may seem obvious but always be careful exploring the internet for ideas regarding self-treatment of neuropathy. Just as there are
many different types of neuropathic complaints, there are countless hints and tips on relieving the symptoms and not all of them may
be appropriate for your specific problem. Above all, as an HIV patient, look out for anything which may clash with your HIV drug regime.
There are several reliable sites on which you can check potential drug interaction problems with supplements (see Links) and it's
always wise to do so. Busy doctors can’t always be expected to be aware of all possible medication interactions, especially if you
are taking a number of drugs.
treatment depends on the extent and type of your neuropathic problems and the following information
reflects only what seems to work for other sufferers. You will also see all these options on recognised medical sites but if in doubt,
ask your neurologist, internist or pharmacist (preferably more than one - opinions differ within the profession too)
Some simple basic things can reduce the pain of polyneuropathy and improve your general health:
Wear looser shoes but also shoes with
soft, padded soles. People with neuropathy are strongly advised to avoid open, or half open sandals, or to walk around bare foot,
either inside or outside (chance of unnoticed wounds through dirt, thorns, nails, broken glass, drawing pins etc). Also, the use of
hot water bottles is strongly discouraged (burn wounds through reduced sensation and feeling)
Don’t walk too far
for too long a time
Soak your feet in ice water
Eating a healthy diet
If exercise is difficult, swimming is a
good alternative (minimum temperature of 28 degrees celsius) thanks to the reduced stress on the joints and muscles
Maintaining a healthy
Controlling blood pressure
Limiting alcohol use
Nutritional Options for Neuropathy
During the course of your search
for information, you will see many references to diabetic neuropathy mainly due to the fact that much more research has been done
in that area. Where the symptoms are the same, it is reasonable to suppose that supplements will have the same effects for HIV –related
neuropathy. Indeed, the following supplements are recommended widely in the HIV field but as always, watch out for contra indications
with your own regime.
In many neuropathies, no specific cause will be identified, let alone the reason for your pain or discomfort.
In addition, many of the causes of neuropathy are themselves not easily treatable. However, a number of supplements have been shown
to interfere with the underlying mechanisms of a variety of forms of neuropathy.
Acetyl-L-carnitine is a modified
amino acid which is known to have protective properties for nerve cells and amongst other things, may also help to support healthy
brain function, mood and memory. Two recent studies have found that acetyl-L-carnitine can limit the neuropathy associated with some
chemotherapy drugs. However, in order to achieve significant reductions in pain, daily doses should be at least 500mg to 1000mg and
that can be expensive (German insurance companies will cover this but not in the Netherlands). Furthermore, it has to be taken over
a long period and like everything else, will not work for everybody.
The research does, however seem to suggest that acetyl-L-carnitine
works. In two related studies of diabetic nerve degeneration and neuropathy, acetyl-L-carnitine accelerated nerve regeneration after
experimental injury. In a human trial2, acetyl-L-carnitine appeared to help prevent or slow cardiac autonomic neuropathy in people
with diabetes. In a large, multicenter human trial, L-carnitine improved nerve conduction velocity and reduced pain associated with
diabetic neuropathy over a one-year period.
Because of the high costs associated with both acetyl L-carnitine and alpha lipoic acid,
the possibility of buying more cheaply via the internet should be explored (always from reputable suppliers of course).
Alpha Lipoic acid is a powerful antioxidant which has also been shown to reduce the pain associated with diabetic neuropathy.
It is a natural anti-oxidant which benefits people with diabetes and heart disease by helping to prevent cell damage throughout the
body. As a natural antioxidant, it attacks free radicals that cause damage to the cells in the body.
A study published in 'Diabetes
Care' has shown that supplementing with Alpha Lipoic acid can partly restore diabetic nerve function after only four months of high-dose
oral treatment. However, as mentioned earlier, this may not apply to HIV patients with neuropathy – not enough research seems to have
been done yet.
Moreover, Alpha Lipoic acid can help improve blood circulation of small capillaries, balance blood sugar and boost
the immune system; reasons enough you might think, to take it.
Alpha lipoic acid is sometimes given to peripheral neuropathy patients
in Europe intravenously to relieve the tingling feet and neuropathic pain. Several European and American studies have shown that giving
between 200 and 600 mg of alpha lipoic acid for three weeks followed by oral supplements significantly decreased peripheral neuropathy
symptoms. An ongoing study is looking at whether alpha lipoic acid can reduce the symptoms of peripheral neuropathy that some people
experience after cancer chemotherapy. Unfortunately, most studies have focused on intravenous alpha lipoic acid therapy. It is less
clear whether simple oral therapy is effective for people with peripheral neuropathy. To get the same benefits, larger doses and longer
treatment times may be needed and that can once more, be an expensive business if you have to pay for your supplements yourself. The
more pressure individuals can bring on their own medical professionals, the more chance the insurance companies will see the benefits
of these supplements.
following information is probably the most tempting for neuropathy patients because it
seems that vitamin supplements are a ‘good thing’ whatever your problem. However excess vitamin use can actually cause neuropathy
instead of helping it, so careful choices backed up by medical consultation is strongly advised. Vitamins from the B group (B6,B11/folic
acid) especially, can work neurotoxically and can trigger neuropathy, or make it worse.
Omega-6 fatty acids.
been shown to improve diabetic neuropathy if given long enough to work. In one double-blind, placebo-controlled study, 111 people
with mild diabetic neuropathy received either 480 mg supplemented Omega 6 daily or placebo. After 12 months, the group taking the
supplement was doing significantly better than the placebo group. Good results have been seen in other smaller studies as well.
The omega-3s are better known and found in high quantities in fish such as salmon and are widely consumed for their anti-inflammatory
powers. Omega-3s are essential fatty acids and are important components of cell membranes, including the delicate myelin sheath that
protects nerves. Studies have shown that they are able to reduce demyelisation in the nerves of diabetic animals, which reduces neuropathic
Vitamin B1 (thiamin) and benfotiamine.
Some animal studies have shown a decrease in pain with a combination of vitamin B1, vitamin
B6, and vitamin B12. The fat-soluble form of vitamin B1, called benfotiamine, has been used effectively to treat alcoholic and diabetic
Diabetes patients with neuropathy have been shown to be deficient in vitamin B6 and to benefit from supplementation.
Interestingly, the neuropathy caused by vitamin B6 deficiency is indistinguishable from diabetic neuropathy.
caused by vitamin B12 deficiency is characterized by numbness of the feet, pins-and-needles sensations, or a burning feeling. Supplementation
that restores normal B12 levels is a part of successful treatment of diabetic neuropathy.
Vitamin E is a powerful antioxidant
that reduces levels of free radicals and oxidative stress. It has been shown to help several types of patients with neuropathy but
once again, high doses are necessary.
Always ask your doctor’s advice regarding adding high doses of extra vitamins to your diet; as
mentioned before, you could be doing more harm than good.
(mentioned in the section ‘How is it treated?’)
Derived from chilli
peppers, capsaicin has proved itself in reducing chronic pain by reducing the stimulation of pain receptors. It is most often used
in cream form. At first, capsaicin may cause an unpleasant, hot feeling that causes many people to stop using it. However, once this
first phase passes, capsaicin can be effective and although not available everywhere, capsaicin patches are easier to apply.
treatments for neuropathy
The following nondrug therapies have been shown to reduce the pain associated with neuropathy:
In this therapy, small electrodes placed on the skin deliver tiny electrical impulses to specific nerve pathways.
This treatment is effective for some types of pain.
During biofeedback, people learn how to control body responses to reduce
pain. Biofeedback is taught with a special machine in a hospital or medical centre. Afterward, patients learn how to control these
responses by themselves.
Acupuncture is a traditional Chinese method of pain relief in which very thin needles are placed
in specific spots to relieve tension and stress. There is plenty of evidence that acupuncture can help some people with neuropathic
Hypnosis seems to work well for those who have faith in the treatment and you can’t argue with success. It should
be performed by a qualified professional.
Relaxation and visualization techniques
These exercises range from deep breathing to imaginary
“escape routes” from the pain. Yoga centres may be able to help people learn how to control their pain in this way.
you Google 'Cannabis and neuropathy' you will come across a large number of links referring to research in this area. In general,
cannabis seems to help large numbers of neuropathy sufferers. It is one of the areas in which the link between neuropathy and hiv
is more closely studied mainly because of the large numbers of gay men living in the big cities, for instance San Francisco, where
research hospitals are most active in investigating the benefits of cannabis to hiv patients.
A recent Canadian study showed the
benefit of smoking marijuana to relieve neuropathic pain and help with sleeping problems. There seems to be a growing body of knowledge
regarding cannabis receptors in the human body, giving strength to the idea that cannabis can have an analgesic effect but then you
may be confronted with problems of legality and also the fact that it is essentially 'smoking' with all the associated problems. If
you are a non-smoker, or an ex-smoker, it is by no means certain if ingesting cannabis by other means (tea, tablets etc) has the same
Again, it is a subject you should be able to discuss with your doctor.
These two videos give a little more background