Methylcobalamin Effects and Diabetic Neuropathy

Methylcobalamin is an active form of vitamin B₁₂ and has been used as a therapeutic adjuvant to treat multiple chronic conditions. In fact, methylcobalamin modulates the synthesis of methionine and S-adenosylmethionine. It has been a part of diabetic neuropathy treatment with positive results and can alleviate the pain sensation.

Daily intake of methylcobalamin is necessary because the human body is not able to synthesize it. Therefore methylcobalamin is considered essential. Besides, it is the only form of vitamin B₁₂ that can cross the blood-brain barrier without transformation.

Neurological benefits of methylcobalamin

The methyl groups donated by methylcobalamin stimulated serotonin production, which in turn enhances mood and exerts protection against excitotoxins.

Converts homocysteine to methionine and reduces the risk of vascular diseases, arterial sclerosis, and strokes. Also, 5-methyltetrahydrofolate is an important element to eliminate homocysteine. Vitamin supplements reduce the chances of building homocysteine associated with stress.

Without methylcobalamin, myelin could not be formed.

Methylcobalamin produces S-adenosylmethionine. This compound promotes mitochondrial energy. This promotes better use of fats and carbohydrates in the metabolic process and makes them available for energy production.

Therapeutic applications of methylcobalamin:

The supplementation of methylcobalamin to treat a multitude of clinical conditions has been extensively reported. Indeed, its use to ameliorate diabetic neuropathy has been recognized, as well as its beneficial effects on rheumatoid arthritis and dementia. The exertion of these benefits relies on methylcobalamin’s capacity to regenerate the injured nerves, as it promotes cell growth and replication linked to proper neuronal functioning.

Nevertheless, methylcobalamin supplementation has been linked to reduced pain sensation caused by diabetic neuropathy, lower back pain, and neuralgia.

Diabetic peripheral neuropathy

The prevalence of diabetic peripheral neuropathy (DPN) is around 30-50%, and it is considered the most common chronic complication of diabetes. DPN commonly presents with pain and symmetrical polyneuropathy. It can easily develop with pain, sensory or motor disorders, and numbness.

DPN’s diagnosis is commonly made by reviewing clinical symptoms, a physical test, and the patient’s medical history. Nonetheless, the medical test may include an examination of:

• Overall muscle strength and tone
• Tendon reflexes
• Sensitivity to touch and vibration

Specific tests to help diagnose diabetic neuropathy:

• Filament test. Your doctor will brush a soft nylon fiber (monofilament) over areas of your skin to test your sensitivity to touch.
• Sensory testing. This non-invasive test is used to tell how your nerves respond to vibration and changes in temperature.
• Nerve conduction testing. This test measures how quickly the nerves in your arms and legs conduct electrical signals. It’s often used to diagnose carpal tunnel syndrome.
• Muscle response testing. Called electromyography, this test is often done with nerve conduction studies. It measures electrical discharges produced in your muscles.
• Autonomic testing. Special tests may determine how your blood pressure changes while you are in different positions and whether you sweat normally.

An association between the prolonged treatment with metformin and a deficiency of vitamin B₁₂ in diabetic patients has been reported, leading to a higher prevalence of methylcobalamin deficiency.

Vitamin B₁₂, methylcobalamin with and without other vitamins and microelements have been supplemented to measure pain sensation and regenerate nerve function improvements. Nevertheless, the underlying reason to perform these large cohort studies is to reduce the secondary effects of tricyclic antidepressants and opioid or opioid-like analgesics. It is also fair to mention that while these medications may aid the pain sensation, there is no myelin production or motor nerve fiber regeneration linked to these drugs. Therefore, the treatment or supplementation of methylcobalamin can treat the condition’s root cause and decrease pain sensation.

A study aimed to review the effectiveness of vit B₁₂ on DPN, that included 4 relevant qualified articles showed interesting results. In one of the studies, nerve conduction velocity improved significantly after the intervention. All of the studies reported a decrease in pain symptomatology and better scores in the testing assessments compared to the control groups.

To conclude on a high note, several supplements are being tested and studied to be part of the medical treatment of DPN. They are all being compared to the beneficial effects conferred by methylcobalamin. In fact, methylcobalamin has been approved by the China Food and Drug Administration for treating peripheral neuropathy and is recommended in the Chinese guideline for type 2 diabetes.

Pharmacokinetics and Dosage

Methylcobalamin’s intake can be administered orally, in the form of a nasal spray (9% bioavailability), muscular injection, or parenterally. This compound needs to be bind to an intrinsic factor, which is made in the stomach, and later it is absorbed by the distal ileum. Furthermore, methylcobalamin gets bound and distributed to every cell by Transcobalamine II. It could be stored in the liver in an amount of 300-500 micrograms, and then it is eliminated via bile.

Dosage:

Stress relief	500 mcg/day
Acute cases of neuropathy	1500mcg/day
Age-related brain decay	1mg/day
Vegetarian diet-related vit B12 deficiency	100mg/day
Basic nerve support	3mg/day

ANTI-INFLAMMATORY GEN(I)E

Cauliflower is all the rage right now, and it is clear to see. Nutritionally speaking is a great source of glucosinolates- linked to preventing cancer, vitamin K, and vitamin C.  If you are trying to cut some carbs and keep your glucose in check, try this cauliflower rice!

Cauliflower Rice

Servings: 4
Cook time: 15-20 minutes

• 1 head of cauliflower, roughly chopped into medium-sized pieces
• 4 tablespoon extra virgin olive oil
• 1 teaspoon salt

Place the cauliflower into a food processor and pulse until the texture resembles rice.

Heat the oil in a large skillet.

Add the cauliflower and salt, or use garlic to bring up the flavor.

Stir and cook evenly in the pan (about 8-12 minutes). Serve hot and with your favorite meal. -Ana Paola Rodríguez Arciniega

References

Gupta, J. K., and Qureshi Shaiba Sana. “Potential benefits of methylcobalamin: A review.” Austin J Pharmacol Ther 3.3 (2015): 1076.

Jayabalan, Bhavani, and Lian Leng Low. “Vitamin B supplementation for diabetic peripheral neuropathy.” Singapore medical journal 57.2 (2016): 55.

Jia, Hai-yan, Hao-ming Tian, and Dong Wei. “Effects of Methylcobalamin on diabetic peripheral neuropathy: a systematic review.” Chinese J Evid Based Med 5 (2005): 609-618.

Additional Online Links & Resources (Available 24/7)

Online Appointments or Consultations:  bit.ly/Book-Online-Appointment

Online Physical Injury / Accident Intake Form: bit.ly/Fill-Out-Your-Online-History

Online Functional Medicine Assessment: bit.ly/functionmed

Disclaimer

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us 915-850-0900.  Read More…

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*

email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico