I really don't take supplements often, I had generally been pretty healthy before, but now I am getting older and having more issues with my health. As for tapering of duloxetine, it has left me with a rather undesirable symptom...neuropathy. So, in an effort to ease some of the symptoms associated with neuropathy, I did some research, found a few recommended vitamins, minerals, supplements, etc, so I thought I would share some of what I have found.
Omega 3 Supplements
I have taken these before, and researched the optimal doses and formulations for Omega 3s as they related to being used to augment treatment for depression or ADHD. This supplement also seems to help with brain zaps from what I have read on other forums. The ratio of EPA/DHA has been examined and found to be pretty important in the overall efficacy of the supplement. These are the two Omega 3 supplements I have selected for 1) most cost effective, 2) most potency in smallest possible dosage, 3) optimal EPA/DHA ratio and 4) least fishy smell and burpless. I prefer the Bioscience Nutrition brand. I am sure there are other good formulations available, but these are ones I use.
- Bioscience Nutrition (now Arazo Nutrition) Triple Strength Omega 3 Fish Oil: 2250mg omega 3s (1200mg EPA/900mg DHA) - 3 softgels
- Bronson Omega 3 Fish Oil Triple Strength: 2720mg (1250mg EPA/ 488mg DHA) - 2 softgels
Neurovascular Support/Nerve Health/Brain Health Supplements
There are a variety of supplements out there formulated for nerve health and to ease neuropathy. I did a search for recommended and effective supplements and looked up information regarding each component of a neuro-health supplement. The top most recommended components include:
- alpha lipoic acid (generally safe evaluated dose for neuropathy-600mg)
- benfotiamine (B1 vitamin) (generally safe evaluated dose- 300-600mg)
- acetyl L-carnitine (generally safe evaluated dose - 500mg)
- N-acetyl Cysteine (1200mg 1-2 times a day, start lower and increase)
- resveratrol (dose clinically evaluated from 500-1000mg, side effects at higher doses)
- evening primrose oil (recommended dose-500mg)
- curcumin (recommended dose- 500-1000mg, start lower and increase, do not take within 4 hours of medications, multiple precautions)
The different formulations also contain B vitamin, calcium, magnesium, chromium, glucosamine, etc. Dosages and ingredients really vary by manufacturer, and I am still researching the most cost effective formulation in this category, I will post my findings later. Before taking any formulated supplement, ALWAYS READ THE INGREDIENTS AND DOSES! There is such a broad array of formulations, some contain subtherapeutic doses, some contain an excess in doses, and if you take multiple supplements or vitamins, double check the total dose you are consuming with all supplements because many formulations contain B, D, C, calcium, magnesium. Some excess vitamin or mineral may be excreted as unused waste, but some become toxic at higher doses or require blood concentration monitoring.
https://www.salubrainous.com has a good and easy to read explanation, scientific references, and precautions for various supplements. I found it useful.
Vitamins and Minerals
There are also some recommended vitamins and minerals for neuro, immune and metabolism/mithochondrial health.
- B vitamins
- B1, B2, B3, B5, B6, B7, B9, B12 (may interact with certain medications, verify interactions)
- Combination (B1, B6, B12) helps relieve neuropathic pain (B6 is toxic at 1000mg per day, must use less than 100-200mg per day)
- B12 can reverse neuropathy and support clinical recovery (dose range 20-1840mcg cyanocobalamin or 4-1500mg methylcobalamin)
- D Vitamins (D2, D3)
- supplementation is only beneficial for deficiency. do not supplement long-term as it may cause toxicity
- maintain calcium and magnesium levels
- 1000-2000IU per day, more than 2000IU and blood levels should be monitored
- D3 is preferred over D2
- combination with B, C, E and Zinc (also omega 3s) help alleviate neuropathy
- dose range 250-500mg start lower and increase
- dose differs based on type (magnesium oxide, magnesium citrate, magnesium gluconate, etc.)
- magnesium oxide has less absorption and bioavailability
- magnesium citrate also used as a laxative
- most common side effect is laxative due to nonabsorption, choose type that works for you
- interacts with many medications, verify interactions
I am still selecting vitamin and mineral brands. Vitamin C + Zinc is an available formulation as well as a Calcium+Magnesium+Zinc+D3 formulation. I need to check formulation concentrations and compare the costs of buying a formulated mix to the cost of buying each supplement as a stand-alone.
I am also stopping my usual multivitamin to prevent possible overdose on any of the above listed supplements. I am creating a supplement regimen specifically to alleviate the neuropathy and withdrawal symptoms I am experiencing with the duloxetine taper. Once I have completely stopped duloxetine and my neuropathy has improved, I will return to my previous supplement regimen of a multivitamin and Omega 3. I use the Twice-Per-Day multivitamin by LifeExtension, it is the most potent and broad spectrum multivitamin I found containing recommended doses for the majority of vitamins and minerals, plus some super-food extract combinations.
When verifying potential drug interactions when using supplements, also check to see if there are any physiological interactions. Some supplements will decrease blood sugar which is a concern for diabetics, or decrease blood pressure, or have an anti-coagulant effect and increase the possibility of bleeding. Make sure to inform your doctor, and when having surgery, it is recommended to stop using most supplements for at least 2 weeks prior to the surgery. Also check supplements for compatibility, as some are powerful antioxidants, and if used with other antioxidants, the doses should be reduced.