Diabetic Neuropathy treated with Neuro-No 2
Why does it work?     By Dr. Steven J. Dolgoff

Neuro-No 2: Why Does it WorkNeuro-No 2: First Line TreatmentTrusted Internet Pharmacies
Pain in 1/2 of Big ToePain in 1/2 of Big Toe, middle 3 ToesPain to little ToePain to 1/2 of Big Toe and 1/2 LegPain inside of heel & up LegOther causes of Painful ToesFact Sheet for N.I.N.D.S.Contact PageReprints & PermissionsReturning MembersResearch LinksDiabetic Peripheral NeurpathyDrugs for Diabetic Nerve Pain3 Steps to treat Diabetic NeuropathyReduce Risk of Nerve DamageRate Your PainNeuro-No 2 DirectionsHow to Order Neuro-No 2 American Diabetes Association B6 Therapy

Erythrocyte O2 transport and metabolism and effects of vitamin B6 therapy in type II diabetes mellitus.

1. L R Solomon
2. K Cohen
+ Author Affiliations


The effects of vitamin B6 on erythrocyte metabolism, erythrocyte hemoglobin O2 affinity (P50), and nonenzymatic glycosylation were studied in 15 Caucasian men with type II (non-insulin-dependent) diabetes mellitus. A control group of 13 healthy Caucasian men was also evaluated. Before treatment, diabetic subjects had low mean cell hemoglobin concentration values and increases in both erythrocyte 2,3-diphosphoglycerate (2,3-DPG) levels and erythrocyte hexokinase activities. Although all three of these changes are associated with a decrease in hemoglobin O2 (Hb-O2) affinity, P50 values were normal in diabetic subjects. Moreover, P50 values normalized to pH 7.4 (P50(7.4] were inversely related to the level of glycosylated hemoglobin (HbA1c). Both erythrocyte 2,3-DPG and erythrocyte ATP were also inversely related to HbA1c. Vitamin B6 nutriture, as determined by erythrocyte aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities, was normal in all diabetic subjects before vitamin B6 therapy. Nonetheless, HbA1c levels decreased after 6 wk of treatment with 150 mg/day pyridoxine and increased again during placebo administration. These changes were not explained by changes in fasting blood glucose. Pyridoxine therapy also decreased P50(7.4) values and increased erythrocyte AST and ALT activities but had no effect on 2,3-DPG, ATP, or the activities of hexokinase, glucose-6-phosphate dehydrogenase, and 6-phosphogluconate dehydrogenase. These observations suggest that 1) nonenzymatic glycosylation may play a role in regulating both erythrocyte metabolism and Hb-O2 affinity in diabetic subjects, and 2) vitamin B6 therapy may modify nonenzymatic glycosylation of hemoglobin in this population.

Articles citing this article

Cobalamin-responsive disorders in the ambulatory care setting: unreliability of cobalamin, methylmalonic acid, and homocysteine testing Blood February 1, 2005 105:978-985

Vitamin B6. Vitamin B6 inhibits glycosylation of proteins (Solomon LR et al 1989), one the major risk factors for developing diabetic neuropathy. Diabetes patients with neuropathy have been shown to be deficient in vitamin B6 and to benefit from supplementation (Jones CL et al 1978). Interestingly, the neuropathy caused by vitamin B6 deficiency is indistinguishable from diabetic neuropathy.

Vitamin B12. A neuropathy caused by vitamin B12 deficiency is characterized by numbness of the feet, pins-and-needles sensations, or a burning feeling (Davidson S 1954; Sancetta SM et al 1951). Supplementation that restores normal B12 levels is a part of successful treatment of diabetic neuropathy (Bhatt HR et al 1983). In a review of clinical trials conducted between 1954 and 2004, vitamin B12, as well as combination therapy of vitamin B12 and methylcobalamin, was shown to reduce pain (Sun Y et al 2005).

The most common forms of supplemental B12 are cyanocobalamin or hydroxycobalamin. The natural form of B12 found in food is methylcobalamin (or a similar form, adenosylcobalamin). The structure of B12 is very complex, with numerous methyl groups attached. Methyl groups (CH3) are used in beneficial methylation reactions, such as those that reduce homocysteine. Methylcobalamin appears to be the most effective form of vitamin B12 to protect the nerves.

Neuro-No 2: First Line Treatment
Neuro-No 2: Directions
Neuro-No 2: How to Order