Herbals For Diabetic Neuropathy Prevention

Though ignored by chronic pain groups, Alpha Lipoic Acid, and L acetyl Carnitine have shown promise if taken early in course of diabetic peripheral neuropathy

Older review:

Exp Clin Endocrinol Diabetes. 1999;107(7):421-30
Alpha-lipoic acid in the treatment of diabetic polyneuropathy in Germany: current evidence from clinical trials.
Ziegler D, Reljanovic M, Mehnert H, Gries FA.

• Oral treatment for 4-7 months tends to reduce neuropathic deficits and improves cardiac autonomic neuropathy.
• Preliminary data over 2 years indicate possible long-term improvement in motor and sensory nerve conduction in the lower limbs.
• A 3-week pilot study of 1800 mg per day given orally indicates that the therapeutic effect may be independent of the route of administration (vs IV)

Newer review:  

Newer review:  Neth J Med. 2010 Apr;68(4):158-62.
Alpha lipoic acid: a new treatment for neuropathic pain in patients with diabetes?
Mijnhout GS, Alkhalaf A, Kleefstra N, Bilo HJ.  abstract here

Newer review:  Neth J Med. 2010 Apr;68(4):158-62.Alpha lipoic acid: a new treatment for neuropathic pain in patients with diabetes?Mijnhout GS, Alkhalaf A, Kleefstra N, Bilo HJ. Review of studies:

• Results show signifcant improvements with even a dose -response – 100 mg no better than placebo but 600 mg getting significant results. One IV study of 600 mg/day IV for 3 weeks got spectacular results bringing down total symptom scores scores by -5.72 versus -1.83 in controls. Results orally were less vigourous.
• “clinically relevant effects on neuropathic pain are seen after only three to five weeks of alpha lipoic acid administration.”
•  alpha lipoic acid may act to prevent neuropathic pain in high-risk patients” -

Re ALC:

  

Role of Acetyl-L-Carnitine in the Treatment of Diabetic Peripheral Neuropathy
Jeffery D Evans, Tibb F Jacobs, and Emily W Evans
Ann Pharmacother 2008;42:1686-91.

• ALC 1000 mg once daily intramuscularly for 10 days, followed by 1000 mg orally twice daily for the remainder of 1 calendar year.
• Both ulnar and sural sensory nerve conduction velocity was improved in patients taking ALC at the one year follow-up interval, with improvements of +2.9 m/sec (vs +0.1 m/sec control group) and +5.7 m/sec (vs +1.0 m/sec controlgroup), respectively.
• “Baseline pain intensity was approximately 45 mm for both the control group and treatment group. Pain decreased by 6.8 and 3.5 mm at 6 and 12 months, respectively, for the control group, while the treatment group demonstrated a decrease of 10.9 and 19.3 mm (p < 0.05 at 6 mo and p < 0.01 at 1 y)."
  

ALC is a very useful drug which I reported on previously here:
What Does One Do To Prevent Post Surgery Pains?

Both those herbals look like preventative agents in a situation where nothing else does much.

Any comments?

 

 

 

 

 

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