.
Peripheral Neuropathy and Long Covid
.
In the long covid study, completed last year, 147 participants with an array of symptoms particularly fatigue, sleep, muscle aches, gut symptoms. 6% of participants also had pins and needles or hyperaesthesia. 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 supplement called Yourgutplus. The second, called Phyto-V, boosted the intake of phytochemicals known for their anti-viral, anti-inflammatory and anti-oxidative properties. In the final publication, although these symptoms were noted, the emphasis was on the substantial improvements in and overall wellbeing.
Since the trial completed, however, the trials unit started receiving emails from people across the world who had bought the supplements independently, letting us know that their long standing neuropathy had improved.
Rachael took the time to email us, this is what she said: “I took Phyto-V to help my recovery from a covid infection. 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”
About 4% of the population 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. In oncology, the majority of cases are caused by chemotherapy but in the general population PN can develop without any apparent cause (idiopathic) or be associated with other chronic conditions.
The first priority for managing PN is to identify and treat any underlying contributory factors including improving diabetic control, reducing alcohol intake, quitting smoking, correcting vitamin B and mineral deficiencies or in the case of cancer patients reducing the chemotherapy dose.
For the rest medical management just involves alleviating symptoms with pain killers, such as gabapentin or amitriptyline. Topical therapies such as chilli (capsaicin) based creams and acupuncture may provide relief from localized neuropathic pain. Aerobic exercise proved beneficial in some trials, especially if combined muscle strength, flexibility and balance. Gadgets such as transcutaneous Electrical Nerve Stimulation (TENS), massage and vibrating tools have also helped some individuals.
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. Exercise can help reduce oxidative stress and inflammation which may be reason why it helps PN. Boosting foods rich in phytochemicals, found in colourful fruit, vegetables and spices, have also 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 but until now robust clinical studies have not been forthcoming
The advantage of research is that all outcomes and symptoms have to be recorded even if unexpected. The improvement in PN seen in the covid trial coupled with the anecdotal emails from around the country has given us the justification to investigate this further. 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.