Peripheral neuropathy

Peripheral neuropathy is a common neurologic disorder that results from damage to the peripheral nerves. It may be caused by diseases of the nervous system or may be a result of systemic illnesses. It has various causes, including exposure to various toxins (e.g. alcohol, lead, mercury, mold, etc.), certain prescription medications (e.g. amiodarone, hydralazine, metronidazole, nitrofurantoin, phenytoin, statins, etc.), mechanical injury that causes compression/entrapment (e.g. carpal tunnel syndrome), nutritional deficiencies/malabsorption syndromes (e.g. vitamin B deficiency), infectious causes (e.g. HIV, Lyme disease), and autoimmune conditions (e.g. Guillain-Barré syndrome, multifocal motor neuropathy).1 One of the most common causes is diabetes. High blood sugar alone however cannot account for the development of nerve damage. Diabetic neuropathy also occurs in patients with well-controlled disease and may be absent in poorly controlled diabetes mellitus.2

Common symptoms include: tingling, prickling, numbness, burning/freezing pain, electric pain, sharp stabbing sensation, extreme sensitivity to touch, and loss of balance/coordination.3

Multiple studies have demonstrated that following a whole-foods, high-fiber, plant-based diet combined with exercise can decrease type 1 diabetes mellitus medications by up to 40%4 or eliminate them completely in type 2 diabetes mellitus.5 Regular exercise — walking for a minimum of 30 minutes 3 times a week — should be implemented; as should strengthening exercises.6 There is also utility in using botanical medicine to address peripheral neuropathy. Curcumin in particular has been shown to be beneficial in treating many inflammatory diseases including diabetes and its complications.7

Acetyl-L-carnitine is an acetylated form of L-carnitine, which is an amino acid that is responsible for the transport of fatty acids into a cell’s mitochondria. It has been shown to reduce pain significantly in diabetic neuropathy.8 A regimen administered as an intravenous infusion over 1 to 2 hours for at least 10 days has been shown to improve chemotherapy-induced peripheral neuropathy in a majority of patients.9

Alpha-lipoic acid is a universal antioxidant that is widely used in Germany. It acts as a powerful antioxidant and also mitigates the toxic effects of heavy metals.10 It has been extensively studied in peripheral neuropathy and has a well-established effective profile.11

Our extensive national network of pharmacists allows us to be able to administer these and other nutraceuticals to our clients in the comfort of our office.

  1. H. Imreova, M. Pura: Differential diagnosis of peripheral neuropathy. Cas Lek Cesk.144:628-633 2005
  2. H. Hamberg: Diseases of the peripheral nervous system. J.B. Wyngaarden L.H. Smith Jr. J.C. Bennett Cecil textbook of medicine. ed 19 1992 Saunders Philadelphia 2240-2247
  3. L. Sorensen, L. Molyneaux, D.K. Yue: The relationship among pain, sensory loss, and small nerve fibers in diabetes. Diabetes Care. 29:883-887 2006
  4. J.W. Anderson: Dietary fiber in nutrition management of diabetes. V. G Vahouny D.Kritchevsky Dietary fiber: basic and clinical aspects. 1986 Plenum Press New York 343-360
  5. J. Tuomilehto, J. Lindstrom, J.G. Eriksson, et al.: Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 344:1343-1350 2001
  6. C.M. White, J. Pritchard, L. Turner-Stokes: Exercise for people with peripheral neuropathy. Cochrane Database Syst Rev. 4:CD003904 2004
  7. D.W. Zhang, M. Fu, S.H. Gao, J.L. Liu: Curcumin and diabetes: a systematic review.Evid Based Complement Alternat Med. 2013 636053 Epub 2013 Nov 24
  8. A. Vanotti, M. Osio, E. Mailland, C. Nascimbene, E. Capiluppi, C. Mariani: Overview on pathophysiology and newer approaches to treatment of peripheral neuropathies.CNS Drugs. 21 (Suppl 1):3-12 2007 discussion 45–46
  9. A. Maestri, A. De Pasquale Ceratti, C. Zanna, et al.: A pilot study on the effect of acetyl-l-carnitine in paclitaxel- and cisplatin-induced peripheral neuropathy. Tumori.91:135-138 2005
  10. A.R. Smith, S.V. Shenvi, M. Widlansky, et al.: Lipoic acid as a potential therapy for chronic disease associated with oxidative stress. Curr Med Chem. 11:1135-1146 2004
  11. D. Ziegler, A. Ametov, A. Barinov, et al.: Oral treatment with α-lipoic acid improves symptomatic diabetic polyneuropathy. Diabetes Care. 29 (11):2365-2370 2006