Tag Archives: vitamin E

Eye health essentials; what you need to know about vitamins, minerals and antioxidants

Can what we eat really influence our eyes?

When was the last time you thought about your eyes? You have to admit it; you wake up and they just start working. There is no warming up period, no lag time between opening your eye-lids and receiving images and, unlike your telephone or internet connection, there are no problems with intermittent connections. You eyes just work, day in and day out. In fact you eyes can process around 36,000 bits of information per hour and contribute towards 85% of your total knowledge. Being composed of over two million working parts you eyes use around 65% of all the pathways within the brain. Eyed are truly miraculous structures yet we just expect them to work and never question their existence until something goes wrong. It is with this in mind may be its about time to consider the special nutritional requirements the eyes have. After all, we have discussed heart health in the past and the importance of nutrition and the brain. The eyes have their own specific needs and being aware of this could help offset some of the slow to develop degenerative conditions that afflict a growing number of people. Feeding your eyes may be one of the best dietary and lifestyle changes you could make to help protect such a vital pair of structures.

Eye essentials

It is a sad reality that in some of the poorest countries in the world a simple supplement of vitamin A could prevent the estimated 250 million cases of deficiency that I turn leads on to night blindness and more seriously a drying of the eyes called xerophthalmia. This type of dry eye is not just an irritating symptom it’s a sight threatening condition. In Africa, if you can’t see you will probably not survive very long! Vitamin A is one of those vitamins that acts as a bit of a double edges sword. Too much can cause toxic reactions that may, rather ironically, include dry eyes, along with other serious issues including headache, drowsiness, abdominal pains and vomiting to name a few. Luckily, this is a rare situation since supplements containing vitamin A tend to deliver it in the form of the non-toxic, water soluble form known as beta carotene. True vitamin A (retinol) is a fat soluble vitamin that over time can accumulate in the body to the point where toxicity symptoms may ensue. Beta carotene, on the other hand, is only converted into retinol within the body if the body is deficient in retinol. Unless there is an overt deficiency of vitamin A in its retinol form the water soluble version is always preferable for this reason if you are taking supplements. Simply check the label where you will probably see the vitamin A ingredient described as being in the beta carotene form. Excessive intake of beta carotene can occur especially if supplements containing it are taken at the same time as a regular serving of carrot juice because carrots are also high in beta carotene. Over time the skin can turn a yellow-orange colour, most noticeable on the palms of the hands and soles of the feet. This situation is known as carotenemia and is not in itself hazardous but is a strong indication that you need to cut back on the carrots and beta carotene supplements! In general, it is recommended that people do not take vitamin A (retinol) for extended periods and that pregnant and lactating women avoid it altogether (it can sneak into the diet via fish liver oils and organ meat such as liver) because of the increased risk of damage to the foetus and breast fed newborn. Keeping you intake of water-soluble vitamin A foods up though. These include the bright coloured fruits such as papayas and oranges and the coloured vegetables like sweet peppers, squash and pumpkin. These foods not only deliver water soluble vitamin A but a complex array of other compounds that are being shown to be of great importance in the fight against nutritional related eye problems and offsetting degenerative eye disease. What needs to be remembered here is the fact that the need for vitamin A in African children is quite different from the requirements of vitamin A in the UK population so boosting the vitamin A (retinol form) intake is probably unnecessary and could be hazardous. On the other hand, maintaining vitamin A levels can be achieved by using beta carotene containing supplements if the diet is very low in the foods mentioned above. However, keep the intake to sensible levels to avoid carotenemia!

The antioxidant connection

There does not appear to be a week that passes without some news on the benefits of antioxidants, but what are they and why are they important in maintaining eye health? Antioxidants are naturally occurring compounds that help slow or prevent oxidative changes in the body and oxidative changes are associated with accelerated degenerative disease. We all live in an oxygen rich environment but this comes at a price. As we breathe our cells utilise the oxygen and produce by-products known as free radicals. These are a group of compounds that if left unchecked or are generated at an accelerated rate cause the oxidative damage we all read about. Antioxidants are the key to keeping this process in check since they neutralize and make safe the free radicals. So, the less free radicals there are buzzing around the less damaging oxidative changes occur and, in turn, the rate of tissue damage and degeneration takes place. Hence, diets high in antioxidants have been advocated for a range of degenerative problems ranging from heart disease and diabetes through to arthritis, cancer and eye problems such as macular degeneration. No one would be as bold as to suggest that such diets can reverse these situations but a change in diet and lifestyle can definitely benefit these problems and could slow their progression.

The key antioxidant nutrients are vitamin A (in the carotenoid form), vitamin E and C along with the mineral selenium.  All these important nutrients can be found in a balanced diet but you can top up a diet with a well formulated food supplement. This may be important in those with food intolerances or for those with specific eye related problems where a guaranteed daily intake of antioxidant nutrients would be desirable.

Key antioxidant foods

Vitamin A

Carrots, squashes, broccoli, sweet potatoes, tomatoes, kale, peaches, apricots and all bright coloured fruits and vegetables

Vitamin C

Citrus fruits such as oranges, limes, coloured berries such as blue berries, strawberries, sweet peppers, green leafy vegetables, broccoli

Vitamin E

Nuts, seeds, whole grains, green leafy vegetables, vegetable oils

Selenium

Fish, shellfish, grains, eggs, chicken and garlic

The carotenoid connection

Within the group of antioxidant compounds the carotenoids appear to have specific influence on the health of the eye. One of these, known as lutein, has come to the attention of scientists and had been the centre of intense investigation when it as noted that in may help off set the effects of macular degeneration. Lutein is found in egg yolks and in the dark green leafy vegetables. It appears to act, like all antioxidants, as a free radical neutraliser but because it accumulates in the tissues that are exposed to the outside environment (the eyes and skin) it exerts this effect to great effect in these tissues over other antioxidants that are distributed to all body tissues. In regards to eye health lutein filters out the high energy blue wavelengths common to sunlight and artificial light. By doing this it is thought that lutein could reduce the damaging effects of these wavelengths on light exposed tissues such as the eye and skin. Getting enough lutein (research suggests around 6-10 mg per day) may be difficult from diet alone since you would need to eat a large bowl of fresh spinach every day to get around 6mg. This could be a case where a food supplement is a good idea. Another up and coming eye specific antioxidan is known as zeaxanthin. Again, it belongs to the carotenoid group of compounds.

Foods high in key carotenoids

High lutein foods

Yellow peppers, spinach, mango, bilberries, green leafy vegetables, broccoli, eggs

High zeaxanthin foods

Orange peppers, corn, lettuce (not iceberg), tangerines, spinach, broccoli, oranges and eggs

Pulling it all together

It is clear that good food promotes all aspects of health but certain foods do appear to be associated with specific eye related nutritional needs. A large trail (the Age Related Eye Disease Study trial, see for details) has confirmed the importance of the antioxidants vitamin A, C, E and the minerals selenium, zinc and copper in slowing the progression of age related macular degeneration so we know that boosting those foods high in these nutrients or taking a well formulated supplement is going to be a good idea. A number of smaller studies have also focused on nutrition with special reference to lutein and zeaxanthin. Both of these compounds have been associated with improved eye health.

When looking to the UK population, the Royal National Institute for the Blind comments that research has shown that many people do not get enough vitamins and minerals from their diet and suggest the use of food supplements. These must not be taken, however, as a substitute for a balanced diet!

When to consider a eye specific supplement

  • When intake of fresh fruit and vegetables are low
  • When the absorption of vitamins and minerals poor
  • When its hard to obtain and prepare fresh produce
  • When food intolerances prohibit eating key foods

Product link

Vision Essentials: balanced all-in-one eye specific nutrition

Useful Contacts

Royal National Institute for the Blind

Macular Disease Society

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Antioxidant supplements & artery health – the latest!

Just published… a key study looking at the effect of antioxidant supplementation with vitamin C, vitamin E, coenzyme Q10 and selenium on arterial health and  inflammation. As the research gathers pace, heart disease and the clogging of the arteries known as atherosclerosis is being view more as an inflammatory disease rather than a passive accumulation of fatty material within the walls of blood vessels.

This latest paper helps support the long held theory that antioxidants can help off set this process and protect the health of the cardiovascular system.

In this study, 70 people with two diagnosed cardiovascular risk factors (see the study for details) were recruited from a hypertension clinic. 35 people were given a 6 month course of capsules containing vitamin C (500 mg) vitamin E (200 iu), co- enzyme Q10 (60 mg) and selenium (100 mcg) while the other 35 were given a placebo. The summary conclusion is displayed below and the results and technicalities can be viewed by following the link at the end of this post.

Conclusions: Antioxidant supplementation significantly increased large and small artery elasticity in patients with multiple cardiovascular risk factors. This beneficial vascular effect was associated with an improvement in glucose and lipid metabolism as well as decrease in blood pressure.

The original paper is free to download from the open access journal by clicking here.

Shargorodsky M, Debbi O, Matas, Z, Zimlichman R. Effect of long term treatment with antioxidants (vitamin C, vitamin E, coenzyme Q10 and selenium) on arterial compliance, humoral factors and inflammatory markers in patients with multiple cardiovascular risk factors. Nutrition & Metabolism 2010, 7:55 doi: 10.1186/1743-7075-7-55

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Ask The Pharmacist; August posting

This is our August blog post. The first in our new monthly postings entitled “Ask The Pharmacist“. We invite you to voice common questions that our colleague, Holistic Clinical Pharmacist Dr. Cathy Rosenbaum, can respond to.

Please feel free to contribute and post a comment below or visit Dr Cathy’s blog by clicking here.

This months question:

  • Dietary Supplement Mania.  Should we worry about mega-dosing fat soluble vitamins or water soluble vitamins or all of them?  Why?
Dr Cathy’s reply:

Fat soluble antioxidant vitamins can accumulate in the body over time and cause unwanted side effects. For example, vitamin E in doses higher than 200 IU daily for more than two years can increase risk of stroke and other cardiovascular disease. Vitamin A intake higher than 1250 IU daily (supplement or juicing) increases risk of hip fracture in both men and women. Water soluble vitamins have their issues in high doses, too. Vitamin C may actually be pro-oxidative in doses higher than 500 mg – 1,000 mg daily. It can cause kidney stones, increased risk of bruising and bleeding as well. The body does not absorb more than 250 mg daily.

All three of these supplements are excellent antioxidants but it’s still better to eat colourful fruits and vegetables from the Mediterranean Diet than to supplement since there are literally thousands of antioxidants in nature from which to choose. The body craves variety.

Be sure you talk with your doctor or pharmacist about the best vitamin supplements for your individual health needs and goals.

Be healthy!

Dr. Cathy

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Limited offer on Smart Q10

If you are a co-enzyme Q10 user – read on… We have a special but limited supply of Smart Q10 that is being offered on a but-1-get-1-FREE deal. This is a genuinely unique product and to our knowledge, the only Q10 product that can boast that 21 studies in support of its use.See April 28th blog entry for a list of these studies.

Q10, also referred to as coenzyme Q 10 or ubiquinone, is a natural fat-soluble nutrient present in virtually all living cells in the body. CoQ10 has a crucial role as a cofactor in the mitochondrial synthesis of cellular energy. Although it is produced by the body and exists in some dietary sources, these levels may be insufficient to meet the body’s requirement.

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The smart choice is Smart-Q10!

What is it and how does it work?
CoQ10, also referred to as coenzyme Q 10 or ubiquinone, is a natural fat-soluble nutrient present in virtually all living cells in the body. CoQ10 has a crucial role as a cofactor in the mitochondrial synthesis of cellular energy. Although it is produced by the body and exists in some dietary sources, these levels may be insufficient to meet the body’s requirement. A deficiency can result from impaired synthesis due to nutritional deficiencies, increasing age, or increased tissue demands. Numerous diseases may exhibit CoQ10 depletion. CoQ10 also functions as a potent antioxidant.
However, all CoQ10 products are not equal. They vary greatly in quality and absorbability. Serum level determination of CoQ10 in the bloodstream is not necessarily the most important measure of efficacy. In order for it to be fully effective, it must cross the cellular barrier and raise the intracellular levels. The only reliable indicator of CoQ10 supplementation is its presence in cell mitochondria. In central nervous system applications, CoQ10 must pass the blood brain barrier, resulting in increased brain intracellular levels to exert its effects.
Smart Q10™ CoQ10 is currently the only coenzyme Q10 supplement supported by studies that show increased serum levels, increased intracellular levels, and demonstrated ability to cross the blood brain barrier.
Smart Q10 CoQ10 wafers contain coenzyme Q10 emulsified in vitamin E and mixed tocopherols and is formulated with Micosolle®, a proprietary excipient.1 Clinical studies have demonstrated that this process enhances the absorption of CoQ10.
Two different methods can be used for the production of coenzyme Q10. One method is natural and the other is synthetic. The natural process utilizes living organisms and is referred to as a “biological fermentation/extraction process.” Coenzyme Q10 can also be synthesized by a chemical process, which produces a similar, but distinctly different product that contains chemical compounds not found in the natural form. smart Q10 CoQ10 contains the natural form of coenzyme Q10.

The Mitochondria
Mitochondria are highly specialized structures (organelles) within each nucleated cell. The number of mitochondria in a cell depends on the cell’s function. Cells with particularly heavy energy demands, such as heart muscle cells, have more mitochondria than other cells. The mitochondria’s primary responsibility is to capture most of the energy in nutrients and convert it into cellular energy. This energy conversion and storage is a complex, multi-step process that follows a specific pathway.
The converted cellular energy is stored in the energy-yielding molecule adenosine triphosphate (ATP) used to fuel the cell’s activities. (This is similar to the energy stored in gasoline that is used to fuel automobiles). Because this process requires oxygen, it is often referred to as cellular respiration. Obtaining as many electrons out of the nutrients as possible is the goal of cellular respiration. That is why part of the pathway is referred to as the electron pathway chain. CoQ10 functions as a vital link in the process of converting nutrients into ATP. Cellular respiration and the electron transport chain are completely dependent on CoQ10.
Mitochondrial Compartments
Mitochondria are encased in double membranes. The smooth outer membrane encloses the periphery of the mitochondria and the inner membrane is enfolded to form the cristae. CoQ10 is found in the cristae folds. Cristae folds provide a large surface area for cellular respiration.
Mitochondria are unusual organelles in that they contain their own deoxyribonucleic acid (DNA) and ribonucleic acid (RNA).9,10 Insufficient CoQ10 levels may have an effect on cellular respiration and mitochondrial DNA.
Smart Q10™ CoQ10 and Support of Cardiac Health
Cardiac cells require large amounts of uninterrupted energy. They have a greater number of mitochondria and subsequently more CoQ10 than any other type of cell. Because of this association, CoQ10’s support of cardiac health is well researched and documented. CoQ10 supports healthy heart contractility and subsequent circulation, blood pressure, and exercise endurance. Due to Smart Q10 CoQ10’s ability to pass through the cell membrane and enter the mitochondria, enhanced levels can be attained.
Smart Q10™ CoQ10 and Support of the Neurological System
The Blood-Brain Barrier
The blood-barrier is a unique anatomical structure. Simply stated, the cells that make up the blood vessels that provide blood to the brain are extremely close together. This greatly restricts what can and cannot leave the bloodstream and enter the brain. While the blood-brain barrier protects the brain from potentially toxic substances, it can be a significant obstacle to therapy of central nervous system disorders. In order to leave the bloodstream and reach the brain cells, a substance must be able to pass through the tightly connected cells of the capillary walls. Only substances with certain solubilities or those that have a transport system can cross the blood-brain barrier to a significant degree.
Recently, CoQ10 has been studied for its effect in support of neurological health. When CoQ10 crosses the blood-brain barrier, mitochondrial concentrations are increased and clinical results indicate that significant neurosupportive effects follow. Clinical studies have examined the role of CoQ10 in the neurological system.
Smart Q10™ CoQ10 and Support of Immune Health
CoQ10 is necessary for immune health.† Increased free radical activity causes damage to cell membranes, mitochondria, and DNA. Supplementation with CoQ10 provides enhanced antioxidant activity that is supportive of the immune system.
Natural Vitamin E
The common name “vitamin E” is an umbrella term for a family of compounds known as the tocopherols. There are at least 8 forms of tocopherols including, alpha-tocopherol, beta-tocopherol, delta-tocopherol, and gamma-tocopherol. These tocopherols are all naturally created by plants, and when used in vitamin E supplements, are considered natural vitamin E.
Recently, the concomitant administration of vitamin E and CoQ10 has been studied. Research has demonstrated that CoQ10 can improve vitamin E’s antioxidant function and protect it from depletion.
Smart Q10™  and Clinical Trials
The formulation of Smart Q10™ CoQ10 is unique among CoQ10 supplements. Currently, three large multi-center studies investigating Smart Q10™ CoQ10 are ongoing. All of these clinical trials are investigating Smart Q10™ CoQ10 health supportive effects on the nervous system. To date, 21 published studies have used Smart Q10™ CoQ10 in their research.
The 21 Studies and Presentations at Medical Symposiums Utilizing Vitaline® Coenzyme Q10 Dietary Supplement Products:
  1. Matthews RT, Yang L, Browne S, Baik MF. Coenzyme Q10 administration increases brain mitochondrial concentrations and exerts neuroprotective effects. Proc Natl Acad Sci USA. 1998; 95:8892-8897.
  2. Langsjoen P. Overview of the use of CoQ10 in cardiovascular disease. Presented at The First Conference of the International Coenzyme Q10 Association. Boston, Mass, May 21-24, 1998.
  3. Koroshetz W. Huntington’s Disease Clinical Trail. Presented at the First Conference of the International Coenzyme Q10 Association. Boston. Mass, May 21-24, 1998.
  4. Shults CW, Haas RH, Flint Beal M. A possible role of coenzyme Q10 in the etiology and treatment of Parkinson’s disease. Proceedings of First Conference of the International Coenzyme Q10 Association, 95:8892-8897, July 21, 1998.
  5. Beal MF. Coenzyme Q10 as a potential treatment for neurodegenerative diseases. Presented at the First Conference of the International Coenzyme Q10 Association. Boston. Mass, May 21-24, 1998.
  6. Beal MF. Energy impairment and Huntington’s disease. Presented at the Mitochondrial Medicine Conference. University of California, San Diego School of Medicine, Mitochondrial and Metabolic Disease Center, San Diego, Calif, Feb 19-21, 1998.
  7. Kieburtz K, Rickey T. Co-enzyme Q10 and remacemide: evaluation in Huntington¡¦s disease (CARE-HD). A controlled investigation by the Huntington Study Group. Clinical trial in progress. Institutions participating in the CARE-HD Study: Allegheny University, Baylor College of Medicine, Boston University, Bowman Gray School of Medicine, Colorado Neurological Institute, Columbia-Presbyterian, Emory University, Indiana School of Medicine, Johns Hopkins University, Massachusetts General Hospital, Rush-Presbyterian-St.Luke’s Medical Center, Tampa General Hospital, and the universities of Alberta, British Columbia, Calgary, Iowa, Kansas Medical Center, Miami School of Medicine, Michigan, Rochester, Toronto, and Virginia. June 1997-2002.
  8. Langsjoen PH, Langsjoen A, Willis R, Folkers K. Treatment of hypertrophic cardiomyopathy with coenzyme Q10. Mol Aspects Med. 1997;18:S145-S151.
  9. Shults CW, Flint Beal MD, Fontaine D, Nakeno K, Haas RH. Absorption, tolerability, and effects on mitochondrial activity of oral coenzyme Q10 in parkinsonian patients. Neurology. 1998;50:793-795.
  10. Flint Beal M, Matthews RT, Tielman A, Shults CW. Coenzyme Q10 attenuates the 1-methyl-4-phenyl-1,2,3,6-tetradopyridine (MPTP) induced loss of striatal dopamine and dopaminergic axons in aged mice. Brain Res. 1998;783:109-114.
  11. Flint Beal M, Matthews RT. Coenzyme Q10 in the central nervous system and its potential usefulness in the treatment of neurodegenerative disease. Mol Aspects Med. 1997;18:S169-S179.
  12. Schwid SR, Mattson DH, Goodman AD. A phase II trial of coenzyme Q10 in MS. Clinical trial in progress. University of Rochester, Department of Neurology, Neuroimmunology Unit, Rochester, New York. 1996-2000.
  13. Koroshetz W. Huntington’s Disease Clinical Trail. Presented at the First Conference of the International Coenzyme Q10 Association. Boston, Mass, May 21-24, 1998.
  14. Shults CW, Haas RH, Passov D, Flint Beal M Coenzyme Q10 levels correlate with the activities of complexes I and II/III in mitochondria from parkinsonian and nonparkinsonian subjects. Ann Neurol. 1997;42:261-264.
  15. Feigin A, Kieburtz K, Como C, et al. Assessment of coenzyme Q10 tolerability in Huntington’s disease. Mov Disord. 1996;11:321-323.
  16. Cros D. Amyotrophic Lateral Sclerosis (ALS). Harvard Medical School- Massachusetts General Hospital Department of Neurology EMG Unit-Bigelow 12, Boston, Mass, 1995-1998.
  17. Tardive Dyskinesia Study Using Coenzyme Q10 and Nicotinamide. Harvard Medical School-Massachusetts General Hospital Department of Psychiatry and Neurology, Freedom Trial Clinic, Erich Lindemann Mental Health Center, Boston, Mass, 1995.
  18. Costeff H. CoQ10 and 3-Methylglutaconic Aciduria. Neuropediatric Unit. Loewenstein Hospital Rehabilitation Center, Tel Aviv. Medical School, Raanana, Israel, 1998.
  19. Flint Beal. Neuroprotective strategies for treatment of lesions produced by mitochondrial toxins: implications for neurodegenerative diseases. Neuroscience. 1996;71:1043-1048.
  20. Flint Beal M, Henshaw R, Jenkins BG, Rosen BR, Schulz JB. Coenzyme Q10 and nicotinamide block striatal lesions produced by the mitochondrial toxin malonate. Ann Neurol 1994;36:882-888.
  21. Schulz JB, Henshaw RD, Matthews RT, Flint Beal M. Coenzyme Q10 and nicotinamide and a free radical spin trap protect against MPTP neurotoxicity. Exp Neurol. 1995;132:279-283.

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Burning Feet Syndrome

Burning Feet

During my last BBC Cornwall phone-in on Sunday 20th July a lady called complaining of burning feet. This is not an uncommon problem and plagues many people, especially those 50 and over. Sadly, its not a condition that is managed very well.
It is important to remember that burning feet may be the only symptom of a more complex underlying cause and should not be ignored. Among the many causes undiagnosed or poorly controlled diabetes is one of the commonest causes. In this case the pain is due to a nerve condition known as a peripheral neuropathy. I would urge all burning feet sufferers to get a simple blood glucose check – may pharmacies can perform this while you wait.
Below are a few more causes of burning feet;
• Fungal foot infections
• Poorly fitting shoes
• Vitamin B12 deficiency (pernicious anaemia)
• Circulatory problems
• Chronic smoking or alcohol use
• Organ disease; kidney or liver
• Glandular problems; thyroid
For most the most common symptom is a burning or stinging pain in the feet that is sometimes accompanied by redness and occasionally swelling.
Studies into burning feet have revealed some interesting findings. In cases of diabetic nerve damage the pain appears to come not only from the nerve problem itself but also from the reduced circulation that accompanies it.

This image to the left (image credit: NASA) clearly shows the cold foot (dark colours) detected by thermography. As you are looking at the picture, its the foot on the left (the patients right foot) that is dark, almost black in colour. This indicates a region of low temperature. Compare this to the other foot and you will see the difference. The reduced circulation appears to be closely associated with the nerve damage. Because nerve pain (neuropathic pain) is such a problem research has been focused on this subject for many years. Not only is neuropathic pain is one of the most difficult types of chronic pain to treat and relief is often unsatisfactory or short-term. Since medical treatment options are limited, doctors often prescribe a combination of therapies in an attempt to relieve symptoms. It can be associated with many conditions including Multiple Sclerosis (MS), stroke, cancer, spinal cord injury, physical trauma, post-herpetic neuralgia (shingles), and peripheral neuropathy resulting from diabetes. To read about some interesting clinical trials being performed click here.
Treatment options
Because the nerve pain is perceived in the brain but the circulatory aspect is affecting the foot itself we need to focus attention both centrally and locally. The diagram to the right shows how it all connects.

The foot nerves are connected via the spinal cord to the brain where the messages are converted into the feeling of pain. Our brain then “maps” this feeling of pain to the region where the signals are coming from – the foot. Hence we feel pain in the foot but perceive it in the brain!
I have found that a cream called Alikeine Red offers great relief from the local circulatory aspect of the burning foot syndrome. Not only does it keep the skin healthy and supple but it can help balance the circulation.
From the vitamin point of view I tend to recommend a months course of vitamin B12 in the biologically active form known as methylcobalamin and taken as a suckable tablet rather than a simple tablet or capsule that is swallowed. The suckable form allows the B12 to be absorbed through the mouth membranes. This is a good way to get it into your system especially it absorption from the stomach is in question.
For those who are not on blood thinning drugs an additional boost to the peripheral circulation can be obtained using the combination of Ginkgo (80mg twice a day withn food) and vitamin E 400iu (1 capsule per day with food) I have also had some success using electroacupuncture. This is defiantly worth a try and may help “re-set” the level of central (brain) sensitivity which in turn can ease some of the nerve pain symptoms.

Further reading
The Neuropathy Trust, a worldwide Charity (1071228) that was founded in 1998 by Andrew Keen to provide a lifeline to people affected by Peripheral Neuropathy (PN) and Neuropathic Pain (NeP).
Vitamin B12 deficiency
Journal abstract regarding Vitamin E being effective in chemotherapy induced neuropathy

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