a bottle off the dashboard.

"Been taking it since the spring," Ray said. "I keep it where I'll see it." It was called NervoLyn.

Walt does not buy things off a dashboard. So he did what he always does: put on his reading glasses, stood in that parking lot and read the label out loud, line by line, while Ray waited.

• Alpha lipoic acid. The company calls it one of the most studied antioxidants for the nerves in the hands and feet, there to help protect nerve tissue from everyday wear. Walt tapped it. "That's the rust."
• Turmeric extract, standardized to 95% curcuminoids. For the body's normal inflammation response around stressed nerves. "Not the jar in your spice rack, then," he said to me. I can't tell you more than that.
• Butcher's broom. An old circulation herb, to keep blood moving all the way down to the feet. A man who spent thirty-one years on his feet appreciated that one.
• L-carnitine and Coenzyme Q10. Fuel for the cells, the energy a nerve needs to do its own repair work.
• Magnesium glycinate, 80 mg. A gentle form of magnesium the company ties to calm nerve signals and better sleep.

"It's not on my list," Walt said. "Everything on my list is for the skin. This is for the cord." He took a picture of the label, took it to his doctor, who said it wouldn't fight with anything he takes and to keep his appointments, and ordered it that night. It's one capsule a day.

What Walt noticed, a month at a time

He takes it with his coffee, at the kitchen table, under the yellow pad.

• Week 1. Nothing. "Same dish towel on the toes."
• Weeks 2 and 3. A strange new tingling in the balls of his feet, and he nearly quit. Ray told him he'd had the same thing and it settled. Some people feel tingling come back into a numb area before more normal feeling returns, though nobody can promise you that's what it is.
• Month 1. The zaps in the recliner got fewer. His wife noticed before he did, because he stopped jumping during the evening news.
• Months 2 and 3. He walked the whole loop around the park with Biscuit, a mile and a quarter, and came home without his feet on his mind. The burning still visits after a long day, but later and shorter.

Why does it take that long? Because nothing in it is a cover-up. If a coating has been wearing thin for years, the body patches it on its own schedule, and the longest wires get their signal back last. The company says most people notice early changes in three to four weeks, and fuller results over eight to twelve weeks of daily use. That is exactly why Walt, a man who never in his life walked half a route, went to the bigger supply after his first bottle.

Who it's for, and who it isn't

It may be worth a look if you're over 50, the burning, tingling or numbness began in your toes and has been creeping up, your doctor has checked the basics, and everything you've tried so far has only cooled things down for a while.

It is not for you if the numbness came on suddenly or on one side, comes with leg weakness, a drooping face or trouble speaking, or you have a sore on your foot that won't heal. Those need a doctor today, not a blog. If nobody has ever checked your blood sugar, B12 and thyroid, do that first. And if you're pregnant or nursing, or you take medicine for blood sugar, blood pressure, blood thinning or nerve pain, show your doctor the label before you begin.

Why a careful man said yes

For Walt it came down to the arithmetic. The company gives you 60 days to find out, with your money back if your feet don't notice. It's a single order, nothing that renews on its own, made in the United States in a GMP-certified facility. He'd already spent more than that on the massager, two kinds of cream and a TENS unit that now lives in a drawer. "Worst case," he said, "I'm out a phone call and a stamp."

So what can you do for neuropathy in your feet?

Do column one, every week, no excuses. Keep whatever from column two gets you through a bad night. And then ask the question Walt's pad never asked: what is happening to the nerve itself? Results vary from person to person, and Walt's are his own. He still sees his doctor, still checks his feet every night with that silly mirror, and still won't drive after dark. But last month he tore the four pages off the fridge and kept one sheet. At the top, in his mail-carrier block letters, it says "THE TRUCK, NOT THE COMPLAINTS."

P.S. Biscuit still sleeps on his feet in the recliner. The difference, Walt says, is that some nights now he can tell she's there. If you're the one in the recliner tonight, here's what Walt finally added to the bottom of his list. And if your feet run hot more than numb, my sister's story about the drawer full of creams is the other half of this one.

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