Re: Neuropathy Treatment

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What are B6, B12, and folate, and what do they do?These are essential nutrients, meaning that they are vital to life. These three vitamins work both independently and together in many of the body's systems.Vitamin B6 assists in making hormones, new proteins, and neurotransmitters ("messengers" between nerve cells) for the body's use. It also helps release stored sugar when we need it for fuel. It works together with B12 and folate to remove homocysteine from the blood. Homocysteine is a substance increasingly associated with a number ofdiseases; more about this later.Vitamin B12 plays a role in the synthesis of DNA, needed for formationof new red blood cells. It takes part in the manufacture of the myelin sheath - the protective coating that surrounds nerve cells. With B6 and folate it removes homocysteine from the blood.Folate, also called folacin or folic acid, is a partner with B12 in DNA synthesis and in removal of homocysteine, and is required in many other vital processes. Without folate, B12 would be unable to complete many of its functions, and vice versa. Folate is the form found in foods, folic acid is the form in dietary supplements.How much do we need of these vitamins?Nutrient needs are broken down by gender, age group, pregnancy, and lactation. New guidelines have also established a Tolerable Upper Intake Level. So, for example, while the RDA for vitamin B6 for males and females age 19-30 years is 1.3 mg/day, the Tolerable Upper Intake Level for both is 100 mg/day, making it easier to provide recommended amounts.

RDA* Tolerable Upper Intake Level ** +Vitamin B6*** + 1.7 mg/day 100 mg/day (age 19 and older)Vitamin B12 + 2.4 mcg/day Not DeterminedFolate + 400 mcg/day 1000 mcg/day* Recommended Dietary Allowance** The Tolerable Upper Intake Level is the maximum level of daily nutrient intake that is likely to pose no risk of adverse effects, and represents the total intake from food, water, and supplements.*** Adults age 51 and older+ not applicable if pregnant or lactatingWhy do deficiencies occur, and what are signs of deficiencies?Vitamin B6. Mild deficiencies of B6 are fairly common in the U.S., mostly because of dietary deficiencies, but sometimes due to use of certain medications which interfere with B6, including hydralazine, isoniazid, MAO inhibitors, penicillamine, and theophylline. (Conversely, large amounts of B6 can interfere with the absorption of levodopa, an important medication for Parkinson's disease. Current use of the combinations of carbidopa-levodopa or benserazide-levodopa offset this interaction for the most part; but use of supplements containing more than 15 mg of B6 can overwhelm the protective effects of the carbidopa and benserazide.)Good food sources of B6 include chicken, fish, eggs, nuts and seeds, dried beans and peas, soybeans, wheat germ, bananas, avocados, and brewer's yeast. Also, some foods, including a number of breakfast cereals, are fortified with B6.Signs of B6 deficiency include irritability, depression, and confusion; sore tongue, sores or ulcers of the mouth, and ulcers of the skin at the corners of the mouth.Vitamin B12. The human body stores this vitamin so well that it can take a long time to deplete, sometimes several years. Nevertheless, there are several reasons why people sometimes do experience deficiency. Animal foods are the only source of B12, therefore people who eat few or no animal products (meat, fish, poultry, eggs, milk) are at risk unless they use vitamin supplements.Another problem is that B12 in foods cannot be absorbed by the bodyuntil it is freed from the proteins in the food; the stomach produces anacid that removes this protein. However, with age, we produce less and less of this stomach acid. Many older adults don't produce enough acid to allow them to absorb B12. Further, people who have acid reflux often use medications that reduce stomach acid, which unfortunately also decreases absorption of B12. Vitamin B12 is one of the few nutrients that is better absorbed in pill form than from dietary sources.Signs of B12 deficiency include numbness or a tingling "pins andneedles" sensation, or a burning feeling; a red, sore, or burning tongue; loss of appetite; gait abnormalities, personality changes, an Alzheimer-like dementia, psychosis, depression, and agitation, particularly in older adults. Other signs are megaloblastic anemia, andelevated serum homocysteine, in people of all ages. Researchers believe that as many as 42% of people aged 65 and older may have some degree of B12 deficiency. Many people with PD are age 65 or older, and should beconsidered at risk and tested for B12 deficiency.Folate. Folate is available in many foods: lima beans, brewer's yeast, orange juice, dried beans, green peas, asparagus, beets, Brussels sprouts, broccoli, corn, spinach and other dark green leafy vegetables, soybeans, nuts and seeds. Further, the U.S. government requires that food manufacturers fortify processed grain products with folic acid. Yet, deficiencies of folate are not uncommon. This could be in part because folate is another of the few nutrients in which the synthetic form is absorbed much better (about 40 percent better) than the natural form.Because of the possibility of deficiency, women, including women with PD, who are pregnant or wish to become pregnant are advised to take supplements of folic acid; deficiencies can result in neural tube defects in the unborn child.