Nerve Repair Supplementation
Good morning, Dr. Markle at the Centeno-Schultz Clinic, and, today, I’d like to take a moment to discuss peripheral nerve injuries and nerve repair supplementation (to help recover from peripheral nerve injuries).
Now, there’s many different types of peripheral nerve injuries that we do treat. They range from a variety of different conditions, such as
- Sciatica, radiculopathy (or radiculitis) This is usually stemming from a Spine Condition from arthritis, or disc herniations irritating a nerve as it exits your spine.
- General Peripheral Neuropathy. (Well, our treatments typically don’t treat peripheral neuropathy, that’s more systemic secondary due to some more metabolic conditions such as diabetes or any chronic medications, or other things that are more systemic). But some of the Supplementations we discuss today could potentially help these conditions.
- Compressive Neuropathies, these fall under the category of things like Carpal Tunnel Syndrome, Thoracic Outlet Syndrome, Cubital Tunnel Syndrome, Tarsal Tunnel Syndrome, Peroneal Nerve injuries, and Baxter’s Neuropathy. And we can treat all of these with advanced regenerative orthobiologics, such as platelet-rich plasma via a nerve hydro-dissection. But, there may be a simpler option to help recover from these injuries, such as supplementation that we’ll be discussing today.
- Crush Injuries that typically happen from fractures, bad traumas, and common nerves affected by this are Tibial nerve, Radial nerve and as well as Intercostal nerves that run adjacent to the ribs that can get damaged in a rib fracture.
So looking at traditional medicine for peripheral nerve injuries, there is a myriad of treatment options. One would be medications, physical therapy, and then another non-surgical one would be phytochemicals which are also known as oral supplementation – so vitamins, minerals. And then after that, you have a host of surgical options, as well as regenerative medicine options that we do here at Centeno-Schultz Clinic.
Medications & Phytochemicals
But let’s talk about medications themselves. Well, medications basically help mask the symptoms of nerve injuries, they can help reduce the symptoms, the numbness, the tingling, the pain.
But the problem with a lot of these medications, they don’t help the underlying cause. They do not help the repair of the nerve, as well as, long-term-wise, some of these medicines can actually be detrimental to the nerves. So, while medications help short-term, long-term-wise they are not really helping the overall condition.
And, then, you have the whole world of Phytochemicals, meaning supplementation from plants, vegetables, and other ways to ingest nutrients, This is will be the main focus of our lecture today: Is there data or research that supports the idea that vitamins and minerals can help with recovery of nerve injuries?
So let’s talk about:
- lipoic acid, alpha- and gamma-lipoic acid
- B vitamins (B1, B2, B3, B5, B6, B7, B12)
- ubiquinone (CoQ10), and
- antioxidants – melatonin, vitamin C, N-acetylcysteine(NAC), L-carnitine.
So we’re going to take a deep dive into a lot of these supplementations from a research standpoint, and how much evidence is there to really treat peripheral nerve injuries to accelerate and assist the recovery.
So if we look at some animal studies researching lipoic acid effects on sciatic nerve injuries in an animal model, they found that these results suggested that ALA is a neuroprotective agent for peripheral nerve injuries, as well as promotes peripheral nerve regeneration, being anti-inflammatory, anti apoptotic effect (meaning they stop the cells from dying).
Additional animal models also show that ALA treatements produce significant improvements of sciatic function index values with non-significant improvements on electromyography compared to B-12 treatments, meaning function improved greatly with ALA compared to vitamin B-12. But with B 12, ALA and B-12 did about the same improvement of electrophysiological function-standpoint. Then when they actually looked at the histopathology, meaning they looked in a microscope to see the structural components of the nerve, ALA was more relevant in axonal structure recovery in comparison to B12 — so improved the swelling around the nerve, as well as the outer coating around the nerve called the myelin.
Then, in animal models, there’s a couple of studies looking at carpal tunnel syndrome. There’s this one and then another one looking at carpal tunnel syndrome. Both of these studies showed that both types of lipoic acid, ALA and GLA, induced antioxidant protective actions, reduce inflammation, promoted neuroregeneration, and decreased the patients’ pain, as well as — when we looked at the function of the nerve, electromyography showed significant improvement of ALA and GLA — compared to just an overall multivitamin, which didn’t show too much improvement.
So ALA and GLA seemed to be very significant for assisting in nerve regeneration as well as being very neuroprotective.
So, there’s a host of B vitamins out there, and they act as coenzymes in substantial fractions of enzymatic processes and play a key role in interactions for a majority of cellular functions, thus these are important for almost every different type of function in your body, including the nervous system. So if you look at some of these complex pathways, B 12 is already critical for the entire pathway.
Now, you don’t need to really know what this pathway is. This is just how your body generates energy to help the repair, and B vitamins help, along the way, in multiple different pathways. We can see B vitamins are coenzymes, meaning they assist the function of your body’s cellular processes. So all these vitamins are very critical in the entire process of accelerating regeneration.
This is an antioxidant with bioenergetic and anti-inflammatory properties and protects the cells against apoptosis of neurons, “apoptosis” meaning cellular death. So, it helps protect cells from dying.
CoQ10 works as essential cofactors in oxidative phosphorylation in mitochondria. So, mitochondria are the units of your cellular membranes that actually produce energy. So, they help in the function of the cellular membranes, as well as the mitochondrial function to increase your oxidative protective functions.
And here’s a research study working on Type 2 diabetes with peripheral neuropathy and CoQ10 showed superior bioavailability. And the form of ubiquitol. So if you’re looking for supplementation, you really want the ubiquitol in comparison to the ubiquinone, because these will have a greater viability, meaning they can help your peripheral neuropathy as well as your body will absorb it and use it.
Essential for developing physiological function of the nervous system, Vitamin C is very critical for the fully functioning neurologic system as we age.
Melatonin has been shown to have very neuroprotective effects on injured neurons, anti-inflammatory effects at the injury site, scar reducing effects (reducing some of the scar tissue forming from an injury), as well as helping proliferate stem cells and stimulates axonal regeneration.
If you look at an acetylcysteine (NAC), it’s been shown to be very neuroprotective as well as helpful in synthesizing glutathione, which is an antioxidant free radical scavenger, meaning it helps rid the body of bad chemicals that build up in the tissue are called free radicals. These compounds help synthesize the things that gobble those free radicals up, so they inhibit their actions, so it protects your your body’s membranes as well as your mitochondrial function.
Acetyl-L-carnitine has also been shown to be a cellular protectant fror free radicals
Antioxidants basically help with all the free radicals that can damage your body’s cellular functions, such as your mitochondrial function. Mitochondria is critically important in your overall function.
How Much of These Should You Be Taking?
So next, let’s talk about, well, how much of these should you be taking? So here’s a quick cheat sheet on all the different vitamins you should be taking, as well as some upper limits and warnings about some of these vitamins you don’t want to take too much of. And before you take any of these vitamins, always make sure you’re discussing these with your physician to make sure there’s no interaction with any current medications you’re taking. (See Video)
So I hope you enjoyed this lecture. My name is Dr. Markle. Again, I’m an Interventional Orthopedics doctor, specializing in Ortho-regenerative medicine. And if you have any questions, concerns, feel free to reach out to us on any of our social media outlets, as well as our website directly. And we’re always happy to further discuss some of these supplementations if they are going to be a first line treatment. If you continue to have problems and pain with any peripheral nerve injuries, we have multiple treatment options and non-surgical options that can help focus on regenerating the nerves as well as improving your pain and function. Thank you.
Have a good day.