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Nutritional Options for Neuropathy

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A good list of vitamins to take to help cure your diabetic neuropathy.

Nutritional Options for Neuropathy

If the cause of the neuropathy is known and treatable, then managing the underlying condition is the best option. In many neuropathies, however, no specific cause will ever be identified. In addition, many of the causes of neuropathies are themselves not readily treatable. A number of supplements have been shown to interfere with the underlying mechanisms of a variety of forms of neuropathy.

Acetyl-L-carnitine. Acetyl-L-carnitine is known to have neuroprotective properties. Two recent studies have found that acetyl-L-carnitine can limit the neuropathy associated with some chemotherapy drugs (Ghirardi O et al 2005; Maestri A et al 2005).

It has also been shown to limit the neuropathy associated with diabetes. In two randomized, placebo-controlled clinical trials, acetyl-L-carnitine, in daily doses of 500 mg and 1000 mg, was shown to yield significant reductions in pain (Sima AA et al 2005).

In two related studies of diabetic nerve degeneration and neuropathy, acetyl-L-carnitine accelerated nerve regeneration after experimental injury. In the first study, diabetic animals treated with acetyl-L-carnitine maintained near normal nerve conduction velocity without any adverse effects on glucose, insulin, or free fatty acid levels, suggesting that acetyl-L-carnitine can hasten nerve regeneration in the context of diabetes (Soneru IL et al 1997). In another study, carnitine deficiency was shown to correct a number of nerve dysfunctions in animals with chemically induced diabetes (Nakamura J et al 1998).

In a human trial, acetyl-L-carnitine appeared to help prevent or slow cardiac autonomic neuropathy in people with diabetes (Turpeinen AK et al 2000). In a large, multicenter human trial, L-carnitine improved nerve conduction velocity and reduced pain associated with diabetic neuropathy over a one-year period (De Grandis D et al 2002).

Lipoic acid. As a powerful antioxidant, lipoic acid positively affects important aspects of diabetes, including prevention, blood sugar control, and the development of long-term complications such as disease of the heart, kidneys, and small blood vessels (Dincer Y et al 2002; Jacob S et al 1995, 1999; Kawabata T et al 1994; Melhem MF et al 2002; Nagamatsu M et al 1995; Song KH et al 2005a; Suzuki YJ et al 1992). It has also been shown to reduce the pain associated with diabetic neuropathy (Halat KM et al 2003). Studies include:

  • Clinical trials of people with diabetes who had symptoms caused by
nerve damage affecting the heart showed significant improvement taking 800 mg oral alpha-lipoic acid daily without significant side effects (Ziegler D et al 1997a,b).
  • In another study, 23 diabetic patients were treated with 600 mg
alpha-lipoic acid, delivered intravenously daily for 10 days, followed by 600 mg oral alpha-lipoic acid for 60 days. At the end of the study, all participants showed significant improvements in cranial neuropathy, as well as improvements in both peripheral and autonomic neuropathy, which affects internal organs (Tankova T et al 2005).
  • In another study, 26 patients with type 2 diabetes were given 600 mg
alpha-lipoic acid daily for 3 months. At the end of the study, 20 patients experienced a significant regression of neuropathic symptoms, while 5 patients experienced a complete cessation of all symptoms. Alpha-lipoic acid was especially beneficial in women and in thinner and younger patients (Negrisanu G et al 1999).

N-acetylcysteine. N-acetylcysteine (NAC) is a powerful antioxidant and a precursor to glutathione, an intrinsic antioxidant. Animal studies have shown that NAC can inhibit diabetic neuropathy and protect against neuropathies caused by chemotherapy drugs (Love A et al 1996; Park SA et al 2000).

Curcumin . Researchers are continually discovering more benefits from curcumin, which is the yellow pigment that gives turmeric its distinctive golden hue. In a study of inherited peripheral neuropathies, curcumin was shown to relieve neuropathy by causing the release of disease-associated proteins that are produced by a mutated gene (Khajavi M et al 2005). Curcumin has also shown promise in animal studies of diabetic neuropathy and as a neuroprotective agent in central nervous system diseases (Osawa T et al 2005).

Omega-6 fatty acids. The body ordinarily makes the gamma linolenic acid (GLA) it needs from linoleic acid, an omega-6 fatty acid found in foods. Among diabetics, however, the body is not able to make sufficient GLA, and it must be supplemented (Cunnane SC et al 1984a,b,c; Horrobin DF 1992a,b; Huang YS et al 1992a,b).

GLA improves diabetic neuropathy if given long enough to work. In one double-blind, placebo-controlled study, 111 people with mild diabetic neuropathy received either 480 mg GLA daily or placebo (Keen H et al 1993). After 12 months, the group taking GLA was doing significantly better than the placebo group. Good results were seen in two smaller studies as well (Cameron NE et al 1998; Jamal GA et al 1990).

Omega-3 fatty acids. The omega-3s are found in high quantities in coldwater fish such as salmon and are widely consumed for their anti-inflammatory powers. Omega-3s are essential fatty acids and are important components of cell membranes, including the delicate myelin sheath that protects nerves. Studies have shown that omega-3 fatty acids, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are able to reduce demyelination in the nerves of diabetic animals, which reduces neuropathic pain (Gerbi A et al 1999).

Vitamin B1 (thiamin) and benfotiamine . Some animal studies have shown a decrease in pain with a combination of vitamin B1, vitamin B6, and vitamin B12 (Franca DS et al 2001; Jurna I 1998; Wang ZB et al 2005). The fat-soluble form of vitamin B1, called benfotiamine, has been used effectively to treat alcoholic and diabetic neuropathies. The most marked pain relief from benfotiamine occurred in patients with diabetic neuropathy after only a three-week trial period (Anisimova EI et al 2001; Haupt E et al 2005; Winkler G et al 1999).

Vitamin B6. Vitamin B6 inhibits glycosylation of proteins (Solomon LR et al 1989), one the major risk factors for developing diabetic neuropathy. Diabetes patients with neuropathy have been shown to be deficient in vitamin B6 and to benefit from supplementation (Jones CL et al 1978). Interestingly, the neuropathy caused by vitamin B6 deficiency is indistinguishable from diabetic neuropathy.

Vitamin B12. A neuropathy caused by vitamin B12 deficiency is characterized by numbness of the feet, pins-and-needles sensations, or a burning feeling (Davidson S 1954; Sancetta SM et al 1951). Supplementation that restores normal B12 levels is a part of successful treatment of diabetic neuropathy (Bhatt HR et al 1983). In a review of clinical trials conducted between 1954 and 2004, vitamin B12, as well as combination therapy of vitamin B12 and methylcobalamin, was shown to reduce pain (Sun Y et al 2005).

The most common forms of supplemental B12 are cyanocobalamin or hydroxycobalamin. The natural form of B12 found in food is methylcobalamin (or a similar form, adenosylcobalamin). The structure of B12 is very complex, with numerous methyl groups attached. Methyl groups (CH3) are used in beneficial methylation reactions, such as those that reduce homocysteine. Methylcobalamin appears to be the most effective form of vitamin B12 to protect the nerves.

Vitamin C. Insulin facilitates the transport of vitamin C into cells, decreasing capillary permeability and improving wound healing. Diabetes depletes intracellular vitamin C, which deprives a diabetic of vitamin C’s cellular protection (Sinclair AJ et al 1994). Vitamin C levels have been shown to be reduced in diabetic patients (Ziegler D et al 2004).

Capsaicin . Derived from hot peppers, capsaicin has been shown to reduce chronic pain by reducing the stimulation of pain receptors. It is often applied as a cream. Initially, capsaicin may cause a prickly, hot sensation that causes many people to discontinue using it. However, once this first phase passes, capsaicin is effective. It has been documented to reduce the pain associated with diabetic neuropathy without adversely affecting glucose control (Halat KM et al 2003).

Vitamin E. Vitamin E is a powerful antioxidant that reduces levels of free radicals and oxidative stress. In a placebo-controlled, double-blind, randomized study of 21 patients with type 2 diabetes, large doses of vitamin E were studied for their ability to reduce neuropathy. During the six-month study, patients were either given placebo or 900 mg vitamin E, then measured for nerve conduction and function. The researchers found that mild to moderate defective nerve conduction was improved with high-dose vitamin E, which suggested that patients with neuropathy might experience a reduction in symptoms (Tutuncu NB et al 1998).

These results appear not to be limited to diabetic neuropathy. In a case study of a 24-year-old man with a progressive disease and peripheral neuropathy, daily supplementation with high-dose vitamin E for two years slowed disease progression and produced significant improvement in his neuropathy (Martinello F et al 1998).

The following supplements have been shown to reduce the pain associated with neuropathy:

  • Fat-soluble vitamin B1 (benfotiamine)—150 milligrams (mg) one to three
times daily
  • Acetyl-L-carnitine—2000 mg daily

  • R-lipoic acid—300 to 450 mg daily (or alpha-lipoic acid: 600 to 1000 mg daily)

  • NAC—600 mg daily

  • Curcumin—800 to 1600 mg daily

  • Gamma linolenic acid (GLA)—900 to 2700 mg daily

  • EPA/DHA—4000 mg daily, providing at least 1400 mg EPA and 1000 mg DHA

  • Vitamin B6—100 mg daily

  • Vitamin B12—1000 micrograms (mcg) of the methylcobalamin form, taken one to four times daily (up to 40 mg daily methylcobalamin may be used in extreme cases)

* Vitamin C—about 2500 mg daily
  • Vitamin E—400 international units (IU) daily (with around 200 mg gamma tocopherol)
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Nutritional Options for Neuropathy A good list of vitamins to take to help cure your diabetic neuropathy.