Postherpetic Neuralgia and B12

[helvella]

Not directly related to PA, but nonetheless of potential interest to those with PA as well as anyone with Postherpetic Neuralgia.

(I currently have PHN and am taking methylcobalamin every day. Alongside capsaicin cream. Difficult to know if it is helping, but I think it is.)

Patterns and Trends in Pharmacological Treatment for Outpatients with Postherpetic Neuralgia in Six Major Areas of China, 2015-2019.

Healthcare (Basel, Switzerland), 06 Mar 2023, 11(5):764

DOI: 10.3390/healthcare11050764 PMID: 36900769 PMCID: PMC10000853

In the combination of drugs, we found that the frequency of mecobalamin, which does not belong to main treatment drugs, was high. Mecobalamin is a vitamin medicine and is the activated form of vitamin B12. A few studies shows that it not only has a good therapeutic effect on PHN, but can also relieve peripheral polynomialism, entrapment neuropathy and glossopharyngeal neuropathy [55,56]. A study showed that in four trials including 383 participants, the scores of the pain numerical scale in the vitamin B12 group decreased faster, compared with the placebo group. Vitamin B12 can improve the quality of life of patients with PHN and significantly reduce the number of patients using analgesics [57]. The combined use of mecobalamin seems to be justified and reasonable, but more relevant studies are also needed in the future to confirm the safety of its use and its impact on patients.

europepmc.org/article/MED/3...

[Jillymo]

Interesting post helvella.

Thank you for posting.

[BadHare]

Sorry about the shingles, I live in fear of this, though great you’ve found something that’s alleviating the pain! It’s a pity GPs don’t prescribe B12 trials for pain relief rather than an assortment of nasty drugs with nastier side effects

I found out accidentally that B12 helps neuropathic pain. I inject hydroxocobalamin daily for pain relief as it helps my sciatic issue's. I’m planning to try alternate days with sublingual methylcobalamin to see if that works better.

[helvella in reply to BadHare]

Shingles itself was a special form of horror. And I reluctantly took codeine and amitriptyline but stopped as soon as I could. (Side effects of ami were not nice. )

And I refused pregabalin and gabapentin.

(My GP only told me the other day, over a year later, that mine was the worst case of shingles she had ever seen. But at least it didn't go in my eyes.)

This PHN is not as bad. But it groans on and on.

Do you think injecting makes a difference? (I don't think I have any absorption issues.)

[BadHare]

I had chicken pox at 45 & thought I was going to die, so shingles would probably finish me off altogether. My GP laughed at me because I looked like an extra from a horror film. I was diagnosed with FM a year after as I didn’t recover though with hindsight it was more likely post-viral fatigue than FM. One of the things that helped pick me up was sublingual methylcobalamin as I wasn’t absorbing ( very high intake) B12 from food or supplements. I tried injecting weekly as it was less expensive than sublinguals, & found my nerve pain & what I was told would be permanent nerve damage started to decrease. Since injecting daily I’ve cut down on my intake of NDT & T3. Perhaps a course of injections might help speed up your recovery too?

I read somewhere that methyl was better than hydroxo for neurological issues, but also that injecting methyl is both expensive & less easy due to having to dilute dry crystals for injecting. I plan to try alternating between injecting hydroxo & sublingual methyl to see if there’s any further improvement. I think there are sublingual sprays available that contain both, so that’s another convenient option to try.

Sometimes codeine & paracetamol has been necessary for pain relief as being unconscious was preferable to unmanageable pain. I had most of the negative side effects from pregabalin & a few other drugs recommended by my pain management doctor. A pain club friend went quite crazy on gabapentin though she seems to find amitriptylene beneficial. Having used it for a few years, I’m appalled that B12 with no negative side effects isn’t widely promoted by pain management clinics, though that idea might be suppressed by big pharma as it’s a cheap alternative.

[helvella in reply to BadHare]

I remember chicken pox when I was around 4 or 5. Still got a couple of (insignificant) scars on my forehead from taking pyjama top off.

Found methylcobalamin helped years ago with something not a million miles away from trigeminal neuralgia. But have never injected any form. Mentioned it to GP but she looked at my serum B12 result and was unwilling.

Amitriptyline made me sleep three or more hours too long each night. Felt tired all the time. And dry, dry mouth.

[BadHare]

I’m not sure how I escaped it at school as I recall most of my friends had it.

Trigeminal neuralgia is reportedly nasty. I have TMJ issues but don’t think B12 makes a difference for me.

Perhaps tell your GP you’re planning to trial self-injections but it would be better/safer for her or the practice nurse to administer them instead.

Amitryptiline doesn’t sound nice, especially if it’s the wrong sort of sleep.