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5 Supplements for Neuropathic Pain


Supplements for Treating Neuropathy Pain

The amount of money spent by Americans on vitamins, minerals, and supplements is estimated to be in the billions of dollars annually. Some individuals, including physicians, see this as a waste of money and resources, while others see it as meeting the demand for more natural methods of healing.


Although vitamins and supplements will continue to be a point of contention for the medical community, there has been clinical research that support the use of certain supplements for patients with specific medical conditions - such as those who suffer from pain caused by peripheral neuropathy.


B Vitamins


B vitamins have long been known to have an effect on nerve health. These vitamins are all water-soluble vitamin and support various functions of metabolism in the human body. All B vitamins are essential for regulating metabolic functions in the human body and many of them are critical for supporting the metabolic functions of nerve cells.


Thiamine (Vitamin B1)


Thiamine, or Vitamin B1, helps our bodies turn carbohydrates (sugars) into energy that the body can use. Thiamine is critical in the maintenance of nerve health in the human body. A deficiency in thiamine can cause numbness, tingling, loss of sensation, a loss of balance, among other neurological signs.


Niacin (Vitamin B3)


Niacin, or vitamin B3, is another essential vitamin and nutrient. It is a precursor to nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP). Niacin deficiency, referred to a pellagra, can lead to weakness, nerve damage, or even paralysis.


Vitamin B6


Vitamin B6 is an essential water-soluble B vitamin. This vitamin is essential for the production of several neurotransmitters such as GABA, serotonin, dopamine, epinephrine, and norepinephrine. It is also involved in the metabolism of glucose and other carbohydrates (sugar). Deficiency in vitamin B6 can cause symptoms of peripheral neuropathy. However, it is important to note that too much vitamin B6 can cause symptoms of peripheral neuropathy as well.


Vitamin B12


Vitamin B12 is another essential vitamin that plays an important role in several different areas of the human body. It plays a critical role in the synthesis of myelin, the protective coating that surrounds nerve cells. Symptoms of vitamin B12 deficiency include decreased or absent reflexes, diminished vibratory sensation or sensation to light touch.


Carnosine


Carnosine is a peptide molecule that contains two amino acids - histidine and beta-alanine. It is naturally produced by the human liver, but can also be consumed through animal sources. Carnosine functions as an antioxidant and also reduces the rate of formation of advanced glycation end-products (AGEs).


Chemotherapy patients frequently develop peripheral neuropathy as a side effect of the chemotherapy drugs. A prospective randomized controlled study published in Toxicology and Applied Pharmacology in 2019 evaluated the neuroprotective effects of L-carnosine on patients undergoing chemotherapy for colon cancer. The patients undergoing chemotherapy treatment with administered oral L-carnosine daily for 3 months. The researchers confirmed the neuroprotective effect of L-carnosine on patients being treated with oxaliplatin.


L-carnosine has also been studied in the treatment of diabetic neuropathy. Chronic wounds are a late-stage complication of diabetic neuropathy. A study published in Amino Acids in 2012 looked at the impact of treating diabetic mice with carnosine. The study found that carnosine supplementation significantly improved wound healing, even in the presence of high blood sugar levels.


Alpha lipoic acid


Alpha lipoic acid (α-Lipoic acid, or thiotic acid) is a compound that is naturally made by the human body. It is sold in the U.S. as a supplement, being marketed primarily as an antioxidant. The ability of alpha lipoic acid to act as an antioxidant is thought to be one of the mechanisms in which it is able to help with neuropathic pain.

A meta-analysis of randomized controlled trials published in the International Journal of Endocrinology studied the effect of alpha lipoic acid on pain caused by diabetic neuropathy. The researchers found that administration of alpha lipoic acid for 3 weeks resulted in a significant and clinically relevant reduction in pain.


A randomized double-blinded placebo-controlled study published in Endocrine, Metabolic & Immune Disorders - Drug Targets assessed the efficacy of alpha lipoic acid on the treatment of individuals with diabetic neuropathy. The study participants were administered oral alpha lipoic acid daily for 6 months. The researchers used parameters such as vibration perception threshold (VPT), neurological symptom score (NSS), neurological disability score (NDS), and visual analog scale (VAS) to determine whether or not there was any benefit of alpha lipoic acid in treating neuropathic pain. The researchers found that there was a clinically significant improvement in all parameters.


N-acetyl cysteine


N-acetyl cysteine, or NAC, is an amino acid that has historically been administered as a prescription medication. It is FDA approved to treat Tylenol ( acetaminophen) poisoning. N-acetyl cysteine functions as an antioxidant precursor. It increases levels of glutathione (a potent and natural antioxidant) in the blood stream.


A study published in the Journal of Pain Research in 2019 looked at the effects of N-acetyl cysteine as an adjunct to treatment of neuropathic pain in diabetics. The study treated patients with diabetic neuropathy using either pregabalin or pregabalin plus NAC for 8 weeks. The researchers concluded that adding NAC to the treatment with pregabalin was better at treating neuropathic pain than using pregabalin alone.


Another study published in Molecular Pain in 2020 aimed to determine the possible benefit of N-acetyl cysteine as a treatment for neuropathic pain in mice. The researchers reported a significant improvement in pain, noting that N-acetyl cysteine shows promise as an add-on drug in treating diabetic neuropathy.


Acetyl L-carnitine


L-carnitine is a compound that is typically consumed in sufficient amounts through a well-rounded diet. Acetyl L-carnitine, a specific form of L-carnitine, has been shown to be superior to L-carnitine in its affects on neuropathic pain.


A paper published in the Journal of Pain Research in 2019 reported on the effects of acetyl L-carnitine when treating neuropathic pain. The authors determined that there was a 20% reduction in pain when compared to placebo. The study also reported beneficial effects on nerve conduction parameters, which measure the ability of nerves to conduct electricity. There was also evidence of nerve fiber regeneration, meaning the nerves seemed to grow back.


Acetyl L-carnitine supplementation may be beneficial to individuals that are taking prescription medications to treat the symptoms of peripheral neuropathy. Some medications that are used specifically to treat peripheral neuropathy have been found to reduce the levels of L-carnitine in the blood stream.


Conclusion


All medications, vitamins, minerals, and supplements should only be taken under strict guidance of a licensed physician. Ultimately, you should work with your doctor to determine if supplementation is right for you.


Here at Black Tie Health™, we offer preliminary consultations via telehealth for only $99. During these consultations, we can discuss treatment options, write prescriptions, and order tests - all of it done online. We can also help you with information on which dietary supplements are likely to be best for your specific medical situation, as well as provide you with recommended dosages.


Telehealth appointments can be made using the "Book Now" button below.





Disclaimer


These statements have not been evaluated by the FDA. These products are not intended to diagnose, treat, cure, or prevent any disease. You should discuss your specific situation with your doctor before taking any dietary supplements. Without proper medical oversight, come dietary supplements have a significant potential for harm in individuals with certain medical conditions or taking certain medications.


Sources


Ansurudeen I, Sunkari VG, Grünler J, Peters V, Schmitt CP, Catrina SB, Brismar K, Forsberg EA. Carnosine enhances diabetic wound healing in the db/db mouse model of type 2 diabetes. Amino Acids. 2012 Jul;43(1):127-34. doi: 10.1007/s00726-012-1269-z. Epub 2012 Mar 24. PMID: 22451275.


Hug G, McGraw CA, Bates SR, Landrigan EA. Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children. J Pediatr. 1991 Nov;119(5):799-802. doi: 10.1016/s0022-3476(05)80306-3. PMID: 1941389.


Di Stefano G, Di Lionardo A, Galosi E, Truini A, Cruccu G. Acetyl-L-carnitine in painful peripheral neuropathy: a systematic review. J Pain Res. 2019 Apr 26;12:1341-1351. doi: 10.2147/JPR.S190231. PMID: 31118753; PMCID: PMC6498091.


El-Nahas MR, Elkannishy G, Abdelhafez H, Elkhamisy ET, El-Sehrawy AA. Oral Alpha Lipoic Acid Treatment for Symptomatic Diabetic Peripheral Neuropathy: A Randomized Double-Blinded Placebo-Controlled Study. Endocr Metab Immune Disord Drug Targets. 2020;20(9):1531-1534. doi: 10.2174/1871530320666200506081407. PMID: 32370731.


Heidari N, Sajedi F, Mohammadi Y, Mirjalili M, Mehrpooya M. Ameliorative Effects Of N-Acetylcysteine As Adjunct Therapy On Symptoms Of Painful Diabetic Neuropathy. J Pain Res. 2019 Nov 19;12:3147-3159. doi: 10.2147/JPR.S228255. PMID: 31819599; PMCID: PMC6875491.


Mijnhout GS, Kollen BJ, Alkhalaf A, Kleefstra N, Bilo HJ. Alpha lipoic Acid for symptomatic peripheral neuropathy in patients with diabetes: a meta-analysis of randomized controlled trials. Int J Endocrinol. 2012;2012:456279. doi: 10.1155/2012/456279. Epub 2012 Jan 26. PMID: 22331979; PMCID: PMC3272801.


Viana MDM, Lauria PSS, Lima AAd, Opretzka LCF, Marcelino HR, Villarreal CF. Alpha-Lipoic Acid as an Antioxidant Strategy for Managing Neuropathic Pain. Antioxidants. 2022; 11(12):2420. https://doi.org/10.3390/antiox11122420


Yehia R, Saleh S, El Abhar H, Saad AS, Schaalan M. L-Carnosine protects against Oxaliplatin-induced peripheral neuropathy in colorectal cancer patients: A perspective on targeting Nrf-2 and NF-κB pathways. Toxicol Appl Pharmacol. 2019 Feb 15;365:41-50. doi: 10.1016/j.taap.2018.12.015. Epub 2018 Dec 25. PMID: 30592963. .

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