Some of the more effective chemotherapeutic drugs produce the negative effect of peripheral neuropathy–damage to the nerves of the arms and legs with symptoms that include tingling, numbness, and burning pain in the hands and feet, as well as gradual weakness of the muscles in the arms and legs.  This often limits the usage of such drugs.  It is known that painful peripheral neuropathy is produced by both the taxane agent, Paclitaxel, and the platinum-complex agent, Oxaliplatin, occurs through a common mechanism-a toxic effect on the mitochondria in primary afferent sensory neurons (nerve cells).  A new study demonstrates that another chemotherapeutic agent from a different class, Bortezomib, a proteasome-inhibitor, produces peripheral neuropathy through the same mechanism–damage to the mitochondria in the peripheral nerve cells.  Supplementing with acetyl carnitine was shown to prevent peripheral neuropathy with Bortezomib by supporting the mitchondria, much as it does with paclitaxel and oxaliplatin.  It is likely that other nutrients that support mitochondrial function, such as lipoic acid, creatine, D-ribose, coenzyme Q10, magnesium, and B vitamins may also be useful adjuncts while taking chemotherapy.

How much acetyl carnitine should be taken?  Each of us are unique and our physiologies, our size, our overall level of health, and our individual response needs to be considered.  If you are suffering with neuropathy related to undergoing chemo, then the type of chemo and the dosage must be taken into account as well as the severity of your symptoms.  I recommend a combination of 500-1000 mg acetyl carnitine plus 100-250 mg lipoic acid taken 2-3 times per day between meals as well as a good B-complex (or a combination of B1, B6, and methyl B12) and a quality fish oil taken twice per day with food.  It may also be helpful to add some GLA in the form of evening primrose oil or borage seed oil.  Some patients have also gotten some relief with benfotiamine, a synthetic derivative of vitamin B1 that has been licensed in Germany since 1993 for the treatment of peripheral neuropathy.  If you are suffering with neuropathy from diabetes or from autoimmune diseases (such as rheumatoid arthritis, lupus, MS, or sarcoidosis),  or infectious disease such HIV, or genetic diseases, such as Charcot-Marie-Tooth disease, the recommendations will likely change.

 

Zheng H, Xiao WH, Bennett GJ. Mitotoxicity and bortezomib-induced chronic painful peripheral neuropathy. Exp Neurol. 2012 Dec;238(2):225-34.

 

Prescription pain pills

A recent Los Angeles Times article (3-29-2013) reports the rising rate of death from prescription drugs in the United States, specifically from overdose due to pain relievers like Oxycontin and Vicodin.  Deaths due to overdose of these drugs rose 3% in 2010 and preliminary data from 2011 show that this trend is increasing.  While such drugs may have some benefit for short term use after a severe injury or after surgery and in a limited number of patients with severe conditions such as terminal cancer, in most other cases, they should not be used.

According to Tom Frieden, head of the Center For Disease Control, “The data supporting long-term use of opiates for pain, other than cancer pain, is scant to nonexistent…. These are dangerous drugs. They’re not proven to have long-term benefit for non-cancer pain, and they’re being used to the detriment to hundreds of thousands of people in this country.”  Rather than treating a symptom, pain, medicine and doctors should strive to find the underlying reason for the pain.  Why is the body crying out for help?  Don’t just ignore these cries for help.  Why is there back pain, headaches, stomach pain, etc.?  Is the body lacking something it needs to heal?  Are there alignment issues, restricted motion in joints, altered movement patterns, and muscle weakness and imbalances that can be corrected?  Is there too much of something that is creating an obstacle to proper function, such as toxins, an undiscovered infection, a source of physiological stress, or food allergies?  What can be done to stimulate the body to heal, such as the right form of exercise, the right nutrients, a way to cleanse out some of the negative stimuli, or some other intervention to get the body on the proper path to healing?  Sometimes addiction to the pain killers can create pain when we try to stop taking them, known as analgesic rebound pain or rebound pain.  When we take pain killers, they suppress our body’s natural pain supressors, known as endorphins.  When we stop the vicodin, endorphin production has been diminished or shut off, which is one reason why more pain is felt.

Another problem with taking pain killers is that pain is a useful signal from our body to keep us from damaging ourselves.  Pain receptors in your arm or your back are telling you that lifting something in a certain manner can damage your muscles and ligaments.  If you block that pain signal with Vicodin or another pain reliever, you could cause damage to your muscles and joints without knowing it.  You are turning off the fire alarm without putting out the fire.