Vitamin Supplements for Neuropathy

Todays' post from NeuroTalk (see link below) is a useful one looking into the area of supplementing your diet with vitamins specifically aimed at helping with your neuropathic problems. It is written by a moderator at NeuroTalk and provides several useful back-up links which give further information as well as looking critically at the reasons for taking certain supplements. Doctors can be surprisingly unwilling to conduct vitamin deficiency tests, possibly because when they do, the results can be misleading. Carrying out the correct form of testing is essential, mainly because as a society, we're throwing vitamin pills down our throats at an alarming rate. It's become big business but you can overdose on supplements too.

Supplements for Peripheral Neuropathy
MrsD
Moderator
Community Support Team

Supplements for peripheral neuropathy may be helpful for some people. Nerve tissue is like other tissues of the body, and requires various nutrients to support it and repair it.

There are nutrients that may be lacking in your diet. They may be depleted by another disease state (diabetes depletes magnesium), or they may be depleted by other drugs you may be taking. Many common drugs affect nutrient status of many things. I consult a reference for questions in this area, and urge people to seriously consider the drugs they are using, like blood pressure, antiseizure drugs, acid lowering drugs for GERD, some antibiotics, etc. The text I use is called the Drug Induced Nutrient Depletion Handbook 2nd ed. and is currently out of print.
There is a website with an abbreviated version of some of this data here:
http://www.chiro.org/nutrition/ABSTRACTS/Nutrient_Depletion.shtml#Corticosteroids
Readers here can always PM me for privacy and details.

People may develop a need for supplements because of poor diet, depletion by illness or drug therapies, and genetic reasons which affect metabolism and various enzyme systems.

This thread is going to discuss the various supplements that have evidence published, that show how they can help.
Please stay on topic with this thread, and be patient too, since it is going to become a LONG read.

I am going to start with Vitamin B12, and Vitamin D. These two have had the most written about them, and are the most common supplements to consider for PN.

Vitamin B12: I have a long thread here:

http://neurotalk.psychcentral.com/thread85103.html

This thread is long and contains information about B12, how to choose it, what dose to take, links to medical data, and some discussion. B12 is depleted by some drugs, metformin for diabetics, and the drugs that control acid in the stomach result in the impairment of B12 absorption from food. There are now recommendations from NIH and professional nutrition groups that persons over 50 in US should take a B12 supplement, since aging can contribute to a deficiency of this vital nutrient.

B12 does not have an upper limit of toxicity and is very easily tolerated, and not expensive. So these 3 factors make it very easy to try. Also doctors tend to ignore it, and even when they test for it, may rely on antiquated lab ranges, and tell patients they are "normal" when they are NOT. There are medical websites to explain this, but I guess doctors don't keep up.
This is one:
http://www.aafp.org/afp/2003/0301/p979.html
If your doctor is one of "those needing education" you could print out this article from AAFP and give it to him/her. This article also explains how ORAL B12 can work as well or better than injectable. Suffice it to say, if you test below 400, you definitely need intervention. If you are at 400 or very close, that is borderline and with PN symptoms you could most likely profit by taking B12 as well to raise your level up. I'd suggest to be at least at 1000 for PN patients. Some people choose to go higher yet. Please consult my thread link to read how to choose a supplement for yourself.

Vitamin D: Vitamin D is not really a vitamin, it is being found. We typically get our Vitamin D from the sun, but with all the warnings out there about skin cancer, people are not getting the sun exposure they need for good health.

I have a thread on this too:
http://neurotalk.psychcentral.com/showthread.php?t=115722&highlight=vitamin

Within the last 5 yrs the research on this subject has exploded and now we have the medical community aware of how deficient Americans are with Vit D. Estimates are 50-70% have below normal serum levels, and some people with other illnesses are extremely low. My link has links to videos and other information about Vit D. And there are several threads about this at our Vitamin Forum with discussions.

We do not get much Vit D if at all from food. Some foods are fortified in US, but with amounts that are very small. So sun exposure is the main way we can get Vit D. It does not work thru glass windows either, because the glass filters out the UV.

Pediatricians are now giving D3 to children for example.
Low D impacts pain. There are studies now showing chronic pain patients need less medication when D3 levels are optimized. The direct link to PN is beginning, and I have one study on that thread to illustrate that. As time passes, we will see much more on this subject.

So because of this new data, I do recommend patients get tested to see where they are. The doctor's recommendations are still fairly antiquated and tend to favor D2 in high amounts once a week or once a month.(doctors also are not treating patients in the 30ng range--calling that "normal"...target range is now accepted at 50-60ng/ml) All of the experts do not recommend D2 (the Rx one) and suggest you use D3. Many of the posts over at our Vitamin forum here discuss this. The links I have in my D thread also discuss this. D3 is OTC (over the counter) and D2 is the RX one 50,000 IU and is RX because historically that is the only D we had for about 40 yrs! And that form appears in doctors' reference books so they prescribe it. In fact the use of D3 is more effective and preferred now.

Testing: This brings me to the subject of testing. It is rather dumbfounding that doctors may test you and then apply the wrong treatment. But one has to watch out for this problem.
With B12, using cyanocobalamin is now considered old information and better results can be had with the activated B12 form called methylcobalamin. Many doctors have no clue that this exists...and is very inexpensive. The same goes for treatment for D deficiency. All D3s are OTC including one 50,000 IU one.

There are blood tests for other vitamins, and interpretation of them is also spotty. Tests for B6, magnesium, thiamine etc really are only medically useful for very very low or very high levels. Using magnesium as an example--very low leads to cardiac arrest and muscle problems, and very high can be poisonous. But people may show "normal" ranges and have various medical problems that respond to some supplementation. Much work was done with magnesium and migraine a few years ago, with patients showing normal serum levels, yet responding favorably to extra magnesium given orally with supplements.

People who really understand testing, often use labs that do "intracellular" levels, and this is thought to be more accurate. Spectracell is one lab mentioned using this technology.
http://www.spectracell.com/

The same is true for B6. The reference ranges for that may be elevated if you are taking vitamins, but those elevations do not necessarily correspond to "toxicity" in any way. Autistic patients may show elevated B6 readings with NO supplementation! And people with a condition called pyroluria, may show very low levels in testing. B6 is a complex vitamin in that very low levels cause PN, and very high toxic levels also cause PN. So interpretation of serum tests may be problematic.
I have threads on our Vitamin forum specializing in magnesium and B6:

http://neurotalk.psychcentral.com/thread1138.html

http://neurotalk.psychcentral.com/thread30724.html

http://neurotalk.psychcentral.com/archive/index.php/t-121683.html