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Q#1: Supplementation for Neuropathy
I am experiencing some very painful peripheral neuropathy in my feet, legs, and hands now. I am pretty sure it's from the meds I'm on which include a lot of the "D" Drugs. (I may have to change this.) I do understand, however, that there is a regimen of supplements that one can take to alleviate the pain and numbing. Can you enlighten me as to what they may be?
A#1: Charlie Smigelski, RD responds:
I have a list of supplements to take to try to remedy neuropathy. I used to suggest that people try them one at a time, but with the rate of neuropathies increasing all the time, I now suggest people take the full list for 8 weeks to try for the best results. If there's no improvement, you can stop the regimen; the damage is not reparable. If it is helping, continue for another 8 weeks for most benefit. To maintain the benefits, continue B-complex 50 and carnitine and magnesium.
1. Take 400 mg of magnesium a day.
2. Get your medical provider to give you a 1 mg vit B12 shot 1 to 2 times a week.
3. Take 2 grams a day of L-carnitine. If you can afford it, get Acetyl Carnitine instead of regular carnitine.
4. Take 400 mg a day of alpha lipoic acid, also know as thioctic
acid.
5. Be sure you are taking a B-complex 50... general B-complex
vitamin supplement. This will have 400 to 800 mcg of folic acid,
important stuff.
6. Take 100mg vitamin B-6 pills three times a day. Do this amount of B-6 for just three months at the most. You will get whatever benefit you can in that amount of time. Then cut back to just the 100mg contained in your B-complex vitamin.
Also, if you are getting neuropathy along with some blood sugar problems, especially during PI (protease inhibitor) treatment, add 2 grams a day of Evening Primrose Oil (as a source of GLA...essential fat) to the above list of supplements. Take the Primrose oil as long as you are on the PI.
Find a Buyers Club to purchase the items, because the carnitine and lipoic acid are way over-priced at regular health food stores. At the Boston Buyers Club (617 266-2223) the regime would be about $50 for the 8 weeks.
Q#2: Causes of Peripheral Neuropathy
I was curious about the cause of peripheral neuropathy. Is it only caused by a disease, or can you also get it by having an accident such as falling down? (November, 1999)
A#2: Charlie Smigelski, RD responds:
(Administrator's Note:Well, it doesn't happen from falling down, but you should check with a medical doctor for possible other nerve problems that might result from an accident like that. Remember, our area of expertise is in nutrition as it relates to HIV disease. Read on for Charlie's response in that context.)
Peripheral neuropathy can occur from HIV disease itself as it destroys neurons or from neurons damaged by "starvation", i.e. lack of proper nutriton.
Proper nutriton here is in reference to the build up of toxic materials, like free radicals, which damage tissue. "Improper" nutrition would be a condition in which antioxidant chemicals are not in proper supply to stave off the attacking singlet oxygen or whatever other free radicals there are in one's system.
"Starvation" may also be due to a lack of formative elements, because HIV treatment medicines are messing up one's metabolism or causing malabsorption, thereby limiting the arrival of nutrients. For example, carnitine is limited in our diet (we don't eat a lot of mutton, the best source) and DDi or D4T and DDc all hamper the body's production of carnitine, and it is needed for nerve repair (as well as for fat-processing). Vitamin B-12 levels are also low, as well as B-6 and magnesium. All these relate to the methylation reactions crucial to nerve growth too. Please read the response to Question #1 above for my suggestions on supplementation for peripheral neuropathy.
