Neurpathic leg pain

[Gedge01]

Help with neuropathy.can anyone advise medication or remedy for diabetic neuropathy .I suffer severe pain in my legs which affects my walking and balance.

I have Parkinsonism and take semenet ,paracetamol,antripalene ,pregablin and azilect.

[silvestrov]

Sorry to hear about your problem and I have 3 recommendations for DPN. The first one is methylcobalamin, the most potent form of vitamin B12. Methylcobalamin is also important for Parkinson's disease patients who are taking Sinemet because long-term use of Sinemet can cause a rise in the non-protein amino acid homocysteine (which is associated with vascular dementia and heart disease). Methylcobalamin helps, along with methyltetrahydrofolic acid/folate, to convert homocysteine into methionine. Methylcobalamin (MC) also does not affect your blood sugar levels like either acetyl l carnitine or alpha lipoic acid.

The first study compares efficacy of methylcobalamin (MC) or acetyl l carnitine (ALC) in treating DPN:

"A total of 232 patients were randomized (ALC n = 117, MC n = 115), 88% of which completed the trial. At week 24, patients from both groups had significant reductions in both neuropathy symptom score and neuropathy disability score with no significant difference between two groups (neuropathy symptom score reduction:..."

ncbi.nlm.nih.gov/pmc/articl...

Alpha lipoic acid has been used in Germany to treat DPN for over 50 years and they use high dose alpha lipoic acid.

"1.) Short-term treatment for 3 weeks using 600 mg of thioctic acid i.v. per day appears to reduce the chief symptoms of diabetic polyneuropathy. A 3-week pilot study of 1800 mg per day given orally indicates that the therapeutic effect may be independent of the route of administration, but this needs to be confirmed in a larger sample size. 2.) The effect on symptoms is accompanied by an improvement of neuropathic deficits. 3.) Oral treatment for 4-7 months tends to reduce neuropathic deficits and improves cardiac autonomic neuropathy. 4.) Preliminary data over 2 years indicate possible long-term improvement in motor and sensory nerve conduction in the lower limbs. 5.) Clinical and postmarketing surveillance studies have revealed a highly favourable safety profile of the drug."

ncbi.nlm.nih.gov/pubmed/105...

Of course you can take acetyl l carnitine and alpha lipoic acid with methylcobalamin for maximum effect. Also, there may be a way to reduce the dose of either acetyl l carnitine or alpha lipoic acid (by combining them). In the following Parkinson's disease study it is shown that the combination....

"Most notably, we found that when combined, LA and ALC worked at 100-1000-fold lower concentrations than they did individually."

ncbi.nlm.nih.gov/pubmed/204...

The best form of alpha lipoic acid is the R-sodium salt fraction because it is more bioavailable than the inferior 'S' (synthetic form).

swansonvitamins.com/q?kw=R-...

Both alpha lipoic acid and acetyl l carnitine have been tested on diabetes patients and both lower blood sugar so you must be careful when using them. A diabetes animal model study:

R-alpha-lipoic acid and acetyl-L-carnitine complementarily promote mitochondrial biogenesis in murine 3T3-L1 adipocytes.

"RESULTS:

Treatments with the combination of LA and ALC at concentrations of 0.1, 1 and 10 micromol/l for 24 h significantly increased mitochondrial mass, expression of mitochondrial DNA, mitochondrial complexes, oxygen consumption and fatty acid oxidation in 3T3L1 adipocytes."

"However, the treatments with LA or ALC alone at the same concentrations showed little effect on mitochondrial function and biogenesis."

ncbi.nlm.nih.gov/pubmed/180...

This study reinforced the additive effect of taking alpha lipoic acid and acetyl l carnitine together.

As for methylcobalamin/B12 it has no scientific dosage upper limit and it can be taken safely in high doses. The following study chronicles the use of high dose vitamin B12:

stichtingb12tekort.nl/weten...

Best wishes!!

[2bats]

I hope that you are on a Keto Diet to reverse the diabetes, but if not I would strongly recommend it!

Best regards, Phil 2bats

[Goldencbc]

Massage and physical therapy help keep the pain from being overwhelming. It is always there however and also interferes with walking. I use walking poles when I walk. My PT says they reduce load on my leg. They help and keep me moving forward. I also do stretches every day.

[bungo70]

Try compression socks (knee high) & high dose thiamine (500 mg)

[Gedge01 in reply to bungo70]

Thank you I found compression socks to be too painful ,I do have walking poles and use them occasionally,

Thanks again for your help

[bungo70]

Amazon sells leg sleeves of different sizes.

[Gedge01 in reply to bungo70]

Thanks for the suggestion. I bought my compression socks from amazon and chose according to their instructions.The problem is not the sleeve but my legs which cannot take any kind of pressure. Thanks for your help

[Cowpatti]

This site usually has a comprehensive list of treatments. Be sure to scroll to the end for all natural treatments. Dr Axe

draxe.com/health/diabetic-n...

[Gedge01 in reply to Cowpatti]

Very comprehensive site.Thanks I will check these ideas out. Thanks for your help.

[chartist]

Gedge01,

Vitamin D is useful for neuropathic pain as outlined in this brief abstract :

ncbi.nlm.nih.gov/pubmed/306...

Vitamin D is also useful for diabetes type 2 as outlined in this short abstract:

ncbi.nlm.nih.gov/pubmed/287...

Art

[Gedge01 in reply to chartist]

Yes, I already take vitamin D but thank you for the suggestion

[silvestrov]

PS. HOT OFF THE PRESS:

Higher vitamin B12 level at Parkinson's disease diagnosis is associated with lower risk of future dementia

Conclusion

"Higher levels of serum vitamin B12 at PD diagnosis correlate with lower risk of future dementia. The role of vitamin B12 in the development of dementia among PD patients deserves further evaluation. "

Published: March 17, 2020 DOI:doi.org/10.1016/j.parkreldi...