To find out how long the life expectancy is in polyneuropathy, I searched scientific databases, especially Pubmed. There I found a study by an American research group. They compared the life expectancy of polyneuropathy patients with that of people without polyneuropathy. This involved collecting data on health from people in an entire county since 1966. The study included nearly 3000 people who suffered from polyneuropathy.

The researchers now compared those who had polyneuropathy with study participants who did not.

In this study, the average life expectancy of people with polyneuropathy was 80 years. Study participants who did not have polyneuropathy lived to 86 on average (You can read the study here: Hoffmann et al. 2015)

I also found two other studies that looked at diabetics. Life expectancy of diabetics with polyneuropathy and diabetics without polyneuropathy was compared (Simoneau et al. 2019, Hsu et al. 2012). Diabetics with polyneuropathy had a lower life expectancy than diabetics without polyneuropathy.

But does that mean that polyneuropathy is deadly? According to the studies mentioned, it is not clear why people with polyneuropathy died earlier. Thus, polyneuropathy is explicitly not listed as a cause of death.

People with polyneuropathy die slightly earlier on average - is polyneuropathy fatal?

Targeted training for balance is surprisingly effective in this regard. Those who have better balance stand more stable and therefore fall less often. This is not only logical, but has also been proven by a large number of scientific studies.

Paticipants in those studies statistically reduced their risk of falling by about one third through training. However, if you exercise more than they did and therefore improve your balance more, you can also reduce the risk even more.

One of my patients was so successful at this that he didn't fall once in the entire year of 2020, after crashing virtually monthy in 2019 and even being hospitalized twice.

Of course, such success stories are not the case for everyone, but it is true for almost everyone that the risk of falling is lower if you are better able to keep your balance and control your movements.

The same training, interestingly, helps many people reduce the symptoms of polyneuropathy. Pain and discomfort often diminish after exercise.

This is because balance training directly addresses the nervous system. In fact, in order to keep a good balance, it is not important to have big muscles and physical strength, but to be able to perceive and control the body accurately - which are tasks of the nervous system.

Therefore, when you train your balance, you not only reduce the risk of falling, but many people also report an improvement in the symptoms of polyneuropathy. The nervous system seems to learn to compensate for the damage caused by polyneuropathy through training. Thus, training does not cure polyneuropathy, but you can train your body awareness despite the nerve damage. Balance training therefore has the potential to improve quality of life, which is at least as important as life expectancy.

However, falls are not the only physical limitation that reduces life expectancy in polyneuropathy. Another crucial risk factor is that people with polyneuropathy are usually less physically fit.

However, those who are more physically fit live longer and healthier lives. This is especially true if you suffer from a chronic disease. Because physical fitness protects against their consequences.

As early as 2002, a research group led by Jonathan Meyers of Stanford University investigated the influence of physical fitness on mortality in people with various diseases. They found, that people who are physically fit, although suffering from chronic diseases, have an impressively lower mortality than physically weak people with the same diseases. (You can read the study here: Meyers et al. 2002)

I have presented the data from this study in the figure on the right. You can see the statistical risk of death as a function of physical fitness and various chronic diseases. You can see so-called MET (Metabolic Equivalents). 1 MET corresponds to energy expenditure at rest. 8 MET would therefore be eight times the energy consumption at rest. This corresponds to walking at 8 km/h, for example.

People who can work at 8 MET for a long period of time (i.e., walk at 8 km/h for several kilometers) have almost no limitations in their life expectancy, even if they suffer from chronic diseases such as diabetes or hypertension.

As you can see in the figure, people who fail to reach 8 MET have a significantly higher risk of death. Those who achieve less than 5 MET have more than twice the relative risk of death than people who manage more than 8 MET. By the way, the same is true for almost all diseases and basically also for healthy people: physical fitness increases life expectancy.

Physical fitness protects - despite illnesses

The reason for the higher life expectancy of fitter people is that fitness means nothing other than well-functioning organs.

To be physically fit, you need a well-functioning heart, healthy lungs and good healthy blood vessels to bring blood and oxygen to your muscles.

The nervous system, which controls the muscles to perform the task at hand, also has to function well and becomes more efficient through training. The stability of the bones must also be great in order to be able to convert the force of the muscles. So the bones of physically fit people do not break as easily.

Physical fitness is therefore nothing other than a sign of well-functioning organs and thus good health. And whats even better: If you become fitter, stronger and more endurant through training, your organs will also function better!

For example, if you can walk farther and faster by training today than you could a month ago, you have a better functioning heart, better functioning muscles, and better functioning blood circulation.

Therefore, the risk of very many diseases decreases if you are physically fitter.

This also applies to diseases that you would not have thought of at first. For example in fit people, the immune system also functions better, which leads to infections not being as bad.

Very fit people are therefore much less likely to contract pneumonia, for example. This is because your immune system is able to fight infections in the respiratory tract before they can develop into a dangerous disease.

And even if you get sick with pneumonia, fit people have better chances of a mild course of the disease. This is because their lungs are more efficient in the first place and are therefore able to take in enough oxygen to supply their body, even if they no longer function as well due to pneumonia. (A study on this can be found here: Kunutsor et al. (2017)

Oxygen uptake capacity is the most common measure of endurance in sports science. So the better your endurance, the better your oxygen uptake, the better the function of your lungs and, also the function of your heart and the blood vessels that carry oxygen from your lungs to your body.

Better fitness means better functioning organs!

You can stay fit despite polyneuropathy!

So you see, especially with polyneuropathy, it's important to stay active anyway.

It is obvious that you are less active in everyday life because the disease simply makes life more difficult. That's why it's important to create routines for physical training.

For example, if you set fixed times for your workouts and work out on schedule during those times, you can make great progress with very little time commitment.

If you start training despite polyneuropathy, you usually have great success in the initial period. After some time, however, you reach a plateau where you can't improve further. After all, the disease causes limitations that you can't simply ignore. However, just keep going!

Keep in mind that it is already a huge success if you manage to maintain the current level of fitness despite polyneuropathy. Because people who don't exercise slowly but surely become weaker, shakier and ultimately less independent. You can at least slow down this process with targeted exercises.

Whether one feels a touch as a light caress or strong pressure, as tickling or scratching, depends on how the signals from the nerves are interpreted in the brain.

So the pain originates in the brain, not in the feet!

Brain training reduces the pain

This is also the reason why it often does not help to work on your the feet or the hands in order to reduce the pain. Some people can get some relief by using foot baths and creams or applying other treatments. But that only helps in the short term, the pain will still come back.

A better way to manage the discomfort is to train the brain to reduce hypersensitivity. Balance training is excellent for this purpose. So this means to practice standing in unstable or even wobbly positions.

Because in order to keep your balance, you need to be constantly aware of your body and feel it very precisely. You also need to respond appropriately to sensations such as pressure on the soles of your feet. This improves the body's perception and makes the brain's work more efficient.

Maintaining balance is one of the most complicated tasks we face in everyday life - even if we often don't realize it. It is necessary to perceive, evaluate and react appropriately to movements of all parts of the body, their position in relation to each other and the tension of the muscles with the highest accuracy.

This means that in order to maintain balance, signals from the body must be constantly received, transmitted and interpreted.

This can lead to a reduction in pain.

You can find practical exercises for this here: Polyneuropathy pain and what you can do about it

87% of patients report less pain and discomfort after training

according to Streckmann et al. 2014

In a study at the University of Freiburg, such balance training was tried out with people suffering from polyneuropathy (Read the study here Streckmann et al. 2014).

As expected, the training improved the patients' balance. More importantly, 87.5% of patients reported fewer symptoms of polyneuropathy. That is: the pain and discomfort got better! In the control group, which did not exercise, not a single patient reported improvement in symptoms at the same time point.

By the way, it was measured whether the nerves in the legs of the patients recovered. For this purpose, the nerve conduction velocity was measured, by which neurologists can recognize how severely a nerve is damaged. The measurements showed no change as a result of the training, even though the symptoms got better.

This means that the improvement of symptoms did not originate in the damaged nerves in the feet or hands, but in the brain!

Muscle pain and nerve pain reinforce each other.

A few days ago, a patient asked me, somewhat concerned, whether she was still allowed to drink coffee because of her polyneuropathy.

She had read that with polyneuropathy you should limit coffee consumption because it aggravates nerve damage. I didn't know that polyneuropathy and coffee were related, so I started researching.

More information about nutrition in polyneuropathy can be found here.

At first, when you search for information, you hardly find anything. One can only find a few websites that recommend limiting coffee consumption in polyneuropathy because it affects the autonomic nervous system and impairs coordination in the nervous system.

It is true that coffee affects the autonomic nervous system and this is one of the reasons why coffee is a stimulant, but does it harm or even worsen polyneuropathy? In most cases, the nerve damage in polyneuropathy is not primarily located in the autonomic nervous system. (The autonomic nervous system, in simple terms, is the part of the nervous system that makes us awake or tired and regulates things like breathing rate and digestion that occur unconsciously, there are particular forms of polyneuropathy that harm it especially, but these are not the most common ones).

Most people suffer from pain, numbness and insensitivity in the feet and hands. And they do not arise from problems in the autonomic nervous system.

So are claims about coffee being harmful just assumptions rather than statements based on facts?

To find reliable information, I looked for scientific studies. To do this, I searched medical databases where most studies can be found.

In such cases, the best address is "Pubmed", the most important database for medical studies. If there is evidence about medically relevant effects of stimulants, it can pretty certainly be found here. Unfortunately, however, almost no studies can be found on the subject. At least not with humans. Apparently, hardly any researchers have ever asked the question whether polyneuropathy and coffee are related.

The only thing I could actually find are two studies with mice that had diabetes. Diabetes induced damage to the auditory nerves in these mice (they suffered from auditory neuropathy). When the animals were given coffee, it actually protected the auditory nerves. The nerves functioned better and could process signals better. So the mice could hear better because their nerves worked better when they got coffee. Here is the link to one of the studies.

Does coffee actually protect against polyneuropathy?

Even if you already have diabetes, regular coffee consumption can somewhatlower blood sugar. Regular consumption seems to be able to reduce long-term blood glucose HbA1c by a maximum of 0.5. That's not a huge difference, but it's impressive for a simple drink. Interestingly, this effect only occurs in the long term. Immediately after drinking coffee, blood sugar even rises for a short time.

Coffee also seems to reduce the risk of heart attacks and strokes in diabetics a bit. Unfortunately, these occur particularly frequently in diabetics, and coffee lowers the risk somewhat. Of course, this only applies if you do not sweeten the coffee too much with sugar 😉

But then, if coffee has a positive effect on blood sugar, why would it be harmful in diabetic polyneuropathy? There is neither statistical evidence nor other claerly valid arguments for this. In fact, it seems to be more likely that coffee helps against diabetes and thus against the nerve damage causing polyneuropathy.

So if your polyneuropathy was triggered by diabetes and you like to drink coffee, go for it! You are more likely to do yourself some good than harm. And you already have to do without so many things you probably like, that it is probably nice to be able to treat yourself to a coffee at least once in a while.

In addition, coffee contains niacin (vitamin B3) and it promotes the absorption of vitamin B12. A deficiency of B vitamins can also trigger polyneuropathy, therefore a deficiency of B vitamins should absolutely be avoided and an appropriate amount of B vitamins should be included in your diet. ( You can find out more about nutrition in polyneuropathy here).

However, the amounts of B vitamins in coffee are not very large, so the hot beverage alone will not make a huge difference if you are suffering from acute B-vitamin deficiencies.

At the same time, however, coffee seems to lead to a loss of vitamin B1. But this effect is not so great that you would have to give up coffee because of it. Especially if you otherwise pay attention to a good diet. Regarding vitamin B1, it is more important to avoid alcohol, which deprives the body of this important nutrient to a much greater extent.

However, as far as vitamins are concerned, in general, the potential for curing polyneuropathy is limited. Of course, if you suffer from nerve damage caused by a deficiency of vitamins, it makes perfect sense to take them. Also if a deficiency has been measured in your blood, you should of course compensate for it.

However, as far as vitamins are concerned, there is a general rule:

Taking more vitamins than necessary is not beneficial!

That is, a normal supply of vitamins of all kinds is enough. If you are not deficient in vitamins, taking vitamin pills or eating a diet rich in them won't help. That is why all attempts to cure polyneuropathy with vitamin pills have failed so far.

So possible effects on the vitamin balance are also no reason for polyneuropathy patients to ban coffee from their diets.

So don't let polyneuropathy spoil your coffee. Being a polyneuropathy patient you have to pay attention to so many things. The disease already brings about enough problems and limitations.

There is no need to worsen the quality of life by giving up coffee as well. Especially because there are no real reasons for this. As I said, there is no scientific basis for not drinking coffee because of neuropathy.

In Chinese medicine, in some cases, it is recommended to reduce coffee consumption when suffering from polyneuropathy. If you are being treated by doctors or naturopaths and a proper diagnosis has been made, which is the basis for such a recommendation, this may well be valid.

Experienced professionals certainly have good reasons for advising you against coffee in some cases.

But this is not generally true for all people with polyneuropathy. These are individual recommendations.

For the general public, there is no reason to generally skip coffee if you have polyneuropathy!

If you want to know more about nutrition in polyneuropathy, you can find more information at the following link:
Nutrition in polyneuropathy

The studies show: Targeted training reduces Polyneuropathy symptoms. Study participants reduced uncomfrotable heat and cold sensations, as well as numbness and tingling in their hands and feet through training. The studies explicitly point out that a control group that did not train did not succeed in doing so: Training pays off! Noticeable. Therefore, scientists even tell physicians to recommend this beneficial training to their patients. This should be enough evidence for you to do it yourself. The exercises are easy and can be done at home. Here is the link to it:

Some patients tell me: "At my age, I don't do sports anymore!" And as a matter of fact it is not necessary to do actual sports. The exercises are not a "sport" like soccer or skiing. In fact, the exercises are so simple that virtually anyone of any age can do them at any time - and have a lot of fun doing them. Many patients also say, "At my age, it's not going to get better anymore." This is also contradicted by the first study in particular: for older participants, improvements in symptoms were even greater than for younger ones. Finally, age pays off for a change! So it's never too late for improvement.

A second study, primarily by researchers at the Sport University of Cologne, Germany, had PNP patients undergo balance training and vibration training. Here they showed that it reduced their pain and even improved their reflexes. Balance training also has a nice advantage: you can do it at home in your own four walls. You don't need a gym, a trainer, a doctor, a physical therapist to do this. It couldn't be easier or more enjoyable.

By the way, the exercises were not about trying as hard as possible. This is not about fitness training. The point is to train the nervous system, not muscles or endurance.

If you try very hard, it even leads to a small training effect. Because the nervous system can adapt better when you are recovered and can still concentrate well. It is more of a learning process than a fitness training. Because you learn new movements and especially to keep your balance better.

This causes the nervous system to adapt to the new tasks. And this adaptation leads to compensate the nerve damage that causes polyneuropathy. And this makes the pain better.

If you do strenuous strength and endurance training then the training is mainly directed at the muscles and the cardiovascular system. The nervous system is not in the foreground.

Polyneuropathy patients who do strength training or endurance training accordingly do not achieve great effects on the nerves. Of course, the training has very very many positive effects on the body and health. However, it alone is not enough to help against polyneuropathy. In studies in which patients with polyneuropathy completed such training, there were slight improvements, but the effect was so small that the effort was disproportionate to the benefit.

However, if you perform training for the nervous system and then add strength and endurance training, the effects complement each other and you achieve greater improvements.

The effect of training on the nervous system is improved and polyneuropathy improves faster. At the same time, strength and endurance training also works better because the better functioning nervous system results in better coordination and allows muscle strength to be used more effectively.
By the way, the effect of strength and endurance training is particularly pronounced in diabetic polyneuropathy. There are even better values for nerve conduction velocity, and more nerves seem to grow in the feet of diabetics when they exercise. Scientific studies on this can be found here: Singleton et al. (2014); Kluding et al. (2012).
Detailed exercise recommendations for diabetes and diabetic polyneuropathy can be found here: Diabetic Polyneuropathy, Exercise for Diabetics.

So, it is best for polyneuropathy patients to combine special exercises for the nervous system with strength and endurance training. However, if you only have time for one or the other, you should focus on the nervous system.

Those who wish are welcome to read the original study texts:

https://www.ncbi.nlm.nih.gov/pubmed/29243164

https://www.ncbi.nlm.nih.gov/pubmed/30382392