In diabetes, levels of blood glucose are too high, either because insulin is low or cells become unresponsive to insulin. Peripheral neuropathy is a nerve disorder that is a problem for 60 to 70 percent of diabetics, according to the National Diabetes Information Clearinghouse. Folic acid is one of the B vitamins important for development and function of the nervous system. Because folic acid deficiency may be associated with neuropathy, eating a folate-rich diet or taking folic acid supplements may help improve symptoms of diabetic neuropathy. Discuss with your doctor whether this is a good strategy for you.
Symptoms and Causes
Although diabetic neuropathy may develop in any nerve, problems usually arise in nerves responsible for sensation in the arms and hands or the legs and feet. Symptoms include tingling, numbness, or, occasionally, pain. Because sensation is poor, patients sometimes experience injuries that go unnoticed, leading to more serious problems. The causes of neuropathy include metabolic problems following periods of high blood sugar, damage to blood vessels supplying nerves, autoimmune factors, or lifestyle issues such as smoking or use of alcohol.
Folic Acid
Folic acid is the synthetic form of the natural B vitamin, folate. The body needs it to support many enzymatic reactions, including several that produce DNA and RNA. Some of these reactions also are important for production of amino acids, the building blocks of protein. Folic acid is critical for normal function of many organs, including the brain and nervous system. Several studies suggest that folate deficiency may be associated with neuropathy and that treatment with folic acid may help improve symptoms of the disorder.
The Evidence
Several studies have identified an association between folic acid deficiency and development of neuropathy. For example, Dr. M. Figueroa et al. published a paper in "Journal of Neurological Science" describing folate deficiency as the likely cause of drug-induced neuropathy. In addition, Dr. P. DeSilva et al. reported a case of optic nerve neuropathy in "Journal of Medical Case Reports," in which reversing folate deficiency with folic acid supplements reduced the neurological symptoms. Although these are promising studies, more research is needed to determine if folic acid might help prevent or reverse diabetic neuropathy.
Sources and Recommendations
Folate, the natural form of folic acid, is found in green vegetables such as spinach, asparagus and broccoli, and in citrus fruits and citrus juices. Many processed foods such as cereals and breads are fortified with folic acid; it is also contained in most multi-vitamins. Folic acid is also available as a separate supplement from health food stores. The recommended daily allowance of folic acid for adult men and women is 400 mcg per day. Consult your doctor to determine if you should consider increasing your intake of folic acid.
References
- National Diabetes Information Clearinghouse: Diabetic Neuropathies: The Nerve Damage of Diabetes
- Office of Dietary Supplements: Folate
- Linus Pauling Institute: Folic Acid
- National Institute of Neurological Disorders and Stroke: Diabetic Neuropathy Information Page
- PubMed: "The role of folate deficiency in the development of peripheral neuropathy caused by anticonvulsants," Figueroa, M. et al, "Journal of Neurolocigal Science," December, 1980.
- Pub Med: "Folic Acid Deficiency Optic Neuropathy: A Case Report," DeSilva, P. et al, "Journal of Medical Case Reports," September, 2008.
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