Vitamin B12 May Be More Effective Than Medications for Diabetic Nerve Pain

Published: October 22, 2012

A significant problem faced by diabetics is the development of nerve pain, called "diabetic neuropathy." Traditionally, tricyclic antidepressants such as Elavil or nortriptyline have been a first-line therapy for this pain. Other medications such as Neurontin and Cymbalta can also be helpful.

What has been ignored by most physicians is how powerful nutritional support can be for eliminating and healing this pain. Especially important are:

  1. Lipoic acid 300 mg twice a day,
  2. Acetyl-l-carnitine 500 mg three times a day
  3. Vitamins B6, B12, and inositol (all present in a good multivitamin powder at optimal levels are also important for addressing diabetic nerve pain)

Give these nutrients 3-6 months to fully kick in as they are helping the nerves to heal as opposed to simply masking the pain. To help the process occur more quickly, it is very reasonable to add vitamin B12 shots. I like 3,000 mcg per dose of Methyl Cobalmin from a compounding pharmacy given by intramuscular injection for 15 doses, at whatever speed is convenient to quickly optimize levels (e.g., daily to weekly). I then recommend the vitamin B12 shots be given monthly if needed to help maintain pain relief.

In the study below, vitamin B12 shots were over four times as effective in relieving pain as the medication nortriptyline.

By giving the nutritional support above in combination with medications for immediate pain relief, diabetic nerve pain can be effectively eliminated. For even more powerful pain relief, I recommend applying the "Nerve Pain Cream or Gel" from ITC Pharmacy. Topical pain creams and gels are discussed in more detail in my book Pain Free 1-2-3. Your physician can call a prescription for the cream in to the pharmacy at 888-349-5453, and the pharmacists will be happy to discuss this therapy with them. Apply 1-3 pea size amounts of the cream or gel to painful areas three times a day. Relief should be seen by two weeks. The pain cream contains a number of different effective medications, but because they are being applied directly to the pain, they result in powerful relief without the side effects seen with taking medications by mouth. Lidoderm patches are available from most pharmacies and are also very effective after two weeks of use.

Diabetic nerve pain can be very effectively addressed by both healing the nerve and masking the pain (as well as by controlling the diabetes). Unfortunately, most physicians are poorly trained in pain management. The good news is that with the information given here, you can get pain free now!

If your physician will not help you with this, see a holistic physician. There are over 1,200 board-certified holistic physicians listed at

Vitamin B(12) may be more effective than nortriptyline in improving painful diabetic neuropathy

Original Journal Article

Talaei A, Siavash M, Majidi H, Chehrei A
Int J Food Sci Nutr 2009 Feb 12.:1-6.

Introduction: Despite many therapeutic options, painful diabetic neuropathy is still a common and challenging complication of diabetes mellitus and is often resistant to therapy with current modalities.

Methods: In this randomized, single-blind clinical trial we compared the efficacy of parenteral vitamin B(12) and nortriptyline, for symptomatic improvement of pain, paresthesia, burning, freezing, stabbing and electrical sensation.. Changes in nerve conduction parameters of amplitude, duration and latency were also compared.

Results: One hundred patients (50 in each group) completed the study. After treatment, the pain score based on a visual analogue scale decreased 3.66 units in the vitamin B(12) group and 0.84 units in the nortriptyline group (P < 0.001). Similarly, the paresthesia score decreased 2.98 units versus 1.06 units (P < 0.001). The decrements of tingling sensation were 3.48 units versus 1.02 units (P < 0.001). Changes in vibration, position, pinprick and nerve conduction parameters were not significant in two groups.

Conclusion: In conclusion, vitamin B(12) is more effective than nortriptyline for the treatment of symptomatic painful diabetic neuropathy.

Jacob Teitelbaum, MD

is one of the world's leading integrative medical authorities on fibromyalgia and chronic fatigue. He is the lead author of eight research studies on their effective treatments, and has published numerous health & wellness books, including the bestseller on fibromyalgia From Fatigued to Fantastic! and The Fatigue and Fibromyalgia Solution. His newest book (June 10, 2024) is You Can Heal From Long COVID. Dr. Teitelbaum is one of the most frequently quoted fibromyalgia experts in the world and appears often as a guest on news and talk shows nationwide including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and Fox News Health.

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