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Peripheral Neuropathy (diabetes) treated by Vitamin D, etc. – Sept 2019

Complementary and Alternative Medicine for Painful Peripheral Neuropathy.

Curr Treat Options Neurol. 2019 Sep 2;21(9):44. doi: 10.1007/s11940-019-0584-z.
Baute V1, Zelnik D2,3, Curtis J2, Sadeghifar F2.
1 Dept of Neurology, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston Salem, NC, 27157, USA. vbaute at wakehealth.edu.
2 Dept of Neurology, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston Salem, NC, 27157, USA.
3 Integrative Medicine Center, Concentra, 1500 W I-240 Service Rd, Oklahoma City, OK, 73159, USA.

The purpose of our manuscript is to review the current evidence supporting the use of complementary and alternative medicine (CAM) in neuromuscular disease, specifically in painful peripheral neuropathy (PPN). We outline the therapeutic challenges of this debilitating condition and describe the best evidence for incorporating such therapies into clinical practice. The most studied modalities include lifestyle modifications with diet and exercise, supplements, and acupuncture. CAM therapies such as yoga, meditation, electrical stimulation, neuromodulatory devices, and cannabis are mentioned as emerging therapies.

Current data suggests that targeted lifestyle modifications, including aerobic exercise and diet modifications that promote weight loss, may improve the natural course of diabetic painful neuropathy and potentially other types of neuropathy. A number of studied dietary supplements and vitamins including B vitamins, vitamin D, alpha-lipoic acid, and acetyl-L-carnitine improve both subjective and objective neuropathic measures. A wide range of neuromodulatory devices and electrical stimulation modalities demonstrate mixed results, and further studies are needed to confirm their benefit. Finally, acupuncture and yoga both demonstrate benefit in a variety of PPNs. Multiple CAM therapies show efficacy in the treatment of PPN. From the strongest level of evidence to the least,

  • lifestyle modifications including exercise and diet;
  • supplements including B12, alpha lipoic acid, acetyl-L-carnitine, and vitamin D in deficient patients; followed by
  • acupuncture and yoga may alleviate symptoms of PPN.
Clipped from the PDF

Vitamin D
…prospective study in 51 patients with painful DPN and vitamin D insufficiency showed that 2000 IU of cholecalciferol (vitamin D3) daily for 3 months resulted in a 50% decrease in the visual analog pain score [33]. A placebo-controlled study in patients with DPN and vitamin D deficiency randomized to 50,000 IU of vitamin D3 once weekly for 8 weeks showed improvement in the Neuropathy Disability Score [34]. Another study of painful DPN found that a single IM dose of 600,000 IU of vitamin D3 had a significant effect on reducing neuropathic pain symptoms and pain scores [35]. This therapeutic effect was maximal at 10 weeks, lasted the 20-week study period, and was independent of baseline vitamin D levels. Further studies are warranted to examine the use of vitamin D3 in those with normal serum vitamin D levels and to employ the use of objective measurements such as nerve conduction studies.

Cannabis (marijuana) for medicinal use has become popular in recent years (currently legal in some form in 32 US states). Aside from cumbersome prescribing issues, the lack of clear safety and quality standards for treatment with cannabis makes many clinicians give pause to this treatment for PPN (despite patients wholeheartedly embracing it). The following section summarizes the evidence for the use of supplements and cannabinoids in the treatment of PPN.

Currently, the endocannabinoid system is being investigated for its role in the modulation of neuropathic pain. Understanding this pathway is an emerging area in the development of new pharmaceutical drugs to treat refractory PPN. Meanwhile, medicinal cannabis (i.e., medical marijuana) and its main chemical components tetrahydrocannabinol (THC) and cannabidiol (CBD) are currently available (where legal) and becoming popular for self-management of refractory chronic pain syndromes. THC is the component responsible for psychoactive symptoms but also with what appears to be dose-dependent analgesic effects [48, 49, 50]. CBD is not psychoactive and has anti-inflammatory and antioxidant properties. Potential THC side effects of cognitive impairment and psychosis, among others, raise concerns regarding the safety and tolerability of high-dose THC preparations for treatment of refractory PPN. There are a small number of studies investigating different formulations of cannabis, including various THC concentrations in smoked whole plant, isolated THC+CBD, plant- derived THC, and synthetic THC. These studies suggest that patients can benefit from cannabis for neuropathic pain relief, however for now, that is still accompanied by expected dose-dependent side effects (largely psychiatric) [48, 49, 50].

It has been observed that almost 25% of type 1 diabetic patients with or without DPN have low levels of circulating magnesium [36]. In type 2 diabetes patients, neuropathy was found to be more prevalent when magnesium depletion was present, though a direct causal relationship is not clear [37]. Two studies have shown a correlation between low magnesium levels and abnormal nerve conduction study results [37, 38]. Long-term supplementation with 300 mg daily magnesium glycinate vs no supplementation for 5 years in type 1 diabetic patients restored a normal magnesium status and slowed down the natural progression of PN based on patient symptoms and neurologic exam [36]. Based on this preliminary information, more research investigating dosing, tolerability, and effectiveness of oral magnesium supplementation in patients with DPN will inform its clinical use.
 Download the PDF from Sci-Hub via VitaminDWiki

Items in both categories Diabetes and Magnesium

VitaminDWiki titles containing "Neuropathy" (15 as of April 2022)

Items found: 15

Vitamin D not only fights PN and chronic pain but also prevents and treats Diabetes

Pain - chronic category has the following

146 items in category Chronic pain

See also

Overview Diabetes and vitamin D contains the following

  • Diabetes is 5X more frequent far from the equator
  • Children getting 2,000 IU of vitamin D are 8X less likely to get Type 1 diabetes
  • Obese people get less sun / Vitamin D - and also vitamin D gets lost in fat
  • Sedentary people get less sun / Vitamin D
  • Worldwide Diabetes increase has been concurrent with vitamin D decrease and air conditioning
  • Elderly get 4X less vitamin D from the same amount of sun
        Elderly also spend less time outdoors and have more clothes on
  • All items in category Diabetes and Vitamin D 493 items: both Type 1 and Type 2

Vitamin D appears to both prevent and treat diabetes

  • Appears that >2,000 IU will Prevent
  • Appears that >4,000 IU will Treat , but not cure
  • Appears that Calcium and Magnesium are needed for both Prevention and Treatment
    • which are just some of the vitamin D cofactors

Number of articles in both categories of Diabetes and:

  • Dark Skin 23;   Intervention 54;   Meta-analysis 35;   Obesity 30;  Pregnancy 40;   T1 (child) 38;  Omega-3 11;  Vitamin D Receptor 21;  Genetics 11;  Magnesium 21    Click here to see details

Diabetic Epidemic

  • Step back to 1994. Suppose an epidemic struck the United States, causing blindness, kidney failure, and leg amputations in steadily increasing numbers.
    Suppose that in less than a decade's time, the epidemic had victimized one out of every eight people
    That epidemic is real, and its name is diabetes, now the nation's sixth leading cause of death.
    Chart from the web (2018?)

See clipped from the PDF at the bottom of thes page: Vitamin D, CBD, Magnesium

Created by admin. Last Modification: Saturday April 16, 2022 14:39:50 GMT-0000 by admin. (Version 13)

Attached files

ID Name Comment Uploaded Size Downloads
12582 PPN Sci-hub.pdf PDF 2019 admin 04 Sep, 2019 14:31 901.48 Kb 397
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