Peripheral neuropathy: Long Covid chance finding suggests nutritional supplement could help PN sufferers


A chance finding in a long Covid study could help millions of people suffering from peripheral neuropathy.
About four per cent of the population are known to be affected by a nerve condition called peripheral neuropathy (PN). That’s more than 2 million people living in the UK, at any one time, with a progressive condition which can cause distress and eventual disability.
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Hide AdSymptoms characteristically include pins and needles, and numbness coupled with an irritating sensation of burning known as hyperaesthesia in a “stocking and glove” distribution. In more severe cases muscle weakness impairs balance and co-ordination causing difficulty with movement and falls.
Most cases start without an apparent cause, called idiopathic. Other cases are associated with other chronic conditions such as diabetes, alcohol abuse, vitamin B and mineral deficiencies. Oncologists, like myself, see a lot of patients with PN as it is a relatively common side-effect of some chemotherapy drugs such as taxanes.
More recently, studies have revealed that PN can also be triggered by a Covid infection, particularly if severe or prolonged. For example, in the National long Covid study, completed last year, 147 participants with long Covid had with an array of symptoms including seven per cent with pins and needles or hyperaesthesia which they had not experienced prior to their infection.
Fortunately, these troublesome neurological symptoms improved in response to the intervention which consisted of two nutritional supplements. The first aimed to improve gut health and vitamin D levels with a supplement called Yourgutplus. The second, called Phyto-V, boosted the intake of specific natural nutrients in plants called phytochemicals known for their anti-viral, anti-inflammatory and anti-oxidative properties.
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Hide AdIn the final publication in the journal COVID, although PN was noted, the emphasis was on the substantial improvements in fatigue, sleep, muscle aches, gut symptoms and overall wellbeing. Since the trial completed, however, the trials unit started receiving emails from people across the world who had bought the supplements independently, letting us know that their long-standing neuropathy had improved.
Rachael took the time to email us, saying: “I took the supplements to help my recovery from a Covid infection. I was nicely surprised that after four weeks my long-standing neuropathy started to improve. When I stopped it, my pins and needles returned. Happily, when I restarted it again they disappeared.”
Following these comments and the results seen in our trial the scientific trials group decided to look into the causes and treatments for PN in more detail.
The first priority for managing and treating PN, whether related to Covid or not, is to identify and treat any underlying contributory factors such as smoking, high alcohol intake, vitamin or mineral deficiency including or in the case of cancer patients reducing the chemotherapy dose although a recent study showed that black patients could benefit from switching to a different brand of taxane chemotherapy.
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Hide AdFor the majority, however, medical management just involves alleviating symptoms with pain killers, especially those which target neuropathic pain such as gabapentin or amitriptyline. Topical therapies such as chilli (capsaicin) based creams and acupuncture may relieve localized neuropathic pain. Aerobic exercise proved beneficial in some trials, especially if combined muscle strength, flexibility and balance. Gadgets such as Transcutaneous Electrical Nerve Stimulation (TENS), massage and vibrating tools have also helped some individuals.
The underlying mechanisms of nerve damage are multifactorial but recently, attention has focused on the contribution of oxidative stress and neuroinflammation. Both of these factors have been shown to accelerate spinal nerve cell degeneration and block repair.
Exercise can help reduce oxidative stress and inflammation which may be the reason why it has been shown to help PN. Boosting foods rich in phytochemicals, found in colourful fruit, vegetables and spices, have also reported reduced markers of oxidative stress and inflammation which correlated with improved peripheral nervous system functional recovery in several laboratory studies. There are some suggestions of benefits in humans but until now robust clinical studies have not been forthcoming
The advantage of a formal research project is that all outcomes and symptoms have to be recorded, whether expected or unexpected. This is why the number of cases of PN were established accurately. In the study, people had symptoms for several months and recovery occurred fairly quickly after taking the supplements but there were not enough cases of PN, to established statistically that the intervention was responsible for the improvements.
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Hide AdMost importantly, the improvements in PN recorded trial, coupled with the anecdotal emails from around the country has provided the impetus, justification and motivation to investigate this further. The scientific committee lead by a team from Bedford and Addenbrookes Cambridge University Hospitals was therefore re-convened and a new trial designed. Participants with PN (from all causes) will be randomised to either placebo, Yourgutplus, Phyto-V or both which will be repackaged so the patients won't know what they will be taking. Likewise, the medical team will not know - a design technique called double blind which aims to reduce any unconscious bias between the two randomised groups.
After 150 patients have finished the six months intervention, the blinding-codes will be cracked open and it will be established, for sure, whether this dietary intervention helps people with PN not caused by Covid. The research group will also be able tell whether Phyto-V works on its own or whether it has to be combined with Yourgutplus as in the Covid trial.
This will be the largest and most robust nutritional intervention in the world addressing the discomfort of peripheral neuropathy and if positive could provide a practical, safe and low cost self-help strategy for millions. More details of the study, its progress and eventual results can be found on the trial website (phyto-v.com) along with practical advice for people living with peripheral neuropathy.
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