Alpha lipoic acid for diabetic sensory neuropathy

A recent review article suggested that a dose of 600 mg alpha lipoic acid (ALA) daily administered for up to 5 weeks could offer benefits in symptoms of diabetic sensory neuropathy without significant side effects. This review also notes that ALA is already approved for treatment of neuropathy in Germany. Furthermore, it seems obviously a better choice than the opioids often prescribed for diabetic neuropathy pain, as these induce addiction.

For more on alpha lipoic acid, see the NYBC entries:
Jarrow ALA sustained and Montiff ALA. NYBC also stocks Jarrow ALA plus Biotin; biotin is a B vitamin that has also been recommended for diabetes.

REFERENCE:

McIlduff CE, Rutkove SB, Critical appraisal of the use of alpha lipoic acid (thioctic acid) in the treatment of symptomatic diabetic polyneuropathy. Therapeutics and Clinical Risk Management. Sept. 2011 Volume 2011:7 Pages 377 – 385

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Neuropathy pain and HIV: supplement recommendations

You may have read reports in late February 2012 about the FDA’s skeptic ism about a patch called Qutenza, which had been tested for relief of neuropathy pain in people with HIV. Following a meeting to review the evidence, an FDA panel concluded that Qutenza, whose active ingredient is a synthetic form of capsaicin (the compound that makes chili peppers hot) was not effective for HIV-related neuropathy pain.

The FDA’s finding on Qutenza reminds us again that neuropathy (generally, pain or tingling in the extremities) continues to be one of the most troublesome effects of HIV/AIDS and/or its treatment—and one of the most difficult to manage. According to a survey report in 2010, for example, more than one third of those on combination antiretroviral therapy for HIV do experience neuropathy, leading to lower quality of life and often disability. So, it may be worthwhile to repeat some of NYBC’s recommendations on this topic:

Peripheral neuropathy: “nukes” (nucleoside reverse transcriptase inhibitors) such mas ddI (Videx), and d4T (stavudine/ Zerit) – and Indinavir, T20, and even 3TC (Epivir)may all cause this feeling of pins and needles or numbness to toes and fingers. It can travel up the legs and become debilitating. HIV, diabetes, alcohol abuse, and vitamin deficiencies can all be causes of peripheral neuropathy. Supplements that are “good for your nerves” and that have the most robust data include acetylcarnitine (1-3 grams/ day, quite well studied for peripheral neuropathy) and alpha lipoic acid (200-600 mg/day). Other agents that can help are Vitamin B12, biotin, lecithin, magnesium, borage oil, evening primrose oil, choline and inositol.

See the NYBC website for more details about these supplements:
http://nybcsecure.org/

Info sheet on “Supplements studied for diabetes/insulin resistance”

NYBC has prepared an updated version of its info sheet on the topic of supplements that have been studied for diabetes or insulin resistance. Here’s the text below:

SUPPLEMENTS STUDIED FOR DIABETES/INSULIN RESISTANCE

Multivitamin/multimineral: Regular use of a multivitamin/multimineral supplement helps people with diabetes maintain good health and reduce infections. Clinical evidence indicates that diabetics have unique nutritional needs, and should take a daily multivitamin to supplement their normal diet.

Note: NYBC stocks Jarrow’s Multi 1-to-3; Douglas Lab’s Added Protection, and SuperNutrition’s family of multivitamins (such as the Opti-Pack).

Reference: Barringer, et al. Effect of a Multivitamin and Mineral Supplement on Infection and Quality of Life. Annals of Internal Medicine. 3/4/2003.

Omega-3 fatty acids (Fish Oil): Many people with diabetes have high blood pressure and elevated cholesterol, which can increase the risk of heart disease and stroke. Omega-3 fatty acids have shown benefit for cardiovascular health in recent randomized controlled clinical trials. The FDA has also approved a health claim for fish oil: “supporting but not conclusive evidence shows that the consumption of EPA and DHA omega-3 fatty acids from fish oil may reduce the risk of coronary heart disease.”

Note: NYBC stocks Max DHA –Omega-3 Fish Oil Purified by Molecular Distillation (Jarrow); and ProOmega –Nordic Naturals (60 softgels or 180 softgels).

Alpha-Lipoic Acid: Alpha-Lipoic Acid (ALA) has the ability to assist with glucose metabolism, and also promotes healthy nerve function. A recent study concluded that ALA (600mg) could be useful in helping to treat the symptoms of diabetes-related neuropathy (= generally, pain, tingling, numbness in feet and hands).

Note: NYBC stocks ALA (Montiff) 300mg/60.

Reference: Ametov et al. The sensory symptoms of diabetic polyneuropathy are improved with alpha-lipoic acid: The SYDNEY Trial. Diabetes Care. 2003, 26 (3)

Other supplements studied for diabetes: Chromium and biotin (these two supplements, taken together, are believed to play an active role in balancing insulin production with glucose uptake). Also: evening primrose oil, resveratrol, bitter melon.

Talk to your doctor before you use these or other supplements. Do not discontinue medications you are taking for diabetes/glucose control without first discussing with your healthcare provider any complementary treatments you are considering!

Chromium and biotin supplementation may help control diabetes

We were interested to see a report from last month on a study of chromium plus biotin to help in managing diabetes.
The study, conducted by Yale University researchers, found that daily supplementation with these two items improved glucose tolerance by 15 per cent, compared to placebo. The investigation focused on the glycemic control and blood lipids of 36 overweight or obese people with type 2 diabetes. Reporting the results in the journal Diabetes Technology and Therapeutics, lead author Gregory Singer concluded that supplementing with chromium and biotin on a daily basis improved blood sugar control and cholesterol metabolism in diabetes patients on an antidiabetic treatment regimen, and could be considered as an adjunct to conventional oral diabetes therapy.

We also note that biotin and lipoic acid have recently been investigated for their potential in helping manage diabetes. See the NYBC entry on biotin for further details.