HIV Digest	HIV Digest Archive

We have heard good reports about a simple prevention or treatment regimen-- calcium, magnesium, and vitamin B6-- to help protect the nerves and prevent or treat peripheral neuropathy (usually felt as pain or numbness in the hands or feet) which can be caused by some drugs used in AIDS treatment, for example d4T or ddI. This nutritional treatment has not been proven to work, but we have heard from physicians and patients who believe it probably does; and there seems to be little "down side" in trying it. Different doctors are using different doses, however.

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Jon Kaiser, M.D., in his new book Healing HIV suggests calcium 500 mg, magnesium 250 mg, and vitamin B6 100 mg, with these doses taken twice a day; he recommends this regimen whenever he prescribes d4T. If the neuropathy is already present, he increases the dose of vitamin B6 to 200 mg twice a day. He uses other treatments as well for relief of neuropathy, including acupuncture.

Dr. Kaiser noted that while improvement can occur quickly, in some cases it may take several months before there is a noticeable change.

Recently we spoke with Virginia Cafaro, M.D., who also has a large AIDS practice in San Francisco. She recommends more calcium and magnesium, but less vitamin B6-- 1000 mg calcium and 500 mg magnesium twice a day (once a day may work), but only 100 mg of vitamin B6 once per day, even if the neuropathy has already occurred. She has not seen improvement from increasing the B6. Also, she highly recommends acupuncture.

Both doctors also use certain prescription medicines which may relieve the discomfort of peripheral neuropathy in some patients.

It may also be necessary to discontinue or reduce the dose of the drug or drugs believed to be causing the problem. If the neuropathy is allowed to become severe, it can cause lasting nerve damage.

Patients should also be aware that large overdoses of vitamin B6 (usually greater than 1,000 mg per day) can actually cause neuropathy in some cases.

Note: Check with a healthcare professional before starting a new treatment-- even one that can be purchased without a prescription. There may be more recent information, or medical conditions or drug interactions to consider, or reasons to balance nutritional therapies with other supplements.

Editor's Note: from AIDS Treatment News