By Brian K. Bailey, DPM – Body-Mind-Spirit Podiatric Center
Last month, we focused on diabetic neuropathy – a common complication of diabetes that can lead to severe pain, foot ulcers, non-healing wounds and, potentially, amputation. This month, we’ll focus on nutritional treatment for diabetic neuropathy.
The first and foremost treatment is my low carb diet, which is used for treatment of metabolic syndrome and diabetes. Briefly, I recommend the “No Carbs after 2 PM Diet” for those with diabetes. In addition, no wheat products at any time. That means no cookies, cakes, candy, biscuits, gravy, breads, pastas, crackers, or chips and no white potatoes or corn.
If you would like to have a detailed copy of the diet, free of charge, call or stop by my office.
There are many supplements that may be taken to help reduce the pain associated with diabetic neuropathy.
Acetyl-L-Carnitine – Two recently published studies indicated that a compound, called acetyl-L-carnitine, is neuroprotective, meaning it can help protect the nerves from damage. These studies found that acetyl-L-carnitine can limit neuropathy that sometimes occurs with some chemotherapy drugs. It has also been shown to limit the neuropathy associated with diabetes. In two randomized, placebo-controlled clinical trials, acetyl-L-carnitine, in daily doses of 500 mg and 1000 mg, was shown to yield significant reductions in pain.
Alpha Lipoic Acid – A powerful antioxidant, alpha lipoic acid positively affects important aspects of diabetes, including prevention, blood sugar control, and the development of long-term complications such as disease of the heart, kidneys, and small blood vessels. It has also been shown to reduce the pain associated with diabetic neuropathy.
N-acetylcysteine – N-acetylcysteine (NAC) is a powerful antioxidant and a precursor to glutathione, an intrinsic antioxidant. NAC can inhibit diabetic neuropathy and protect against neuropathies caused by drugs and alcohol.
Curcumin – Curcumin has shown promise in animal studies of diabetic neuropathy and as a neuroprotective agent in central nervous system diseases. It is also a powerful anti-inflammatory agent.
Gamma Linolenic Acid – People with diabetes are often not able to produce sufficient GLA, and it must be supplemented. GLA improves diabetic neuropathy if given long enough to work.
Omega-3 fatty acids – Found in cold-water fish, flax and chia seeds. Omega-3 fatty acids, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are able to reduce demyelination (a process whereby the protective covering of the nerves wears away) in the nerves of diabetic animals, reducing neuropathic pain.
Benfotiamine – A fat-soluble form of vitamin B1, benfotiamine has been shown to effectively treat alcoholic and diabetic neuropathies. Pain relief arising from benfotiamine occurred in patients with diabetic neuropathy in three weeks.
L-Methylfolate – Folate is involved in neurotransmitter synthesis and critical enzymatic reactions throughout the body. By depleting excess homocysteine, folate benefits cardiovascular health and nervous system function. Up to 40 percent of adults are affected by genetic flaws that limit the amount of folic acid converted to the active form called 5-methyltetrahydrofolate (5-MTHF). This bioactive folate is up to seven times more bioavailable than folic acid. This greater bioavailability is especially important in people who have a genetic enzyme deficiency since it requires no conversion to become metabolically active. People with elevated homocysteine levels have a greater risk of cognitive decline and depression. Unlike folic acid, 5-MTHF is able to cross the blood-brain barrier, which is especially important for people with cognitive difficulties. 5-MTHF enhances the synthesis of acetylcholine in the brain, the neurotransmitter associated with memory.
Vitamin B6 – Vitamin B6 inhibits glycosylation of proteins, one the major risk factors for developing diabetic neuropathy. Neuropathy caused by vitamin B6 deficiency is indistinguishable from diabetic neuropathy.
Vitamin B12 – A neuropathy caused by vitamin B12 deficiency is characterized by numbness of the feet, pins-and-needles sensations, or a burning feeling. Methylcobalamin appears to be the most effective form of vitamin B12 to protect the nerves.
Vitamin C – Diabetes depletes intracellular vitamin C, which deprives those with diabetes of vitamin C’s cellular protection.
Vitamin E – High gamma tocopherol is the best formulation. Stay away from pure alpha tocopherol. Mild to moderate defective nerve conduction was improved with high-dose vitamin E, which suggested that patients with neuropathy might experience a reduction in symptoms.
Wisdom is to treat the cause of neuropathy if known. But for management of pain, the best treatment is a topical compounded formula with diclofenac, gabapentin, imipramine, bupivacaine, PTX and ketamine. Cytomel®, a synthetic thyroid hormone, may boost peripheral nerve regeneration.
Body Mind Spirit Podiatric Center
500 14th Street, Ashland, Kentucky, 41101
Phone (606) 324-FOOT
Brian K. Bailey, D.P.M., is a podiatric physician and surgeon in private practice at Body-Mind-
Spirit Podiatric Center, 500 14th St., Ashland, Ky. Dr. Bailey is also a Clinical Professor of Podiatric Medicine & Surgery at Pikeville College of Osteopathic Medicine and a Personal Wellness Coach & Fitness Trainer. Dr. Bailey has written several books, including: Secrets to Happiness, Inner Peace and Health, Metabolic Syndrome 2011, Nutrients for Prostate Cancer Prevention and Eradication, Breast Cancer Prevention and Holistic Treatment, and Prostate Cancer Prevention and Holistic Treatment. New patients are welcome. For more information, please call the office at (606) 324-FOOT (3668).