If you are diabetic or experience peripheral neuropathy, you may benefit from taking nutritional supplements that help nourish and protect nerve health. NERVEsustain is a nutritional supplement that has been specifically designed to replenish the vitamins that are commonly depleted by medications taken to balance blood glucose, while also protecting nerve health, with optimized levels of supportive nutrients. All of that is delivered in a single, convenient daily capsule.

What is Peripheral Neuropathy (PN)?

The job of the peripheral nervous system is to relay information back and forth between your central nervous system (brain and spinal cord) and the rest of your body. If you touch a hot stove or the sharp spines of a cactus, this communication is necessary for the brain to get sensory information from the skin, and the hand to get signals from the brain to quickly move away. 

Peripheral neuropathy is caused by damage to nerves of the peripheral nervous system. This condition often causes weakness, numbness and pain, sometimes described as stabbing, burning or tingling [1]. These symptoms are most often felt in hands and feet, but can also affect other areas of your body. Peripheral neuropathy can result from traumatic injuries, infections, metabolic problems, inherited causes, and exposure to toxins [1]. One of the most common causes is diabetes [1].

Is Peripheral Neuropathy Permanent?

Not always. If the cause of peripheral neuropathy is a metabolic issue that can be remedied, often the symptoms are relieved as the root cause improves. There are also some nutritional changes that may support and strengthen the peripheral nervous system.

What is the Relationship Between Diabetes and Peripheral Neuropathy?

Nerve health is significantly affected by glucose balance. Imbalanced glucose levels can, over time, lead to symptoms of burning, tingling, and numbness stemming from peripheral neuropathy. These effects may be exacerbated by concurrent vitamin deficiency [2,3].

As the number and percentage of the population diagnosed with type II diabetes continue to grow, along with it, we see a similar rise in the number of people suffering from its complications—one of which being peripheral neuropathy. In addition to an increase in the sheer number of patients with type II diabetes, more diagnoses are being made at earlier ages, leading to patients living a longer portion of their life span under diabetic conditions. As diabetes increases the risk of issues related to dysregulated blood sugar, the earlier one is affected (or the longer the diabetic period in a person’s life), the greater the probability they will at some point experience adverse complications from the disease.

What Nutrients Support Nerve Health?

Healthy nerves rely on adequate levels of certain B vitamins, but there are occasional roadblocks that stand in the way of attaining those levels. Some commonly prescribed medications interfere with the absorption of certain vitamins or deplete levels of certain B vitamins [2,3]. We also know now that it is extremely common to inherit MTHFR genetic polymorphisms can affect the body’s ability to properly process folate.  NERVEsustain is a nutritional supplement that has been specifically designed to replenish the vitamins that are commonly depleted by medications taken to balance blood glucose, while also protecting nerve health, with optimized levels of supportive nutrients. All of that is delivered in a single, convenient daily capsule.

is a nutritional supplement that has been specifically designed to replenish the vitamins that are commonly depleted by medications taken to balance blood glucose, while also protecting nerve health, with optimized levels of supportive nutrients. All of that is delivered in a single, convenient daily capsule.

What ingredients are in NERVEsustain?

L-5-MTHF (L-methylfolate) is a bioactive form of folate (vitamin B9). A deficiency of folate alone is known to cause neuropathy symptoms, but it is also associated with high homocysteine levels, which is yet another risk factor for neuropathy. High homocysteine is associated with a greater risk of peripheral neuropathy in those suffering from diabetes [4]. 
Your folate needs may be higher than average if you are taking medications that are known to deplete folate, including anticonvulsants [5], oral contraceptives [6], and medications designed to control blood sugar [7]. 

Do genes matter?

As mentioned earlier, a significant percentage of the population have inherited MTHFR gene polymorphisms that affect our ability to process and use the folate from our diets. The C677T polymorphism, specifically, 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, so you can keep your levels of activated folate high without relying on your genetically predetermined ability to process folic acid.

What other deficiencies can cause PN?

Methylcobalamin (Vitamin B12) is another vitamin that can cause neuropathic issues when levels are depleted [11]. The myelin sheath that surrounds nerves both protects them and aids in the fast transmission of information. A B12 deficiency can lead to the degradation of this protective sheath, leading to damage to nerves and symptoms of tingling, burning, and numbness. B12 is also a cofactor involved in maintaining normal homocysteine levels.

Vitamin B12 deficiency is common, especially in the elderly and in strict vegetarians. B12 levels are also influenced by the amount of stomach acid an individual has and the abundance of intrinsic factors available to assist in absorption. Unfortunately, these tend to wane as people age and again, many common medications reduce stomach acid as a side effect. 

Gastric bypass surgery, issues related to Crohn’s disease, and ulcerative colitis can all also result in difficulty in absorbing B12. Luckily, studies show that oral forms of B12 can be as effective as injections for replenishing body stores [12]. 

Pyridoxal 5’ Phosphate (Vitamin B6) deficiency can also create neuropathic issues [11], manifesting as tingling and pain in hands and feet. Certain 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 (Vitamin B2) is involved in the healthy metabolism of other B vitamins, including folate and B6. As such, it has a balancing influence on homocysteine levels. It is also a cofactor for the MTHFR enzyme, aiding in the remethylation of homocysteine to methionine.

Thiamine (Vitamin B1) can be depleted by excessive alcohol consumption. Alcohol use can create alcohol-induced neuropathy, which can be made worse by the depleting effect of alcohol on body stores of thiamine [11].

Magnesium is involved in the normal transmission of nerve impulses. When glucose levels are high, the body requires more magnesium, which means those with diabetes are at a higher risk of deficiency [13]. Magnesium is involved in modulating normal insulin response.

Ascorbyl Palmitate is a fat-soluble form of vitamin C. Vitamin C is a powerful antioxidant for tissue protection and some studies have shown it has the potential to boost the bioavailability of L-methylfolate [14].

References

  1. Mayo Clinic. “Peripheral Neuropathy”. Patient Care & Health Information: Diseases & Conditions. Accessed June 10, 2019. https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061
  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. 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.
  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. 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.
  7. 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.
  8. 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.
  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. Hammond N, Wang Y, Dimachkie M, Barohn R. Nutritional neuropathies. Neurol Clin. 2013 May; 31(2):477-489.
  12. 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.
  13. Barbagallo M, Dominguez L. Magnesium and type 2 diabetes. World J Diabetes. 2015 Aug 25; 6(10): 1152-1157.
  14. 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.