Nutritional supplements

A variety of nutritional supplements have been tried as treatments for peripheral neuropathy in people with HIV. Again, studies generally have not separated people with HIV-associated and drug-induced neuropathy.

Several nutrients are essential for proper nerve function, including vitamins B1 (thiamine), B2 (riboflavin), B3(niacin), and B6 (pyridoxine), B9 (folic acid), B12 (cobalamin), and E, as well as the minerals calcium, magnesium, phosphate, and potassium. Small studies and anecdotal evidence suggest that nutrient supplements including the B vitamins, magnesium, and chromium may prevent the onset of neuropathy and relieve neuropathic pain, although this has not been confirmed in clinical trials.1 2

Acetyl-L-carnitine (ALC) has generated considerable interest as a treatment for neuropathy associated with d-drugs. ALC is a natural amino acid that is necessary for proper mitochondrial metabolism. In one study of 21 patients with nucleoside reverse transcriptase inhibitor (NRTI)-associated peripheral neuropathy, ALC reversed the loss of nerve fibres in the skin and reduced neuropathic pain.3 Benefits of ALC have been seen in patients treated for over four years.ref] ALC has also been shown to relieve neuropathy due to cancer chemotherapy.4 5

Research into gamma-linolenic acid, an omega-3 fatty acid, and alpha-lipoic acid suggest they may help relieve neuropathy pain in diabetics. In one 23-person study, significant improvement was seen in both sensory and autonomic neuropathy.6 Evening primrose oil and curcumin, a component of tumeric, have also been proposed as neuropathy therapies, based on anecdotal reports or animal studies.7

References

  1. Haupt E et al. Benfotiamine in the treatment of diabetic polyneuropathy: a three-week randomized, controlled pilot study (BEDIP study). Int J Clin Pharmacol Ther 43: 71-77, 2005
  2. Sun Y et al. Effectiveness of vitamin B12 on diabetic neuropathy: systametic review of clinical controlled trials. Acta Neurol Taiwan 14: 48-54, 2005
  3. Hart AM et al. Acetyl-l-carnitine: a pathogenesis based treatment for HIV-associated antiretroviral toxic neuropathy. AIDS 18: 1549-1560, 2004
  4. Maestri A et al. A pilot study on the effect of acetyl-L-carnitine in paclitaxel- and cisplatin-induced peripheral neuropathy. Tumor 91: 135-138, 2005
  5. Ghirardi O et al. Acetyl-L-carnitine prevents and reverts experimental chronic neurotoxicity induced by oxaliplatin, without altering its antitumor properties. Anticancer Res 25: 2681-2687, 2005
  6. Tankova T et al. Treatment for diabetic mononeuropathy with alpha-lipoic acid. Int J Clin Pract 59: 645-650, 2005
  7. Osawa T et al. Protective role of antioxidative food factors in oxidative stress caused by hyperglycemia. Ann N Y Acad Sci 1043: 440-451, 2005
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

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The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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