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Keywords: neuropathic pain, nerves, neuropathy, nervous system, neuralgia, trauma, multiple sclerosis, nerve damage, nutraceutical
OBSERVATIONAL STUDY ON THE USE OF A NUTRACEUTICAL IN PATIENTS SUFFERING FROM NEUROPATHIC PAIN
OBSERVATIONAL STUDY ON THE USE OF A NUTRACEUTICAL ON PATIENTS AFFECTED BY NEUROPATHIC PAIN
Lucia Villa, Antonio Beneduce
Introduction: neuropathic pains
Neuropathic pain is a particular type of disease of the nervous system, also called neuralgia, in which chronic and persistent pain arises as a result of nerve deterioration. The most common case is peripheral neuropathy, in which nerves of the peripheral nervous system are damaged. However, there are also neuropathies of the central nervous system. There are multiple causes of this kind of pathology: direct trauma suffered by the nerve as a result of impact or crushing, or damage caused by other diseases, such as viral infections (usually complications of herpes zoster infections), diabetes, or multiple sclerosis.
In each case, the common component lies in the fact that the nerve is damaged and, although it does not completely lose function, problems are detected in performing daily activities. Neuropathic pain is fundamentally different from nociceptive pain caused by skin nerve receptors that, upon sensing abnormal situations in their area of expertise, send a clear signal of pain to the central nervous system (this process played an important evolutionary role in enabling the survival of the human species as a defense mechanism).
Neuropathic pain originates within the nerve fiber itself and is basically caused by an alteration in the myelin coating of the axons of some neurons. This results in alterations in nerve signal transmission and, as a result, a sensation of pain and burning along with a decline in function of the affected nerve. Damage to the myelin sheath can be of various origins: particularly severe and protracted blunt and crushing trauma can damage the myelin sheaths, as can certain bacteria that attack nerve cells(syphilis, Lyme disease), or viruses that directly infect them, or that infect and damage cells supporting the neuron(HIV, H.zoster).Diabetic hyperglycemia can also result in nerve damage due to reduced supply of nutrients and oxygen by the capillaries.
Diseases such as multiple sclerosis or amyotrophic lateral sclerosis, on the other hand, cause problems in the production of the myelin sheath of axons at both the CNS and peripheral levels, giving rise, among other symptoms, to neuropathy that can be both central and peripheral.
In addition to this, another important cause of myelin sheath deterioration, and consequently neuropathic pain, is the consumption of chemotherapy drugs, such as cisplatin, or chronic exposure to toxic substances such as alcohol, arsenic, lead , or mercury.
Neuropathic pain is often a symptom of a more serious problem; however, it still needs to be treated appropriately to improve the quality of life for those affected.
Objective of the study
The aim of the study was to evaluate the efficacy and tolerability of the nutraceutical Neuroken 36cps in patients with peripheral neuropathic pain of various origins by evaluating the patient’s condition before and after a 3-month treatment period.
Materials and Methods: how to treat neuropathic pain?
A total of 86 patients with various diseases causing peripheral neuropathic pain were recruited for the study. The patients ranged in age from 20 to 90 years, both men and women. Following an initial follow-up visit, the researcher asked the patient to complete a questionnaire where various symptoms of neuropathic pain graded with a scale from 0 (symptom absent) to 3 (strong symptom) were indicated, and then asked the patient to undergo a therapy consisting of daily intake of Neuroken, taking 1 capsule at breakfast and 1 capsule at lunch for a period of 3 months. Following the period of nutraceutical therapy, a second follow-up visit was made and the patient was again asked to fill out a questionnaire indicating the level of neuropathic pain symptoms he was currently experiencing. The results of the questionnaire were compared with those obtained at the beginning of the study.
3.1 Criteria for inclusion and exclusion
It constitutes criteria for inclusion:
- Presenting peripheral neuropathy of any kind
It constitutes an exclusion criterion:
- Already be on therapy for neuropathic pain with other drug or nutraceutical
- Have allergy or sensitivity to the active ingredients in the product in use
3.2 Characteristics of the tested product
Neuroken 36cps is a nutraceutical formulated in gastro-resistant capsules that prevent deterioration of the active ingredients by gastric juices and enzymes, preserving them until they reach the intestinal lumen where they are absorbed and exert their therapeutic effect.
Neuroken 36cps Contains:
L-Acetylcarnitine: L-Acetylcarnitine is an endogenous molecule that has antioxidant activity and plays an important role in energy metabolism. It modulates the release of neurotransmitters such as acetylcholine, serotonin, and dopamine in the brain and acts on neurotrophic factor receptors such as the NGF receptor (nerve growth factor) and mGlu(metabotropic glutamate) receptor by stimulating their expression through epigenetic mechanisms. In addition to this, it also induces increased expression of mGlu group 2 receptors at nerve endings. These receptors are involved in pain expression at the nerve level and act as a kind of “brake” of the pain stimulus, thus counteracting nerve sensitization and neuropathic pain.
α-lipoic acid: has antioxidant and anti-inflammatory action that helps relieve nerve inflammation. Especially, it reduces neuropathic pain caused by diabetes by going to act on the causes of this problem, namely the poor blood flow to the nerves caused by capillary damage resulting from prolonged hyperglycemia. Because of the increased blood flow to the nerve and the antioxidant/anti-inflammatory action, an improvement in the patient’s quality of life is achieved by reducing pain.
B vitamins: Vitamin B12 is known to play an important role in preventing the development of neuralgia in patients undergoing chemotherapy treatment and, more generally, deficiency of this vitamin can induce neuropathic pain situations. In addition to their efficacy in preventing neuropathic pain caused by chemotherapy, B vitamins are also known for their ability to reduce neuropathic pain caused by diabetes or alcoholism. There is experimental evidence regarding the function of these vitamins in the proper functioning of the nervous system and how specifically vitamin B5 is involved in myelin homeostasis in rats. Consequently, it is reasonable to assume that it plays a similar role in humans as well, contributing to aggravating situations of neuropathic pain when there is a deficiency.
Results of the study
Of the 86 patients recruited for the study, 49 were men and 37 were women; the patients had a mean age of 60.84 years. Patients at the first follow-up visit complained of symptoms of average intensity for each of the parameters identified by the completed questionnaire. Exceptions were alterations in digestion and sweating, reductions in mobility and the presence of itching: in fact, these parameters were mild on average.
Following 3 months of treatment with the nutraceutical Neuroken, all assessed parameters decreased and patients reported mild values in each case, and for the 4 parameters mentioned that were already mild at the beginning of treatment, the final values had decreased to become extremely mild or absent.
For each of the parameters considered, the average value reduction at the end of the study in fact exceeded 40 percent, even exceeding 80 percent reduction for the mobility reduction parameter.
Conclusions of the study
The intake of the nutraceutical Neuroken in patients with peripheral neuropathy has not generated any side effects and has demonstrated an appreciable reduction in classic neuropathic pain symptoms: it follows that Neuroken may be considered a possible useful treatment for the purpose of moderating neuropathic pain in a physiological manner, through the supplementation of vitamins and antioxidants that help to reduce the problem, improving the quality of life of sufferers.
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