Vitamin B12 as therapy for preventing and treating painful neuropathy (nerve inflammation)

– including diabetic neuropathy

Neuropathic pain is caused by disease or damage in the somatosensory nervous system. According to a new review article that is published in the scientific journal Nutrients, it seems that therapy with vitamin B12 may have a positive effect on this type of pain. It also appears that vitamin B12 deficiency is rather common in people with diabetic neuropathy, which is a serious complication that may result in amputation in worst case. Therefore, it is vital that diabetics make sure to get enough vitamin B12. Patients with pain caused by peripheral neuropathy may also consider taking the other B vitamins and vitamin D.

The symptoms associated with peripheral neuropathy often develop slowly, starting with sensory disturbances that are felt as stabbing, burning, or tingling pain. Peripheral neuropathy may be a result of excessive alcohol consumption, metabolic disturbances, diabetes, autoimmune reactions, chemotherapy, and poisoning. It is important to treat the underlying cause. Nerve inflammation generally does not go away but is something you have to learn to live with. Motor spasms and cramps can be treated with physiotherapy, assistive devices, and various types of adjustment. Pain relief therapy may be necessary, although there is a risk of serious side effects.
Peripheral neuropathic pain can impair quality of life and is associated with human and financial costs. Therefore, there is a need to develop new strategies for prevention and therapy.

Why vitamin B12 is relevant for the treatment of peripheral neuropathy

A new strategy is to use vitamin B12, even in cases where a person is not decidedly deficient of the nutrient. Vitamin B12 has a number of vital functions in the body such as maintaining and regenerating peripheral nerves. Vitamin B12 is also important for the formation of the myelin sheath that protects the nerves. The vitamin is also believed to promote the regeneration of the “burning” nerves through control of various processes. Also, B12 can be used as mono therapy or as part of the treatment against neuropathic pain.

The results and limitations of the study

The scientists behind the study gathered data from 325 published articles, 24 of which were suited for the purpose. The researchers looked at different types of neuropathy and the effect of giving supplements of vitamin B12. Based on the comprehensive data, the scientists concluded that there is evidence for using high-dosed vitamin B12 supplements in the treatment of neuropathic pain, especially if you combine them with supplements of other B vitamins. Giving vitamin B12 in combination with other B vitamins is well suited for treating peripheral neuropathic pain caused by herpes zoster, shingles, alcohol, and diabetes. The review article also mentions that the selected studies have certain limitations in their design, lack of vitamin B12 blood analysis, description of neuropathic pain, and follow-up. In any case, it is relevant for patients with peripheral neuropathy to have their blood levels of vitamin B12 measured and to make sure to get enough of this nutrient, all the other B vitamins, and even vitamin D.

Lack of vitamin B12 and vitamin D are widespread among patients with diabetic neuropathy

Diabetic neuropathy is caused by inflammation and damage to the nervous system, which controls our cardiovascular function. The damage typically affects the nerve and circulatory system in the feet and legs. In worst case, it is necessary to amputate the affected limb. Diabetic neuropathy is insidious and is often overlooked because the symptoms typically occur in the late stages of the disease. Diabetic neuropathy is associated with an increased risk of morbidity and death caused by cardiovascular failure and other factors.
According to a doctoral thesis by Christian Stevns Hansen, a Danish physician, low blood levels of vitamin B12 and vitamin D are linked to an increased risk of developing diabetic neuropathy. Although more research is required, inexpensive vitamin supplements may hold a great potential as a new way to prevent and treat diabetic neuropathy without side effects. Not only would this benefit the individual patient, it would even be useful to society.
It is also worth noting that diabetics using metformin are at risk of a vitamin B12 deficiency. Diabetes patients also have an increased need for vitamin D, which is because diabetes makes it more difficult for them to activate the vitamin in their body. Most cells have vitamin D receptors that are important for regulating blood sugar levels and inflammation. This is highly relevant for diabetics.

References:

Thomas Julian et al. B12 as a Treatment for Peripheral Neuropathic Pain: A systematic Review. Nutrients. 2020

Christian Stevns Hansen. Almindelige vitaminer og mineraler er forbundne med alvorlige komplikationer hos diabetes patienter. Formidling af Ph.d. afhandlingen: Exploring new risk markers for diabetic cadiovascular autonomic neuropathy.

https://www.sundhed.dk/sundhedsfaglig/laegehaandbogen/neurologi/tilstande-og-sygdomme/neuropatier/autonom-perifer-neuropati/