[(accessed on 19 June 2020)]; Moher D., Liberati A., Tetzlaff J., Altman D.G., Prisma Group Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Most pet owners administer 3 to 5 mg of methylcobalamin daily. It is a neurotrophic substance with an affinity for neuronal tissues and has been found to be important in maintaining and regenerating peripheral nerves [12]. No serious adverse effects apart from those associated with local injections were witnessed across all groups [36]. There was a more significant reduction in pain measured by NRS and improvement in quality of life in those receiving local subcutaneous injection over the intramuscular group. 2. the contents by NLM or the National Institutes of Health. No validated quantifier of pain is used, only pain prevalence. According to the International Association for the Study of Pain (IASP), neuropathic pain is pain caused by a lesion or disease of the somatosensory nervous system [1]. (13) This same study also showed a statistically upward trend in the VPT, approaching a mean of 1.4 m at week 12 of treatment compared to 2.0 m at baseline.(13). Vitamin B12 Supplementation in Diabetic Neuropathy: A 1-Year - PubMed Open label. doi: 10.4093/dmj.2018.0259. FOIA The site is secure. Perform a medical check to determine if the leg weakness is caused due to low potassium levels. Articles which could not be obtained at least as an abstract. This is consistent irrespective of where in the body PHN manifests. Whilst this paper describes a statistically significant reduction in pain measured by the numeric rating scale (NRS) from baseline in both arms, there was no enhancement of outcome with the addition of B12 and ALA. No adverse events were reported in either treatment group [24]. The treatments were given three times daily for a duration of 30 days. government site. Vitamin B12 deficiency has been associated with significant neurological pathology, especially peripheral neuropathy. [(accessed on 19 June 2020)]; Girach A., Julian T.H., Varrassi G., Paladini A., Vadalouka A., Zis P. Quality of life in painful peripheral neuropathies: A systematic review. Xu et al. Furthermore, this study did not find any adverse effects resulting from the combination treatment. Yaqub BA, Siddique A, Sulimani R. Effects of methylcobalamin on diabetic neuropathy. There was a significant reduction in pain evaluated by NRS and LRS. Pain intensity measured on NRS was improved in both methylcobalamin arms, but significantly more so in the subcutaneous methylcobalamin arm. Efficacy and Safety of the Combination of Superoxide Dismutase, Alpha Lipoic Acid, Vitamin B12, and Carnitine for 12 Months in Patients with Diabetic Neuropathy. Of the included papers, 16 were randomised control trials (RCT), five were single arm interventional studies, one was a non-randomised comparative interventional study and one was a phase IV clinical trial. Open label. In some countries, vitamin B12 is categorised as an analgesic drug. (11) Only one study demonstrated statistically significant (p = 0.006) improvement in the nerve conduction velocity of the peroneal nerve by 1.1 m/s compared to that of the placebo group, which dropped by 2.7 m/s. The impact of a nutritional supplement capsule containing L-methylfolate, methylcobalamin and pyridoxal-5-phosphate as a treatment for diabetic neuropathy was explored by Trippe and colleagues. cyanocobalamin) ranged from 20 mcg to 1,840 mcg daily. Diabetic Neuropathy: Causes Symptoms And Treatment [(accessed on 19 June 2020)]; Manchikanti L., Falco F., Benyamin R., Kaye A., Mark B., Hirsch J. Res. eCollection 2023 Feb. Kong L, Zhao H, Wang F, Zhang R, Yao X, Zuo R, Li J, Xu J, Qian Y, Kang Q, Fan C. Mol Ther. The symptoms were paraesthesia, a burning sensation, numbness, loss of sensation and muscle cramps. In a randomised open label study, Sil et al. Dietary supplements may help reduce diabetic neuropathy symptoms, but more research is needed. [(accessed on 19 June 2020)]; Maladkar M., Rajadhyaksha G., Venkataswamy N., Hariharan R., Lohati S. Efficacy, safety, and tolerability of Epalrestat compared to Methylcobalamine in patients with diabetic neuropathy. National Library of Medicine Most cats respond favorably to methylcobalamin within a few weeks of Only Stracke et al(13) showed a clinically significant improvement in one out of the two nerves studied. A summary of the findings of included trials. All rights reserved. An official website of the United States government. This study therefore demonstrates superiority of local administration of these agents over IM administration for AOHN. At the end of the treatment period, participants showed significant improvements in total NTSS6 scores with a particular reduction in deep aching and burning pain. Sonobe M, Yasuda H, Hatanaka I, et al. (12,13), The main outcomes in the selected RCTs can be grouped into electrophysiological measures (namely VPTs and/or nerve conduction velocities) and neuropathic symptoms. [(accessed on 19 June 2020)]; Kuwabara S., Nakazawa R., Azuma N., Suzuki M., Miyajima K., Fukutake T., Hattori T. Intravenous methylcobalamin treatment for uremic and diabetic neuropathy in chronic hemodialysis patients. Of these, a total of 24 studies were included in this review. One of them had a Jadad score of 5,(10) two had a score of 4(11,12) and one had a score of 3. Transcutaneous electrical nerve stimulation and cobalamin injection versus transcutaneous electrical nerve stimulation plus lidocaine injection. [(accessed on 19 June 2020)]; Pellegrino M., Matteoli M., Bertolacci L. Effect of colchicine and vinblastine on identified leech neurons. Similarly, another study demonstrated no difference in the VPT between the treatment and placebo groups. Epalrestat outperformed methylcobalamin. Clicking on their link in our Affiliate Programs page will result in a very small commission for DCC. One such proposed therapy is vitamin B12 supplementation, even in the absence of B12 deficiency. The https:// ensures that you are connecting to the Methylcobalamin tablets successfully treat the symptoms of feline diabetic neuropathy in a short period of time. (11), All the studies analysed outcomes relating to VPTs or nerve conduction velocities. Degenerative orthopaedic alteration with neural compression. P.Z. Symptoms of feline neuropathy include pain, weakness, and paralysis. The two intervention groups were TENS plus B12 injection, and TENS plus B12 and lidocaine injection. No placebo arm. Did not include patients with severe neuropathy. contain added ingredients, it's important to read package labels to Diabetes mellitus is a common chronic disease that in 2020 affected 10.5% of the US population, or an estimated 34 million people. Several pathogenic mechanisms contribute to the DPN aetiology, including microangiopathy and oxidative stress. Patients and methods: Selection of studies, data extraction and assessment of methodological quality were performed independently and duplicated by two reviewers. For the most part, the published evidence base describes B12 as a treatment for pain in peripheral polyneuropathies with fifteen studies addressing this topic. Electrodiagnosis in diseases of nerve and muscle: Principles and Practice. (11,12) The duration of therapy in the four studies varied from 12 weeks(13) to 16 weeks(10,12) and 24 weeks. There was an improved quality of life with a focus on pain. Finally, many studies had a short follow-up duration and, therefore, we were not able to comment on the long-term effects of B12 therapy. In this prospective, double-blind, placebo-controlled trial, 90 patients with type 2 diabetes on metformin for at least four years and both peripheral and autonomic DN were randomized to an active treatment group (n = 44) receiving B12 and a control group (n = 46) receiving a placebo. After three cycles, subjects were assessed for the change in their VAS pain score. About 2 weeks ago I thought I noticed a little weakness in his hind legs but I wasn't really sure so I decided to keep an eye on him. and transmitted securely. [(accessed on 19 June 2020)]; Negro L., Almeida P., Alcino S., Duro H., Librio T., Melo Silva U., Figueira R., Gonalves S., Neto Parra L. Effect of the combination of uridine nucleotides, folic acid and vitamin B12 on the clinical expression of peripheral neuropathies. This study is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines [15]. / Advertisement September 19, 2022 by Celeste Yarnall Feline neuropathy is a condition that affects the nervous system of cats. All authors contributed to a selection of included articles, data collection, synthesis and interpretation of the evidence. doi: 10.1002/14651858.CD011265.pub2. Taking into account the above evidence, overall there is level II evidence that B12 can improve pain in patients either as a monotherapy or as part of a combination therapy. Open label study design. A search of PubMed and the Cochrane Central Register of Controlled Trials for all relevant randomised controlled trials was conducted in December 2014. [(accessed on 19 June 2020)]; Sil A., Kumar H., Mondal R.D., Anand S.S., Ghosal A., Datta A., Sawant S.V., Kapatkar V., Kadhe G., Rao S. A randomized, open labeled study comparing the serum levels of cobalamin after three doses of 500 mcg vs. a single dose methylcobalamin of 1500 mcg in patients with peripheral neuropathy. The IASP Subcommittee on Taxonomy Pain terms a list with definitions and notes on usage. Standard medical therapy (combination of oral methylcobalamin, tramadol and gabapentin) versus standard medical therapy plus extraoral glossopharyngeal nerve block. It can be caused by a variety of factors, including trauma, infection, and certain medications. Selection process of randomised controlled trials (RCTs) for inclusion in review. Using Jadad, 13 of the RCTs were evaluated to have a low risk of bias and 3 were at a high risk of bias. J. (9) Other good-quality studies have been published since 2006, warranting an updated review on this topic. FOIA Methylcobalamin is a Small study size. The primary study endpoint was the percentage of participants with a pain VAS reduction of 20 mm at 30 days of treatment. vitamin B and non-vitamin B supplementation) and placebo groups after four months, although no significant differences between the three groups were observed. [(accessed on 19 June 2020)]; Xu G., Lv Z.-W., Feng Y., Tang W.-Z., Xu G.X. Methylcobalamin: A Potential Vitamin of Pain Killer - Hindawi The two groups were split in precisely the same way and received the same interventions. According to the following website www.zobaline.netthe form of methylcobalamin is only important if B12 is given orally and that if B12 is given by injection then other forms of B12 will work too. Although pets that are Both arms had a statistically significant reduction in pain measured by VAS, but the improvement was greater in the arm inclusive of nucleosides. supplements. Case series with less than 10 participants. Development of red blood cells and nerve cells: It is an essential micronutrient that is responsible for the maintenance and development of nerve cells, red blood cells, and their coverings. eCollection 2023. compared twice-daily oral administrations of 75 mg pregabalin alone (n = 15) to an arm additionally treated with oral doses of 100 mg alpha lipoic acid (ALA) and 750 g methylcobalamin (n = 15) over a period of 12 weeks. VPT, MNSIQ, QoL, pain score, SNCV, SNAP, and ESCF significantly improved in the active group (p < 0.001, p = 0.002, p < 0.0001, p < 0.000, p < 0.0001, p < 0.0001, and p = 0.014, respectively), whereas CARTS and MNSIE improved but not significantly. There was a significant reduction in prevalence of pain in both groups. The study was conducted using human subjects. cells due to hyperglycemia. In Farvid et als study, neuropathy was measured using the Michigan Neuropathy Screening Instrument (MNSI), a brief 15-item questionnaire. In June 2005, Sun et al conducted a systematic review on the effectiveness of vitamin B12 on diabetic neuropathy. Finally, we searched only two databases for relevant articles and excluded all non-English studies. Unfortunately, there is no evidence that any of these agents modify the underlying pathophysiology of peripheral neuropathy. Dongre and Swami performed an open label study of pain response in patients with peripheral neuropathy who received oral sustained release pregabalin of doses of either 75 mg or 150 mg, which were given along with oral methylcobalamin 1500 g for a duration of two weeks (n = 384). Three treatment arms: (A) B1, B2, B6, B12; (B) Regimen A plus folate; (C) Placebo. Federal government websites often end in .gov or .mil. (18) This may be the mechanism through which methylcobalamin acts to modify and treat the underlying pathophysiology of peripheral neuropathy. No placebo group. In patients with DPN, vitamin B12 deficiency may be caused by the use of antidiabetic agents such as metformin. Deficiency of vitamin B12 (also known as cobalamin), which results in a lack of methylcobalamin, has been associated with significant neurological pathology, especially peripheral neuropathy. Changes in vibration perception thresholds, neuropathic symptoms and nerve conduction velocities, as well as the adverse effects of vitamin B12 therapy, were assessed. Hansen CS, Lundby-Christiansen L, Tarnow L, Gluud C, Hedetoft C, Thorsteinsson B, Hemmingsen B, Wiinberg N, Sneppen SB, Lund SS, Krarup T, Madsbad S, Almdal T, Carstensen B, Jrgensen ME; CIMT study group. performed a study in which they randomised patients with a diagnosis of CIPN and multiple myeloma to a treatment regimen of either acupuncture plus methylcobalamin (n= 49) or methylcobalamin alone (n = 49). Farvid et als study,(10) which used the MNSI score to assess neuropathic symptoms, showed an improvement in both the treatment (i.e. National Library of Medicine An official website of the United States government. Before Potential Benefits of Methylcobalamin: A Review - ResearchGate (14) All four studies used primarily vitamin B12 in its oral form. Schedule follow up vet checks to determine response to methylcobalamin supplementation. neuropathy if they aren'tformulated in the methyl form. compared oral treatment with methylcobalamin 500 g or epalrestat 50 mg thrice daily in a population of patients with diabetic neuropathy (n = 242) over a 12-week period. Treating Feline Diabetic Neuropathy with Methylcobalamin - Vetinfo.com (12) In Fonseca et als study, symptoms and disability were assessed using the 6-item Neuropathy Total Symptom Score (NTSS-6) and the Neuropathy Disability Score, respectively. Bethesda, MD 20894, Web Policies A Double-Blind, Randomized, Placebo-Controlled Study to Assess the Efficacy of a Nerve Support Formula on Neuropathic Pain in Individuals Suffering from Type II Diabetes Mellitus. Placebo versus oral capsule of thiamine, riboflavin, niacin, pantothenic acid, pyridoxine, folate (B9), cyanocobalamin, biotin, choline and inositol. Small study size. Sun Y, Lai MS, Lu CJ. (1,2) Some DPN patients may experience extremely painful symptoms, whereas those who have a more marked neuropathic deficit may not have any symptoms. The prevalence of foot ulceration and its correlates in type 2 diabetic patients: a population-based study. Cochrane Database Syst Rev. In two studies,(12,13) DPN was defined as the presence of at least one subjective symptom and two out of three objective criteria of neuropathy. The study also reported that epalrestat had less adverse events than methylcobalamin therapy, though side effects in neither group were serious and were most commonly headache or gastrointestinal upset [26]. Local administration of methylcobalamin and lidocaine for acute ophthalmic herpetic neuralgia: A single-center randomized controlled trial. These regimens may be also associated with potentially serious adverse effects, which may not be tolerated by the patients [10]. The authors of this study did not expand upon the form of B12 utilised. Methylcobalamin for Cats - Make It Work - Right Use - iKittyCat (11) Farvid et al supplemented this with capsule counts and individual sessions with skilled counsellors, who promoted compliance to the intervention at regular intervals. Xu et al. Effect of mannitol plus vitamins B in the management of patients with piriformis syndrome. Not all pain syndromes are of a single pathophysiological somatosensory origin; for example, cervical radiculopathy is a mixed pain syndrome, in which a nervous lesion causes a common neuropathic pain syndrome, but in which there are also potentially nociceptive pain elements related to noxious stimuli of skeletal and soft tissue [2,8]. Methylcobalamin is used in the treatment of diabetic neuropathy, degenerative disorders and in the preliminary treatment of amyotropic lateral sclerosis.