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Diabetes Complications

Treating Neuropathy

Ever since I learned about a new treatment for neuropathy at the annual convention of the American Diabetes Association in June, I have been trying to think of a good reason why not to write about it. I failed.

As a journalist, I am naturally skeptical. As Louis Menard wrote in the current issue of The New Yorker, “A person whose financial requirements are modest and whose curiosity, skepticism, and indifference to reputation are outsized is a person at risk of becoming a journalist.” That’s me.

I am skeptical of any purported cure for diabetes. I am even skeptical of new treatments for any of its complications. I am especially skeptical of the so-called “medical foods” that our companies keep dreaming up.

But I am also curious about anything new out there that really might be able to help us. And we do need help with diabetic neuropathy.

At least 60 percent of us have some degree of neuropathy. Diabetes raise our blood glucose level, and a high level of glucose in our blood can damage the nerves in our bodies. Often the nerves at the body’s periphery are the first to suffer with burning, shooting, or stabbing pains. Uncontrolled, the pain becomes severe.

Then, the pain goes away. Not a good thing, because this is from numbness and deadness of the nerves. This can lead to ulcerations and amputations. In fact, more than 60 percent of non-traumatic lower-limb amputations occur in people with diabetes.

That’s why my curiosity trumped my skepticism about the new medical food called Metanx. Pamlab LLC in Covington, Louisiana, developed and markets it.

I stopped by the Metanx booth on the exhibition floor of the American Diabetes Association’s convention when people from two companies that were demonstrating devices to test neuropathy told me about Metanx. Intrigued, I talked with Pamlab’s director of marketing services, Jim Currie.

He gave me a raft of studies on the effectiveness of Metanx. The most impressive was an abstract that leading diabetes researchers presented at the convention. This research, “Effect of Combination L-Methylfolate, Pyridoxal-5´-Phosphate, and Methylcobalamin on Neuropathy Symptoms and Inflammatory Biomarkers in Patients with Diabetic Peripheral Neuropathy (DPN),” shows that Metanx does provide some relief. While it didn’t improve the study’s primary endpoint, the perception of vibration, it did offer some important improvements on secondary endpoints, including symptoms of neuropathy and health-related quality of life.

The study has 10 authors, and I recognize the names of at least three of them. Vivian Fonseca, MD, is chief of the endocrinology section at Tulane’s School of Medicine and the American Diabetes Association’s vice president for medicine and science. Lawrence Lavery, DPM, and Julio Rosenstock, MD, are professors at the University of Texas Southwestern Medical Center at Dallas. All three are respected researchers.

A point in favor of Metanx, I think, is that it’s available only by prescription. That means your doctor will be watching your progress and any untoward events that might develop. I wouldn’t expect that many of us would have any such problems, though, because of what Metanx is.

Metanx is vitamin B — albeit in a special form. It consists of the active form of folic acid, which is B9, along with the active form of B12 and B6. Our bodies can immediately use the active form of these B vitamins, unlike over-the-counter forms, Pamlab says. To get equivalent benefit from OTC forms of these B vitamins we would have to take lots of pills.

The major problem with taking Metanx — or any diabetes medication like insulin or metformin — are the mental, not physical, side effects. The mental side effect is to relax too much.

But, you might say, “Relaxation is good for us!” It is to a point. But when we relax so much that we put our trust into drugs to take care of us, we stop doing what we have to do first and always. That is to keep our blood glucose as closely controlled with diet and exercise as we know how.

Since we know that Metanx alone won’t reverse diabetes neuropathy, we won’t rely on it. What we can rely on is to get our blood glucose level down to normal. The effectiveness of doing that doesn’t make me a bit skeptical.

This article is based on an earlier version of my article published by HealthCentral.

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  • Grandpa Chet Cox at

    My feet and legs have, the past six months, been waking me up on fire. I am taking Susan’s advice immediately! Please thank her for me.

    And if there’s anything new in nerve pain, let us all know pleeeease. I came THIS close to buying an expensive “nerve relief” from http://www.neuropathytreatmentgroup.com

    • David Mendosa at

      Dear Chet,

      Susan’s advice could not be better for anyone who suffers from neuropathy. Meanwhile, to cut the pain, there are FDA-approved drugs that can help. I reviewed them recently at http://www.mendosa.com/blog/?p=3344

      With metta,

  • Maddie at

    This subject is dear to my heart as i suffer from peripheral neuropathy and alongside having diabetes.

    I found this article overwhelming but great to read and hopefully i can take some comfort away with me. Thanks for a lovely article.

  • Susan Schneider at

    Hi David: I was diagnosed with diabetes II after a neurologist picked up neuropathy in both my lower legs. That was my presenting symptom. After a rough start with my team, I met with a friend who is a retired neurologist (Stanford trained) who told me to do 4 things: drop my weight by 10% to a BMI of 22-24, keep my A1C under 6.0, up my exercise to 150 min a week, and go on alpha-lipoic acid 300 mg bid. Just like you said, no drugs, just do it right. While the pain is occasionally evident, it is always when my sugars creep up above 120, so I have to exercise right then. I have managed this regimen for 3 years with no trouble. I love your advice. Keep it coming. Susan

    • David Mendosa at

      Dear Susan,

      Thank you. And you are so fortunate to have received such great advice from your friend.