digest
Introduction: Common deficiencies in sciatica and carpal tunnel syndrome
Let's talk about the three common nutritional deficiencies in sciatica as well as carpal tunnel syndrome. Sciatica can really be a pain in the butt, literally. You have this pain that goes right down the back of the leg, and it can really affect someone if they're sitting or driving. Carpal tunnel syndrome can be a big issue too, and sometimes people go for surgery when in fact they probably didn't need to do that.
So today I'm going to discuss three common nutritional deficiencies, and they involve the B vitamins: B1, B6, and B12. We're going to discuss a little bit about how to differentiate whether your problem is more of a B6 deficiency, a B12 deficiency, or a B1 deficiency. These three vitamins are intimately involved in the nervous system, especially the sciatic nerve and carpal tunnel syndrome, which is pain or numbness in your wrist. I want to just dive right in.
Vitamin B6
Let's first start with vitamin B6, which is called pyridoxine. There are different forms of B6. Pyridoxine is the inactive form; it has to convert to another form to be active. The active form is called pyridoxal 5-phosphate, or P5P. This conversion happens in the liver. You have to realize how important B6 is in many problems, including those of the nervous system, because it is involved in over 160 different enzymes. Those are our enzyme pathways, so you can have all sorts of problems. Today we're going to focus more on the nerve problems that can occur.
B6 helps make the myelin sheath. That's one thing it does. The myelin sheath is the coating around the nerve, and when you lose that coating, the nerve stops working and you start having symptoms like burning, numbness, tingling, and pain, because that nerve keeps everything flowing through the nervous system. The protein that builds myelin, which is a type of fat insulation, is dependent on B6 as well. B6 also helps produce neurotransmitters, the nerve communications that travel through the nervous system, which is a little different than hormones, which travel through the blood. As far as B6 is concerned, the two big ones are serotonin and dopamine.
B6 is especially important in protecting nerve integrity, specifically the sensory nerves, more than the motor nerves. There are two types of nerves: one that controls muscle movement, and the sensory nerve that has everything to do with pain and different sensations. It can produce burning pain or numbness, which is a lack of pain. Anything you can feel is more of a sensory nerve issue, and two big examples are sciatica and carpal tunnel syndrome.
In practice, I had a machine that measured how fast the sensory nerves traveled through your arms. It's called nerve conduction velocity testing, and we would check these sensory nerves. Unfortunately, back then I had no clue about B6 and other vitamins and how greatly they can affect the nerves. B6 helps increase the conduction of the nerves, the velocity at which nerves transmit nerve signals. B6 is also involved in the metabolism of the nervous system. B6 can also affect the nerves of the eyes; if you're deficient, you can get myopathy, which is nearsightedness, or difficulty seeing far away. B6 deficiencies are also involved in seizures. So if you know anyone who has seizures, you should definitely recommend B6 and/or have them watch this video.
There is a paradox with B6 that I want to talk about; it's a mystery. In some cases, when people start taking large quantities of vitamin B6, they end up expressing symptoms of B6 deficiency. That's an odd thing, but I'm going to explain why it occurs. These two forms of the vitamin, the inactive and the active, can compete with each other. Say, for example, you start taking a lot of the precursor to B6, which is pyridoxine. You could end up blocking the active form, creating a B6 deficiency and sensory nerve problems.
Consider this: the RDA for B6 is very small, about 1.4 to 2.1 milligrams. If you buy vitamin B6 in tablet form, it comes in 50 milligrams, 100 milligrams, or sometimes 250 milligrams, which could be around 2,000 times more than the RDA. Most of the time people don't know the difference between these two types of B6, so they take a lot of the inactive form and end up with B6 toxicity. They actually start experiencing neurological problems and don't connect the dots. So, straight off the bat, if you have a B6 deficiency, I recommend taking the active form rather than the inactive form of B6.
The other thing you should know is that in about 36 percent of all supplements sold, you'll see B6 as the inactive version. You could be unknowingly getting a lot of this B6 and actually creating B6 deficiencies without realizing it.
So how does one become deficient in B6? By taking the wrong form of B6 in large amounts. You may have inflammation in your gut or some type of problem with celiac disease or Crohn's, which can be a problem. Maybe you've had your gallbladder removed. As we age, it becomes more difficult to absorb B6. Certain medications block vitamin B6, alcohol will do it, and birth control pills will cause a deficiency. Even your genetics play a role: there are genetic variations that can be picked up on a gene test that cause a weakness in your system in converting the inactive form to the active form, as well as in the absorption of B6. In that case, you would want to take larger amounts of the active form of B6 to correct the problem.
You may not be able to get enough B6 from your diet alone, depending on what you eat, because foods very high in B6 are usually animal protein foods such as fish and meats. If you are vegan or vegetarian, you are more susceptible to becoming B6 deficient, since the form of B6 in plants is not as bioavailable. If you're a smoker, or if you're diabetic, you could be deficient in B6. If you drink a lot of coffee, say over four cups a day, you can also be deficient in B6.
Vitamin B12
The next most important vitamin involved in nerve problems is B12. I've done many videos on this topic. It's very insidious because it can sneak up on you, and by the time you know you have a B12 deficiency, it could be too late, because it can create serious damage. When you think about B12, think about myelin: the myelin sheath is the coating I just mentioned that surrounds the nerve and allows nerve impulses to travel. Without B12, you can't make myelin. B12 is therefore central to nerve regeneration, myelin production, and nerve growth factors. B12 is very important, and I would not recommend the synthetic version called cyanocobalamin. I would recommend methylcobalamin, which is the natural form.
Virtually the same reasons you could be deficient in B6 could make you deficient in B12: drinking too much alcohol, being diabetic, having malabsorption, taking birth control pills, and especially genetics, which is very common. There are other things as well, such as not having enough stomach acid. How would you know if you don't have enough stomach acid? You get acid reflux or GERD, and you may have gastritis. But I think the two main reasons people are deficient in B12 are that they don't eat animal products, such as red meat or liver, and mainly eat plant-based foods or grains, or genetics. I've been diving into DNA recently, and B12 deficiency is a common problem for so many people, and it's such a simple problem to solve once you understand that methylcobalamin is the form you want to take. Another cause of B12 deficiency is taking a lot of folic acid, which can create a hidden B12 deficiency. I did a whole video on that.
Vitamin B1
Then we have B1. I've done videos on this too. A B1 deficiency usually shows up as peripheral neuropathy, and it's usually involved with diabetes, pre-diabetes, or someone with really bad insulin resistance, because B1 is all about helping you metabolize carbohydrates and sugar. The more carbs or sugar you eat, the more B1 you need to metabolize them. That person usually ends up with a B1 deficiency and starts having neurological problems in the bottom of the feet, but they can also have them in the hands. They can have these problems in other syndromes like sciatica too, so that's a differentiating factor: do you have a history of eating a lot of carbs, do you have pre-diabetes? If so, definitely include B1. Other things can create a B1 deficiency too, like too much coffee or too much tea.
B1 is involved in supplying blood flow to the nervous system. Without B1, you essentially starve the nervous system of the blood supply and oxygen it needs, and you can have all sorts of issues. The type of B1 I would recommend is benfotiamine, a fat-soluble version of B1 that penetrates the nerves about 25 percent more strongly and is great for helping with the myelin sheath. B1 is also a powerful antioxidant and can counter the complications of diabetes, not just in the nerves that go to your muscles but also in the nerves that go to your eyes, and in other tissues such as the heart and kidneys.
I wanted to raise your awareness of three really important vitamins involved in sciatic pain that can greatly help you if you start taking them. You can take all three or narrow it down to the one that seems most relevant to you. This information is something I don't cover in some other videos, so I wanted to include it. There are other causes of sciatic pain as well, one of which is losing the normal curve of the lower back. If you have not seen that video, there is a simple solution, and I've put it up right here. Check it out.