Vitamin B-12 is considered essential for nerve health. A lack of B-12 damages the myelin sheath that surrounds and protects nerves. Without this protection, nerves cease to function properly. The following factors may put you a a higher risk for not getting enough vitamin B-12 from diet alone:
Vitamin B-12 can help to restore the structure and function of nerves.
Benefits of Vitamin B-12
Dosing Vitamin B-12 (Methylcobalamin)
Since B-12 is a water-soluble vitamin, it’s generally considered safe, even at high doses. No maximum daily dose has been established for B-12 due to its low level of toxicity.
Your body excretes whatever it doesn’t use.
Methylcobalamin is the activated form best for utilization and considered most effective in using to treat diseases.
Ultra-high doses of methylcobalamin are appearing in research to treat peripheral neuropathies and clinically in ranges of approximately 1mg (1,000mcg) to 5mg (5,000mcg).
Benefits of Folic Acid (Folate)
Combining folic acid with vitamin B-12, together, works to reduce nerve pain. Folic acid improved peripheral nerve healing and increases axon myelination. Folic acid has shown to protect against diabetic peripheral neuropathy by upregulating nerve growth factor. Peripheral nerve repair by way of promoting proliferation of and secretion from Schwann cells with use of folic acid supplementation.
Folic Acid vs. Folate vs. 5-MTHF: What’s the Difference?
Folic acid is the lab-derived synthetic version of natural folate. Then one step further, 5-MTHF (L-5-methyltetrahydrofolate) is considered the active (more easily usable) form of folate, and the most prevalent form in plasma. Therefore, when supplementing with folic acid, 5-MTHF form is considered superior.
Dosing Folic Acid
Daily folic acid intake of 400mcg daily is generally recommended for adults. When supplementing folic acid for nerve protection and repair, a typical dose for adults is 700mcg to 1,600mcg daily. Folic acid daily intake should not exceed 5,000mcg, according to the Center for Disease Control.
Acetyl-L-carnitine is an amino acid and antioxidant that is naturally produced in the liver and kidneys. It is an effective protectant for nerve health and effective at lessening neuropathy symptoms once they’ve developed, especially pain.
Benefits of Acetyl-L-Carnitine
Taken as a supplement, a typical dosage is 500mg twice a day.
Warning for Acetyl-L-Carnitine
Mayo Clinic warns not to use acetyl-L-carnitine if you use warfarin, a blood-thinning medication, because the combination may increase bleeding risk. Talk to your doctor if being treated for hypothyroidism or have a history of seizures before supplementing with acetyl-L-carnitine.
Alpha-lipoic acid is an antioxidant the body uses to manage or prevent the tissue-damaging process, oxidative stress. Oxidative stress is part of what causes nerve fiber damage in many types of peripheral neuropathy. Alpha-lipoic acid may help to reverse the free radical damage of oxidative stress and slow or stop nerve damage.
Benefits of Alpha-Lipoic Acid
Alpha-lipoic acid may relieve neuropathy symptoms, especially burning and stabbing pain within a few weeks.
Dosing Alpha-Lipoic Acid
Fewer symptoms at all three dosages: 600mg, 1,200mg, and 1,800mg. However, more side effects were experienced with the higher dose.
If taking medication for diabetes, start with lower doses and work up slowly.
Alpha-lipoic acid may lower blood glucose levels.
Curcumin is the primary active compound in turmeric, a powerful herb known for its anti-inflammatory, antioxidant, and calming properties. Because sensitive damaged nerves may be irritated and further inflamed by spicy foods, it is advised to utilize curcumin extracted from turmeric rather than the herb or turmeric supplements. Curcumin has shown to prevent chronic neuropathic pain from developing when taken in the early stages of nerve damage).
Benefits of Curcumin
The World Health Organization indicates safe intakes for the average adult at 300mg per day. However, curcumin studies to alleviate pain utilize significantly higher doses of up to 5,000mg daily.
Curcumin supplements often include pepper to increase absorption. However, pepper can increase pain in some neuropathy patients. Therefore, it is advised to be mindful of the potential for turmeric or curcumin supplements with pepper to increase pain, and opt for products without pepper or use fresh turmeric.
To achieve maximum benefits, steady use for 4-8 weeks is advised.
Coenzyme Q10, usually referred to as simply CoQ10, is a potent antioxidant. It appears to play a role in reducing nerve tissue damage from oxidative stress and reducing nerve damage pain. As an antioxidant, it also serves to protect cells from oxidative damage, such as that caused by high blood sugar and body toxicity. Studies have also shown CoQ10 to prevent peripheral neuropathy and reduce neuron loss. One of the roles CoQ10 plays in the body involves the generation of energy, adenosine triphosphate (ATP), in cells.
Benefits of CoQ10
A therapeutic dose is 200 – 400 mg per day.
Warnings for CoQ10
People with hepatitis C or Huntington’s disease should avoid CoQ10
The role of magnesium for the treatment of acute and chronic pain has been suggested for decades. Due to blocking the detection of pain, it may prevent central sensitization, a prime candidate for the cause of difficult to treat chronic neuropathic pain. When it comes to nerves, magnesium is vital for the movement of electrical impulses through your nervous system. A deficiency of magnesium can be noticed with feelings such as:
Magnesium deficiency is all too common with 61% of adults and 90% of teens reported deficient in a national survey. Deficiency of magnesium can lead to peripheral nerve damage. On the flip side, magnesium toxicity can cause problems with kidneys and damage to intestines. Follow the advice of your doctor or pharmacist regarding magnesium supplementation if you are taking medications for thyroid, osteoporosis, or cancer, or if taking diuretics, antacids, or antibiotics.
Benefits of Magnesium
A therapeutic dose of magnesium is 400-800mg per day.
Omega-3 polyunsaturated fatty acids (PUFAs) are a type of fat the body cannot make on its own. They are an essential fat, which means they are needed to survive, and must come from food or supplementation. Omega-3 fatty acids are noted for their role in the development and maintenance of healthy nerves and beneficial for promoting peripheral nerve health. Supplementation of fish oil has been shown to prevent the decline of nerve conduction in diabetic neuropathy. Animals models have shown omega-3s to speed the recovery of nerve function. A 2017 review shows omega-3s to be a viable treatment for central and peripheral nervous system diseases to restore function. Stimulation of neuron growth was shown in a 2018 review, through more research is needed. The combination of Omega-3s EPA and DHA (derived from fish) is shown to alleviate pain hypersensitivity and improve nerve function for a safe alternative for prevention and treatment of peripheral nerve damage.
Benefits of Omega-3 Fatty Acids
Dosing of Omega-3 Fatty Acids
Omega-3s in the form of EPA and DHA is best for nerve health use and can be obtained by eating fish and seafood, grass-fed beef, and taking fish oil supplements. You can safely take up to 5,400mg per day. Taking at least 1,000 mg is recommended.
18 months of lowering HgA1c scores patients showed decreased pain, and increased nerve fiber count on ENFD.
Most important element of lifestyle improvement; patients showed increase in ENFD count.