Wednesday, May 27, 2015

Wisdom Wednesday: Inositol

Inositol is a “vitamin like” substance that is found is nature and can be manufactured in laboratories. It was at one time considered a B vitamin. However, because the human body can make inositol from glucose, that vitamin status was revoked. Mice cannot make inositol and a deficiency in the diet causes mouse alopecia.

By comparison, vitamin D is also made in the human body just by exposure to sunlight. It is converted from cholesterol rather than glucose. It really is a hormone, not a vitamin. However, the nutrition board still considers vitamin D a vitamin. Even the world of vitamins is political.

Inositol is used to treat neuropathy, depression (especially bipolar disorder), polycystic ovarian syndrome (PCOS) and multiple sclerosis (MS). MS patients are unable to synthesize inositol and the addition of inositol to the diet dramatically reduces MS symptoms.

The dosage of inositol can be quite high. For PCOS, 1200mg per day is a typical dose while 18 grams per day is often used in treating MS.

Inositol opens the blood brain barrier, allowing more nutrients to enter the nervous system. This often facilitates repair of neuropathy. Cocaine dealers often cut their coke with inositol. It enhances the effects and speed of the drug on the brain, while dramatically improving profits. Be aware if you purchase a large container of inositol at the health food store, the clerk is going to assume you are a drug dealer.

Clinically, I use inositol for most forms of neuropathy, most commonly sciatic or femoral neuropathy. I actually prefer to use St. John’s Wort but so many patients coming to my office are on medications that interact poorly with St. John’s Wort. Too often, very effective herbs are contraindicated because of medications. Fortunately, inositol has none of those issues.

Recently, I have been amazed by the recovery of several elderly patients suffering from chronic neuropathy with short term use of inositol. Doses of 3 grams per day often will resolve all symptoms of neuropathy in a couple of weeks in patients in their late 70’s and 80’s. These patients are generally not in good health and I did not anticipate such a rapid response. Remember, inositol was my second choice because they all taking several medications that contraindicated the use of St. John’s Wort. Patients taking 6, 8, or even 10 or more medications typically do not respond well to any short term treatment.

The key to the proper use of inositol is determining the presence of neuropathy. If a patient has radiating pain down the leg, it may be referred pain with little or no inflammation of the nerve. In sciatica or femoral neuralgia, the nerve is inflamed but not necessarily damaged, especially in the acute stage. Inositol has no value in any of theses scenarios.

However, as these inflammatory nerve conditions become chronic, neuropathy (nerve damage) often occurs. This will delay and often prevent healing. Neuropathy is often characterized by numbness, tingling, muscle weakness and muscle atrophy. It results in loss of function. Pain alone is not an indicator of neuropathy no matter how severe.

The Bottom Line:
If you suffer from neuropathy (or think you do) please seek the advice of a qualified nutritionist and ask about inositol. It may no longer be considered a vitamin, but it can work wonders.

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