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Management of diabetic small-fiber neuropathy with combination L-methylfolate, methylcobalamin, and pyridoxal 5'-phosphate.
MedLine Citation:
PMID:  21769070     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Agents used to treat symptoms of diabetic peripheral neuropathy (DPN) are only palliative, not disease modifying. Although studies of monotherapy with L-methylfolate, methylcobalamin, or pyridoxal 5'-phosphate suggest that each of these bioavailable B vitamins may reverse the pathophysiology and symptoms of DPN, data on the efficacy of this combination therapy are limited. Therefore, we assessed the efficacy of an oral combination of L-methylfolate, methylcobalamin, and pyridoxal 5'-phosphate for improving epidermal nerve fiber density (ENFD) in the lower extremity of patients with DPN. Eleven consecutive patients with type 2 diabetes with symptomatic DPN were assessed for ENFD at the calf by means of skin punch biopsy and then placed on twice daily oral-combination L-methylfolate, methylcobalamin, and pyridoxal 5'-phosphate. After approximately 6 months of treatment, patients underwent follow-up biopsy. At the end of their treatment, 73% of patients showed an increase in calf ENFD, and 82% of patients experienced both reduced frequency and intensity of paresthesias and/or dysesthesias. This preliminary study suggests that combination L-methylfolate, methylcobalamin, and pyridoxal 5'-phosphate increases ENFD in patients with DPN.
Authors:
Allen M Jacobs; Dunlei Cheng
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Reviews in neurological diseases     Volume:  8     ISSN:  1949-4378     ISO Abbreviation:  Rev Neurol Dis     Publication Date:  2011  
Date Detail:
Created Date:  2011-07-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101223246     Medline TA:  Rev Neurol Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  39-47     Citation Subset:  IM    
Affiliation:
Allen M. Jacobs & Associates, Ltd., St. Louis, MO.
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