Diabetic Peripheral Neuropathy - 6 - Treatment in English Health by Dr. Bhairavsinh Raol books and stories PDF | Diabetic Peripheral Neuropathy - 6 - Treatment

Featured Books
Categories
Share

Diabetic Peripheral Neuropathy - 6 - Treatment


Introduction
Great Vitamins and other suppliments for Neuropathy
B-Complex Vitamins particularly
B-1(Benfotiamine)
B-6 (Thiamine)and
B-12(Methylcobalamin)
Vitamin C
Vitamin D
Alpha-lipoic acid
Glutathione.
N-acetyl cysteine
Acetyl N Carnitine
Magnesium.
Calcium.


(a) Vitamin B12 supplement in diabetic neuropathy:
Vitamins B-1, B-6, and B-12 have been found to be especially beneficial for treating neuropathy. Vitamin B-1, also known as Thiamine, helps to reduce pain and inflammation and vitamin B-6 preserves the covering on nerve endings.
However, one explanation is that vitamin B-12 plays an important role in nerve repair and myelination and may thus improve symptoms of neuropathy, including pain.

Overall, there are limited randomized trials of vitamin B for neuropathic pain.
B Vitamin supplements are good for aiding nerve repair.
Vegetables to regenerate nerves naturally:
Green and leafy vegetables,
Broccoli, spinach and asparagus all contain vitamin B, a nutrient important for nerve regeneration and nerve function. Spinach, broccoli and kale also contain a micronutrient called alpha-lipoic acid that prevents nerve damage and improves nerve function.

A lack of B-12 damages the myelin sheath that surrounds and protect nerves. Without this protection, nerves cease to function properly and conditions such as peripheral neuropathy occur. Even B-12 deficiency that is relatively mild may affect the nervous system and the proper functioning of the brain.

Manifestations of Neuropathy caused by Vitamin B-12 deficiency:
Vitamin B-12 deficiency can present with neurologic manifestations including subacute combined degeneration of the spinal cord, peripheral neuropathy, optic neuropathy, ataxia, cognitive disturbances, and mood changes, in addition to megaloblastic anemia.

Symptoms of B-12 deficiency neuropathy:
Memory loss. pins and needles (paraesthesia) loss of physical co-ordination SW CE(ataxia), which can affect your whole body and cause difficulty speaking or walking, damage to parts of the nervous system (peripheral neuropathy), particularly in the legs.

The peripheral neuropathy induced by vitamin B-12 deficiency can recover/reverse completely with substitutive treatment.
Although treatment regimens of B-12 injections vary, some doctors recommend injections of 1,000 micrograms (mcg) of vitamin B-12 daily for five days followed by the same amount given once a week for five weeks, and then a lifelong dose of one injection per month, containing 100 to 1,000 mcg of vitamin B-12.

(b)Benfotiamine(Vitamin B-1/Thiamine) as a supplement for diabetic neuropathy:
People use benfotiamine for nerve damage caused by diabetes (diabetic neuropathy). It is also used for alcohol use disorder, Alzheimer disease, arthritis, and other conditions, but there is no good scientific evidence to support most of these uses.
Benfotiamine is a lab-made version of vitamin B1, also called Thiamine. Scientists are studying it to see if it might help conditions like diabetes-related nerve damage, Alzheimer's disease, and alcohol dependence.
Benfotiamine is a relative of Thiamine, better known as vitamin B-1. Thiamine is critical for the metabolism of our brain's major energy source glucose. Benfotiamine, which converts to Thiamine in the body, enters cells more easily than Thiamine itself.

Dosing: Benfotiamine is most often used by adults in doses of 150-600 mg by mouth daily for up to 6 months. Speak with a healthcare provider to find out what dose might be best for a specific condition.
Benfotiamine may also be beneficial in preventing diabetic nephropathy and retinopathy. A study of 20 patients given 400 mg daily of benfotiamine showed improvement in neuropathy scores and decrease in pain complaints over a 3 week period. Therapeutic benefits can be seen as early as 3 weeks, with the most significant improvements occurring in patients taking the highest dose of benfotiamine, that is, 600 mg/day at 6 weeks.
Treatment was well tolerated by patients and no benfotiamine-drug interactions were reported.
Benfotiamine Alpha-lipoic acid Methylcobalamin
Pyridoxine combination is used to treat nutritional deficiencies.
It contains Benfotiamine, Alpha lipoic acid, Pyridoxine, and Methylcobalamin.

In this combination drug;
Benfotiamine, a synthetic form of Vitamin B-1 or Thiamine, helps deliver essential nutrients to the . Spinach, broccoli and kale also contain a micronutrient called alpha-lipoic acid that prevents nerve damage and improves nerve function.
It also treats numbness, tingling, burning, and needle-like sensations in the hands and feet.
Alpha-lipoic acid is an antioxidant that prevents cell damage and also decreases pain and numbness in neuropathy.
Pyridoxine treats and prevents vitamin B-6 deficiency, anaemia, peripheral neuropathy, and seizures (fits). It is involved in protein, fat, and carbohydrate metabolism and the creation of red blood cells and neurotransmitters.

Methylcobalamin regulates body functions and helps rejuvenate and protect damaged nerve cells by producing a substance called myelin.

(c) Vitamin B-6(Pyridoxine) in diabetic neuropathy:
In adults, vitamin B-6 deficiency can cause inflammation of the skin (dermatitis) and a red, greasy, scaly rash. The hands and feet may feel numb and prickling like pins and needles. The tongue may become sore and red, and cracks may form in the corners of the mouth. People may become confused, irritable, and depressed. Vitamin B-6 plays an important role in the body. It is needed to maintain the health of nerves, skin, and red blood cells. Pyridoxine has been used to prevent or treat a certain nerve disorder (peripheral neuropathy) caused by certain medications (such as Isoniazid).

(d)'Vitamin C as a supplement:
Vitamin C plays a synergistic role in reducing pain in patients with diabetic neuropathy. It improves QOL due to its analgesic properties. Moreover, it is cost-effective and appears to be a safe and adjuvant therapy for specific pain relief.
Vitamin C that is Ascorbic acid (AA) is an essential micronutrient that has been safely used in the clinic for many years. The present study indicates that AA has an unexpected function in facilitating nerve regeneration.Studies show that consuming more vitamin C can increase your blood antioxidant levels by up to 30%. This helps the body's natural defenses fight inflammation. Vitamin C is a strong antioxidant that can boost your blood antioxidant levels. This may help reduce the risk of chronic diseases like heart disease.
Larger amounts would require a doctor's prescription. The reason for the imposed limit was that experts say that in high doses the vitamin C can cause neurological symptoms, such as tingling and numbness, and possibly permanent nerve damage
The upper limit for vitamin C in adults is 2,000 mg. Individuals with chronic liver disease, gout, or kidney disease are recommended to take no more than 1,000 mg of vitamin C per day. High vitamin C intakes have the potential to increase urinary oxalate and uric acid excretion.
The upper limit for all adults is 2,000 mg a day. Although too much dietary vitamin C is unlikely to be harmful, large doses of vitamin C supplements might cause diarrhea.
Fruits and vegetables are the best sources of vitamin-C.
Citrus (oranges, kiwi, lemon, grapefruit)
Bell peppers.
Strawberries.
Tomatoes.
Cruciferous vegetables (broccoli, Brussels sprouts, cabbage, cauliflower)
White potatoes etc.

(e) Vitamin D supplement:
Neuropathic pain is a common complication of diabetes mellitus. Vitamin D deficiency is very common among patients with type 2 DM and among the general population. There is increasing evidence suggesting that vitamin D deficiency could be associated with the development of neuropathic pain.
Treatment with a single intramuscular dose of
600000 IU of vitamin D in patients with painful diabetic neuropathy is associated with a significant decrease in the symptoms of painful diabetic neuropathy.
In another study, vitamin D supplementation has been reported to have beneficial effects on neuropathic pain and prevent neuronal degeneration. Patients with DN have more balance disturbance problem than normal healthy subjects and diabetic individuals without neuropathy.
Oral supplementation of vitamin D 3 (50,000 IU) once weekly for 12 weeks was associated with improvement in the serum level of vitamin D and significant decrease in the symptoms and sign of diabetic neuropathy.
Vitamin D is believed to help improve the body's sensitivity to insulin,the hormone responsible for regulating blood sugar levels and thus reduce the risk of insulin resistance, which is often a precursor to type 2 diabetes.
Vitamin D supplementation may help lower average blood sugar levels in people with type 2 diabetes and is especially effective in people who also have a vitamin D deficiency, and are non-obese and deficient.

“Caution should be taken with vitamin D dosages, for people with or without diabetes,” said Smith. “The standard dosage is 400 IUs per day, but for those with diabetes, the current recommended safe daily dose to maintain optimal vitamin D levels is 1,000 to 2,000 IUs per day.”
Supplementation for more than 12 weeks at ≥ 1000 IU/day may be most beneficial.

(f) Alpha lipoic acid supplement : Alpha-lipoic acid is used for nerve pain in people with diabetes. It is also used for obesity, altitude sickness, aging skin, high levels of cholesterol or other fats in the blood, and many other purposes, but there is no good scientific evidence to support many of these other uses.Because alpha-lipoic acid is an unproven treatment, there is no established dose. However, studies have used between 600-1,800 mg daily for diabetes and neuropathy; one review concluded that the evidence is convincing for the use of 600 milligrams daily for three weeks on symptoms of diabetic neuropathy.
The best time to take alpha-lipoic acid:
Studies show that roughly 30-40% of supplemental ALA is absorbed. As such, absorption might be enhanced when taken on an empty stomach. The best time to take alpha-lipoic acid is typically first thing in the morning, at least 30 minutes before eating or drinking.

(g) Acetyl-L-carnitine (ALC) supplement in diabetic neuropathy:Acetyl-l-carnitine. Also known as ALC, Acetyl-l-carnitine is naturally produced by the liver and kidneys and can often be supplemented to treat a variety of symptoms.

The research reveals Acetyl-l-carnitine. Also known as ALC, Acetyl-l-carnitine is naturally produced by the liver and kidneys and can often be supplemented to treat a variety of symptoms.
acetyl-L-carnitine may also help boost brain health and function as you age. Additionally, the risk of deficiency is higher for those with diseases like cirrhosis and kidney disease. If you have one of these conditions, a supplement may be beneficial.Taking acetyl-L-carnitine by mouth might slow the rate of disease progression, improve memory, and improve some measures of mental function and behavior in some people with Alzheimer disease, depression. Taking 1-4 grams of acetyl-L-carnitine by mouth daily seems to improve mood and decrease depression in some people.
Acetyl-L-carnitine improves pain, nerve regeneration, and vibratory perception in patients with chronic diabetic neuropathy. Acetyl-L-carnitine(ALC) is useful supplement in painful peripheral neuropathy.
ALC was administered at two doses (500 or 1,000 mg) three times a day (t.i.d.) for 1 year. Patients treated with 1,000 mg ALC t.i.d. showed significant improvements at both 26 and 52 weeks.
(h)N- Acetyl Cysteine:N-acetyl cysteine (NAC) is used by the body to build antioxidants. Antioxidants are vitamins, minerals, and other nutrients that protect and repair cells from damage. You can get NAC as a supplement or a prescription drug.
The recommended dose is 1 sachet 3 times a day, or as prescribed by your doctor. Empty the sachet contents into a small amount of water in a glass and stir until it dissolves (mixes) completely, just before drinking. It is important to drink all of the mixture. N-Acetyl-cysteine, an effective and safe approach been used clinically, alleviates neuropathic pain through a unique mechanism suppressing the activation of matrix metallo-proteinases.

A study indicated that NAC treatment in diabetes effectively protects from diabetic cardiomyopathy, possibly through inhibiting the ROS production and fibrosis, which warrants further clarification.
N-Acetyl Cysteine improves the diabetic cardiac function.

Acetyl-L-carnitine (ALC) has shown a neuroprotective effect in patients with peripheral neuropathies of different etiologies. Preclinical studies demonstrated a central anti-nociceptive action, both in neuropathic and nociceptive pain models.

(i)Glutathione:
Glutathione is essential for the immune system's proper functioning and is vital in building and repairing tissue. It acts as an important antioxidant, which helps protect your body from damage to cells caused by free radicals.
Chemoprotective drugs, such as glutathione, may help prevent peripheral neuropathy caused by drugs like paclitaxel and carboplatin.
Preliminary research has found that glutathione may help with chemotherapy related neuropathy, diabetic neuropathy, and neuropathy of unknown origin.
Glutathione is best taken before eating or with an unfilled stomach, In request for the body to retain the glutathione quick. You can take it before eating a supper. In any case, nevertheless it very well may be taken in whenever of the day.
(j)Magnesium:
The beneficial effects of magnesium treatment have also been demonstrated in patients suffering from neuropathic pain, such as in those with malignancy related neurologic symptoms, postherpetic neuralgia, diabetic neuropathy, and chemotherapy induced peripheral neuropathy.
In general, studies have found that taking 250–350 mg of magnesium daily appears to benefit people with diabetes. It's best to take magnesium with food to improve absorption.
Magnesium citrate is considered easier to absorb than magnesium oxide, and Nature Made provides 250
mg of the nutrient in each serving.
Magnesium taurate may be the best form of the mineral for managing high blood sugar, according to Healthline.
Magnesium glycinate is best for neuropathy.Magnesium glycinate is especially for people with nerve pain or nerve degenerative diseases like diabetes mellitus and multiple sclerosis.If you have pain, a dose of 250 to 500 mg of magnesium a day can start to decrease these deficiencies as well as the pain, after just several weeks while also leaving you feeling more energetic and decreasing your risk of heart disease!
People with diabetes, intestinal disease, heart disease or kidney disease should not take magnesium before speaking with their health care provider.Signs of a magnesium overdose can include nausea, diarrhea, low blood pressure, muscle weakness, and fatigue. At very high doses, magnesium can be fatal.

(K)Calcium supplement:
his overload of calcium causes the cells to become hyperactive, which in turn causes the characteristic symptoms of neuropathy such as tingling and pain.The Foundation for Peripheral Neuropathy also suggest that calcium could help with chemotherapy-related neuropathy, but again, research is limited. However, the study published in Nutrients found that high dietary calcium had no effect on chemotherapy-induced neuropathy in some people.

Information compiled by: Dr. Bhairavsinh Raol