B12 and Diclofenac

[helvella]

I have recently, reluctantly, been using a diclofenac gel for a painful foot. Looking up diclofenac to check various things, I noticed this paper.

I had not previously considered B12 to be an analgesic! (Though well aware of the neuropathy issues that a deficiency can cause.) And I was surprised by the potentiation effect of B12 on diclofenac.

Do be aware this is a veterinary paper - might not be the same in humans.

Vet Res Forum. 2013 Winter; 4(1): 19–24.

PMCID: PMC4293892

PMID: 25593681

The effects of vitamin B12 and diclofenac and their combination on cold and mechanical allodynia in a neuropathic pain model in rats

Esmaeal Tamaddonfard,1,* Farzad Samadi,2 and Karim Egdami2

Abstract

The present study was performed to investigate the effects of long-term intraperitoneal (IP) injection of vitamin B12 and diclofenac in separate and combined treatments on cold and mechanical allodynia in a neuropathic pain model in rats. Neuropathic pain was induced by crush injury in right tibial nerve. Acetone spray and von Frey tests were used to obtain cold and mechanical allodynia responses, respectively, on day 11 after nerve crush. Normal saline, vitamin B12 and diclofenac were injected intraperitoneally for 10 consecutive days after surgery. Normal saline treated rats showed cold and mechanical allodynia responses after nerve crush. Vitamin B12 at doses of 50, 100 and 200 µg kg-1 and diclofenac at a dose of 2 mg kg-1 produced antiallodynic effects. Antiallodynic effects were not observed when subanalgesic doses of vitamin B12 (25 µg kg-1) and diclofenac (0.25 mg kg-1) were used together. By increasing the dose of vitamin B12 to an effective dose (100 µg kg-1), antiallodynic effects were observed when compared with diclofenac (0.25 mg kg-1) alone. The results indicated that vitamin B12 and diclofenac produced neuropathic pain suppressing effects. Moreover, a potentiation effect was observed between vitamin B12 and diclofenac.

Key Words: Allodynia, Diclofenac, Rats, Tibial nerve injury, Vitamin B12

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

(I tried to check if this had previously been posted but HU's search didn't find anything. Apologies if it is a repeat.)

[helvella]

And another paper here:

Effects of intracerebroventricular injection of vitamin B12 on formalin-induced muscle pain in rats: Role of cyclooxygenase pathway and opioid receptors

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

And a pretty recent review paper:

Vitamin B12 as a Treatment for Pain

painphysicianjournal.com/li...

[waveylines in reply to helvella]

Interesting Helvella. The neurologist I saw about my tremors was wanting to start research on the effects of B12 on the neurological system as he told me several of his patients had found it benificial. I think the medical profession are quite ignorant of B12 & its uses. Question is does it relieve pain or does it do a more central role & repair the nerves......

[helvella in reply to waveylines]

I very much agree with the question but, in this specific instance, I think it likely it acts to relieve pain. But I could so very easily be completely wrong.

[Marz in reply to helvella]

I have always understood that B12 is involved in maintenance of the Myelin Sheath that protects all nerves. So when the sheath is degraded pain is unpleasant as nerves could be exposed (inside )

I have also read that B12 is used as a pain reliever in Eastern European countries and Russia. Sorry - no links .

When Carpal Tunnel Syndrome is mentioned on TUK - Low B12 is often the first thing people think of ..

Thank you for the post and links

[helvella in reply to Marz]

Fully agree that B12 seems to be required for maintaining the myelin sheath. However, I am not sure that the reported effects would occur in the right time frame?

If the myelin is damaged, that can cause the nerve not to work properly. But I'd expect repair (insofar as that is possible) to be relatively slow and not to regress in the same sort of time. (Though new damage can, of course, occur.)

[fbirder in reply to helvella]

Any nerve repair would be better than no nerve repair at all.

[waveylines in reply to helvella]

Thing is isnt it the nerve that generates the pain message in response to damage? So how can the researchers seperate out a nerve being repaired (even in part) from simple pain relief. Nerve pain is normally relieved by blocking the signals......this is the opposite of what B12 does as its involved in the repair of the myelin sheath.

I am no scientist and my knowledge is scant......but I am curious.

My own B12 recovery had an intial fast process which has slowed down to gradual improvements still ongoing months later....I still have neurological damage but it is much reduced, the pain I had has long gone. I think the medical profession has much to learn about B12....

[helvella in reply to waveylines]

Certainly agree that the whole issue is complicated!

My thought was that if you have a substance which acts like an anaesthetic in the sense of stopping pain signals, you would expect it to take effect, reduce the pain, then more or less slowly reduce in its effect with the pain tending to return. After all, that is what many of us report when using paracetamol (or similar) for a variety of pains and discomforts.

If, however, you have a substance which encourages (however you define that!) repair, an initial dose might start the repair, but continuing dosing would be required to complete the repair.

I guess that your description could cover both! But possibly the turning point when it stopped worsening followed by some repair could, perhaps, be quite quick. But maximum repair could take a long time.

[waveylines in reply to helvella]

Thanks Helvella that makes sense. Im not scientific at all so I always find your articles /posts helpful/interesting. Hope they research this a lot more more......& look at its longlevity as most pain killers, nerve blockers loose their efficacy over time so not great for chronic conditions.

[EAPLind in reply to helvella]

I was told that there isn't anything that can encourage the repair of damaged nerves....no therapies, no medications, nothing. Damaged nerves CAN heal at 1 inch per month.....or not at all. So if you have numbness, heavy feeling, pain in your legs, it can take years for those nerves to heal.

[helvella in reply to EAPLind]

It is always difficult to even adequately discuss substances which are fundamental to our biochemistry. For example, with B12 a certain level is an absolute requirement for certain processes but more than that basic level might be observed to have additional effects. The following paper discusses B12 (and other B vitamins) in relation to cell regeneration in our nervous system and other tissues.

Tissue Engineering Therapies Based on Folic Acid and Other Vitamin B Derivatives. Functional Mechanisms and Current Applications in Regenerative Medicine

pdfs.semanticscholar.org/e8...

[EAPLind in reply to helvella]

Thank you . The article looks interesting. I was not able to read it due to their cover stamps on each page .... but I will try to find it online .

[Foggyme Administrator in reply to EAPLind]

EAPLind / helvella

Here’s a link to a version without watermarks..

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

👍

[helvella in reply to Foggyme]

Thank you - should have looked there myself.

[Foggyme Administrator in reply to helvella]

👀🙃

[EAPLind in reply to Foggyme]

Thank you for the clear version.

[waveylines in reply to EAPLind]

But there is hope for improvement.....I had severe tremors in my whole body, tingling, shooting pains, some numbness but 18months on initially alternates days, last 9 months daily of b12 jabs I am 90% recovered. Still get tired (but sustain much longer) & only now have a very mild tremor in left hand & right leg, other symptoms gone. Ive had to do exercises to build lost muscles as was very weak, still ongoing but getting stronger slowly.

My GPs are amazed. Neurologist wants to use my case to argue for research he wants to do on b12..

There is much the doctors dont know anout b12 healing properties

[olga67 in reply to waveylines]

Hi waveylines, could you please tell me at what point did you start the exercise and how did you progress?

[waveylines in reply to olga67]

It was a year after starting treatment. However it remains low key, more about building muscle & strength rather than cardio. Its very basic but my legs are a little stronger. Nothing is a quick fix & you have to listen to your body & not push hard or I found I crashed. I manage twice per week in the gym. Thats it.

[olga67 in reply to waveylines]

Thank you for sharing your experience, I appreciate it. I’ve been advised by my GP and my naturopath (which prescribes me NDT) to strengthen my muscles. I shall start next week under the guidance of a physiotherapist. I feel so weak and fragile, sometimes I doubt I can do it. But I am desperate to get better, hence my question.

Best wishes for 2020

[fbirder in reply to EAPLind]

Nerve repair rates will depend on the cause of the damage.

If it is physical damage to the axons (part of the nerve cell) themselves then repair can take decades.

If it is damage to the blood supply, or the myelin sheath, then repair can be a lot faster.

[EAPLind in reply to fbirder]

If the nerve damage was due to a Vit B12 deficiency....caused by Taking proton pump inhibitors( not a blood supply or myelin sheath issue )..... then what is the healing prognosis ? Is it what I was told ? Thank you .

[deniseinmilden]

As much as I'm pro research and not a fan of rats I did think "poor rats"!!

Thank you again for another very good link. It's really interesting, not least because it looks at new ideas and effects of B12 beyond the commonly received wisdom.

I'm also pleased that B12 is obviously in the minds of scientists, if not medics.