NERVEsustain™ - Peripheral Nerve Support

30 CAPS Product No. 00525

Egg Free Egg Free
Gluten Free Gluten Free
Peanut and Tree Nut Free Nut Free
Dairy Free Dairy Free
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The rise of Type 2 Diabetes has increased the number of those living with painful long-term consequences of deregulated blood sugar, including peripheral neuropathy. NERVEsustain nourishes nerve health with an array of bioactive B vitamins known to be integral in maintaining proper nerve function. In addition, a combination of these vitamins supports healthy homocysteine levels. High homocysteine and associated MTHFR polymorphisms may be other risk factors in diminished nerve health. Certain common medications given to balance blood glucose have been studied to deplete some of these important B vitamins over time. Protect nerve health with optimal amounts of supportive nutrients delivered in a single daily capsule.

  • Nourishes healthy nerve function and structure*
  • Provides key nutrients for homocysteine metabolism*
  • Delivers bioactive forms of B vitamins, including L-methylfolate
  • Supplies optimal amounts of nerve supportive nutrients in a single daily capsule


*These statements have not been evaluated by the Food & Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.

NERVEsustainTM Peripheral Nerve Support


Product Code: 00525            Capsules per Bottle: 30


Each size 0 vegetarian cellulose capsule contains:


Vitamin C (as Ascorbyl Palmitate)


Thiamine (as Thiamine Mononitrate)

50 mg

Riboflavin (as Riboflavin 5’ Phosphate)

40 mg

Vitamin B-6 (as Pyridoxal 5’ Phosphate)

70 mg

Folate (6 mg folate from 8.25 mg L- 5- Methylfolate, calcium salt)

10 mg DFE

Vitamin B-12 (as Methylcobalamin)

4 mg

Magnesium (as Magnesium Citrate)

50 mg

Other ingredients: vegetarian cellulose capsule


Description: The number of people suffering from Type 2 diabetes and one of its primary complications, peripheral neuropathy continues to grow. The rise of Type 2 diabetes has led to an increase in those suffering from its complications including peripheral neuropathy. Many people are being diagnosed at a younger and younger age, leading to a longer span of life with diabetes increasing both the risk of issues due to dysregulated blood sugar and to a possibility of living with those conditions over a longer time. NERVEsustainTM for Peripheral Nerve Support is designed to provide a full range of B vitamins associated with protecting and maintaining nerve health. Healthy nerves rely on adequate levels of certain B vitamins [1]. These necessary vitamin functions may be negatively affected by very common medications including Metformin which can deplete certain B vitamins [2,3] and the MTHFR genetic polymorphism which can affect folate activity. Besides vitamin deficiency, nerve health is highly affected by proper glucose balance. Improper glucose balance can, over time, lead to symptoms of burning, tingling, and numbness stemming from peripheral neuropathy and this may be exacerbated by concurrent vitamin deficiency [2,3]. Protect nerve health in this population with optimal amounts of nutrients delivered in a single daily capsule.


L-5-MTHF is a bioactive form of folate. A deficiency of folate is known to cause neuropathy symptoms. A deficiency of folate is also associated with high homocysteine levels, another risk factor for increased incidence of neuropathy. Folate needs may be increased in those taking medications that are known to deplete folate including anticonvulsants [5], oral contraceptives [7] and Metformin [6]. In addition, useful folate levels are affected in a certain percentage of the population with the MTHFR gene polymorphism. The C677T polymorphism is associated with a greater risk of both high homocysteine [8] and diabetic neuropathy [9, 10]. L-methylfolate is the bioactive form of folate that bypasses the MTHFR enzyme.

Methylcobalamin (Vitamin B12) is another vitamin that can cause neuropathic issues when depleted [1]. Vitamin B 12 deficiency is common especially in the elderly and in strict vegetarians. B 12 levels are also influenced by the amount of stomach acid and intrinsic factor available to assist absorption— these tend to wane as people age and are negatively influenced by common medications that reduce stomach acid. Other common medications that deplete B 12 include Metformin [2,6] and corticosteroids. Gastric bypass surgery and issues from Crohn’s and ulcerative colitis can result in difficulty in absorbing B 12. Studies show that oral forms of B 12 can be as effective at replenishing body stores as injections [11]. A lack of B 12 depletes the myelin sheath that surrounds nerves, protecting them and aiding in fast transmission of information. This damage can result in symptoms of tingling, burning and numbness. B 12 is also a cofactor involved in maintaining normal homocysteine levels.

Pyridoxal 5’ Phosphate (Vitamin B6) deficiency can also create neuropathy issues [1] manifesting as tingling and pain in hands and feet. Drugs such as antibiotics, oral contraceptives and the class of antidepressants known as monoamine oxidase inhibitors can all deplete B6. B6 is a cofactor needed for the remethylation of homocysteine to methionine.

Riboflavin is involved in the healthy metabolism of other B vitamins including folate and B6. As such it has positive influence over homocysteine levels. It is also a cofactor for the MTHFR enzyme, aiding in the remethylation of homocysteine to methionine.

Thiamine is depleted by excessive alcohol consumption. Alcohol use can create alcohol induced neuropathy which can be worsened by alcohol’s depleting effect on body stores of thiamine [1].

Magnesium is involved in the normal transmission of nerve impulses. High glucose states use more magnesium, leading to a higher risk of deficiency in those with diabetes [12]. Magnesium is involved in modulating normal insulin response.

Ascorbyl Palmitate is a fat-soluble form of vitamin C. Vitamin C is a powerful tissue protective antioxidant and some studies have shown it has the potential to boost the bioavailability of L-methylfolate [13].

Homocysteine: The combination of L-5-MTHF and methylcobalamin is important in the lowering of homocysteine with B6 and riboflavin as cofactors in this process. High homocysteine is associated with a greater risk of peripheral neuropathy in those suffering from diabetes [8, 14,15]. The MTHFR C677T polymorphism (homozygous) is associated with increased risk of high homocysteine levels [8] as are depleted levels of folate, B12 and B6.

Source Materials: Ascorbyl palmitate is derived from ascorbic acid (corn sorbitol) and palmitic acid (palm oil). Riboflavin 5’ phosphate is synthesized from riboflavin (fermentation). Methylcobalamin is derived by fermentation. Thiamine Mononitrate, Pyridoxal 5 phosphate, and L-methylfolate are synthetic.

Vegan Statement: NERVEsustainTM contains no ingredients derived from animal sources. Suitable for vegans.

Allergens:  According to information provided by our suppliers, these capsules are free of the eight major allergens as identified by the Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA): Wheat (gluten), eggs, milk, soybeans, shellfish, fish, peanuts, tree nuts.

Recommendations: Use as directed by a healthcare professional.

Precautions: Pregnant or lactating women and individuals taking prescription medications should consult with a healthcare professional before taking any supplement.



  1.  Hammond N, Wang Y, Dimachkie M, Barohn R. Nutritional neuropathies. Neurol Clin. 2013 May; 31(2):477-489.
  2. Wile D, Toth C. Association of metformin, elevated homocysteine,and methylmalonic acid levels and clinically worsened diabetic peripheral neuropathy. Diabetes Care. 2010 Jan;33(1): 156-161.
  3. Gupta K, Jain A, Rohatgi A. An observational study of vitamin B12 levels and peripheral neuropathy profile in patients of diabetes mellitus on metformin therapy. Diabet Metab Syndr. 2018 Jan-Mar;12(1):51-58.
  4. Yilmaz M, Aktug H, Oltulu F, Erbas O. Neuroprotective effects of folic acid on experimental diabetic peripheral neuropathy. Toxic Ind Health. 2016 May; 32(5): 832-40.
  5. Martinez Figueroa A, Johnson RH, Lambie DG, Shakir RA. The role of folate deficiency in the development of peripheral neuropathy caused by anticonvulsants. J Neurol Sci. 1980 Dec;48(3):315-23.
  6. Wulffele MG, Kooy A, Lehert P, et al. Effects of short-term treatment with metformin on serum concentrations of homocysteine, folate and vitamin B12 in type 2 diabetes mellitus: a randomized, placebo-controlled trial. J Intern Med. 2003; 254: 455-463.
  7. Wilson SM, Bivens BN, Russel KA, Bailey LB. Oral Contraceptive use: impact on folate, B6 and vitamin B 12 status. Nutr Rev. 2011 Oct; 69(10): 572-83.
  8. Refsum H, Nurk E, Smith AD, et al. The Hordaland homocysteine study: a community-based study of homocysteine, its determinants and associations with disease. J Nutr. 2006; 136: 1731S-40S.
  9. Wu S, Han Y, Hu Q, et al. Effects of common polymorphisms in the MTHFR and ACE genes on diabetic peripheral neuropathy progression: a meta-analysis. Mol Neurobiol. 2017 May; 54(4): 2435-2444.
  10. Yigit S, Karakus N, Inanir A. Association of MTHFR gene C677T mutation with diabetic peripheral neuropathy and diabetic retinopathy. Mol Vis. 2013 Jul;19: 1626-30.
  11. Vidal-Alaball J, Butler CC, Cunnings-John R, et al. Oral vitamin B12 versus intramuscular B12 for vitamin B12 deficiency. Cochrane Database Syst Rev. 2005; (3): 00004655.
  12. Barbagallo M, Dominguez L. Magnesium and type 2 diabetes. World J Diabetes. 2015 Aug 25; 6(10): 1152-1157.
  13. Verlinde PN, Oy I, Hendrickx ME, et al. L-ascorbic acid improves the serum folate response to an oral dose of [6S]-5-methyltetrahydrofolic acid in healthy men. Eur J Clin Nutr. 2008; 62 (10): 1224-1230.
  14. Ansari R, Mahta A, Mallack E, Luo JJ. Hyperhomocysteinemia and neurologic disorders: a review. J Clin Neurol. 2014 Oct;10 (4): 281-288.
  15. De Luis DA, Fernendez N, Arranz ML, et al. Total homocysteine levels relation with chronic complications of diabetes, body composition and other cardiovascular risk factors in a population of patients with diabetes mellitus type 2. J Diabet Complications. 2005 Jan; 19(1): 42-46.



These statements have not been evaluated by the Food & Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.


NERVEsustain™ - Peripheral Nerve Support
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