Peripheral neuropathy (PN) is a type of  nerve damage that characteristically causes pins and needles, numbness coupled with a distressing sensation of burning known as hyperaesthesia a “stocking and glove” distribution. In more severe cases muscle weakness, impaired balance and coordination causing difficulty with movement and falls.

About 4% of the population of the UK are known to be affected by PN at any one time. That’s over 2 million people living in the UK with the distress of PN without any effective treatments being available for the majority. For many people, no underlying cause is found (idiopathic) but contributory factors include:

  • Diabetes
  • Alcohol abuse
  • Vitamin B deficiency and mineral deficiencies
  • Chemotherapy such as cisplatin, taxanes and vincristine
  • Long covid

The underlying mechanisms of nerve damage is multifactorial but recently, scientific attention has focused on the contribution of oxidative stress and neuroinflammation. Both of these factors have been shown to accelerate spinal glial (nerve) cell degeneration and block repair of damaged nerves.

The first stage in the management of PN is to identify any underlying causes and, if possible treat them. In the case of chemotherapy, reducing the dose or even stopping chemotherapy may be the only option. For the majority, however, medical management just involves alleviating symptoms with pain killers, especially those which target neuropathic pain such as gabapentin or amitriptyline.

Self-help strategies for PN include topical therapies such as chilli (capsaicin) based creams and acupuncture may provide relief from localized neuropathic pain. Gadgets such as transcutaneous Electrical Nerve Stimulation (TENS), massage and vibrating tools have also helped some individuals. Aerobic exercise proved beneficial in some trials, especially if combined muscle strength, flexibility and balance. Exercise can help reduce oxidative stress and inflammation which may be reason why it helps PN.  As well as exercise, quitting smoking, ensuring adequate vitamin D, other vitamins and minerals would be logical

Boosting foods rich in phytochemicals, found in colourful fruit, vegetables and spices, have 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 with PN but until now robust clinical studies have not been forthcoming.  Recently, however, some intriguing information has been gained from a scientific study involving people suffering from long covid:

The Long covid study and peripheral Neuropathy

This study, completed last year, involved 147 people with multitude of distressing symptoms including 6% with peripheral neuropathy, pins and needles or hyperaesthesia. 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 capsule 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. In the final publication in the journal COVID, although these symptoms were noted, the emphasis was on the substantial improvements in fatigue, sleep, muscle aches, gut symptoms and overall wellbeing.

Since the trial completed, the trials unit started receiving emails from people across the world who had bought the supplements independently, letting them know that their long standing neuropathy had improved.  For example,  Rachael who took the time to email the trials unit,  said:

“I took Phyto-V to help my recovery from a covid infection after seeing the media reports of the study. I was nicely surprised that after 4 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 – I won’t stop now”

Following these comments and the results seen in the trial the trials team decided to look into the causes and treatments for PN in more detail. 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 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 6 month intervention, the blinding-codes will be cracked open and we will find, for sure, whether our suspicious are confirmed. We 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.