Carpal Tunnel Supplements. Xanya Sofra Weiss

Just inside your wrist is a narrow, bony passage called the carpal
tunnel. Anything but empty, this tunnel contains nine tendons as well
as a nerve called the median nerve, all of which are encased,
sausage-like, in a slippery sheath called the synovium. When the
synovium and tendons become inflamed and swollen, they squeeze the
median nerve, which runs to the fingers.

Ever watch a live
electrical wire rub metal? The pinched median nerve can send angry
sparks of pain, numbness and tingling from your fingertips to your
shoulder. More often the pain is in the thumb and the index and middle
fingers. Sometimes the ring finger is also involved. Many people who
suffer from CTS say it feels like their hands have fallen asleep;
others complain of weak grips and stiff fingers.

Women seem to
suffer from CTS more often than men. Changes in female hormones caused
by pregnancy, taking birth control pills and menopause somehow make the
synovium swell. And because women generally have small wrists, just a
little swelling is enough to cause carpal tunnel pain, experts say.

Surgeons agree that CTS should not be treated with surgery during pregnancy. Studies by Dr. Ellis found that vitamin B₆
helped relieve CTS in 11 percent of the pregnant women with severe CTS
signs and symptoms during their pregnancies. These women were treated
with 50 to 300 milligrams of B₆ daily for at least 60 to 90
days before giving birth. And there was no harm to either the mother or
the child. If you'd like to try this therapy, you should discuss it
with your doctor.

Obesity creates a similar situation. "There
is about a fivefold increase in CTS in people who are obese and couch
potatoes. So we encourage them to be in better shape and lose weight,"
says Morton Kasdan, M.D., clinical professor of plastic surgery at the
University of Louisville in Kentucky and clinical professor of
preventive medicine and environmental health

at the University of Kentucky in Lexington.

CTS has also become the unofficial health complaint of the modern age,
the result of an increase in cases among people in manufacturing jobs.

Officials at the U.S. Bureau of Labor Statistics don't keep records of
the number of CTS cases reported each year. Between 1986 and 1992,
cases of "repetitive trauma disorders" (a category that includes CTS
and similar conditions) zoomed from 50,000 to 282,000.

Another
common culprit is working on a computer, which doesn't require you to
take frequent breaks, as changing paper in a typewriter would. "The
repetitive activity produces inflammation, and this leads to swelling,"
explains Dr. Tunell. "That's a major contributor for the patients I
see."

Food Factors The pain hits your wrist, your hand and sometimes even your shoulder. But carpal tunnel syndrome can start in your stomach. Here are some things to consider. Hold the reins on cocktails. Alcohol is known to deplete the body of nutrients, especially the B vitamins, which are vital for preventing carpal tunnel syndrome. Drop those pounds. Many doctors have noted that people who lose weight sometimes also lose their symptoms of carpal tunnel syndrome. If you're on a weight-reducing diet, be sure to eat foods that contain vitamin B6, such as bananas and avocados.

Prescriptions for Healing Many doctors recommend B vitamins for carpal tunnel syndrome. Because even the foods richest in vitamin B6, such as bananas, avocados, brewer's yeast and beef, provide barely a single milligram of B6, you'll probably need to take a supplement. B-complex capsules often include all of the recommended vitamins. Nutrient Daily Amount Biotin 300 micrograms Riboflavin 25 milligrams Vitamin B6 50-200 milligrams MEDICAL ALERT: Take vitamin B6 in amounts above 100 milligrams only under the supervision of your doctor.

The Benefits of B₆

Doctors are divided on why vitamin B₆ seems to provide relief from CTS.

The author of five published studies that demonstrate the benefits of vitamin B₆ for CTS, Dr. Ellis contends that synovium swelling and inelasticity are caused by a B₆ deficiency.

Dr. Ellis and Karl Folkers, D.Sc., Ph.D., professor and director of the
Institute for Biomedical Research at the University of Texas at Austin,
once healed 22 of 23 people with CTS just by giving them 50 to 300
milligrams of vitamin B₆ daily for at least 12 weeks. And a number of them had already undergone surgery without experiencing relief. "Vitamin B₆ is as important to your body as oxygen and water, only it takes a little longer to show the benefits," says Dr. Ellis.

The average diet, Dr. Ellis says, provides only about 1.4 milligrams of vitamin B₆
a day, in part because the nutrient is lost in processing, so many
people are just not getting enough. "Raw foods are the best sources,
because heat destroys it," he says. Foods containing B₆ include potatoes, bananas, chicken breast, top round of beef, fish, brown rice and avocados.

Other doctors believe vitamin B₆
acts as a diuretic, helping the body to eliminate excess fluid. "During
pregnancy, your feet swell, your hands swell, rings don't fit anymore.
You're retaining fluid, especially in the wrists," says Dr. Tunell. For
some women, the problem worsens when they lie down, as fluid that makes
the ankles swell during the day is redistributed throughout the body,
including to the wrists, he says. "B₆ helps you get rid of the extra water gain that's causing carpal tunnel," he says.

Another theory, backed up by two European studies, suggests that vitamin B₆ somehow short-circuits an angry nerve's ability to transmit pain signals. "We don't know the mechanism, but we do know B₆
reduces the amount of pain that animals feel, and that may be what's
happening here," says Allan L. Bernstein, M.D., chief of neurology at
Kaiser Permanente Medical Center in Hayward, California.

Medical experts do agree on one thing: No matter how vitamin B₆
gets the job done, you have to be careful not to take too much. In
studies using laboratory animals, researchers found that excess B₆ can harm your central nervous system.

Researchers at the U.S. Department of Agriculture Western Human Nutrition

Research Center in San Francisco fed 12 experimental animals 1, 10, 100, 200 or 300 times their requirement of vitamin B₆ for seven weeks. At the three highest levels of B₆ intake, the animals' reaction time to a loud noise was reduced. Signs of a B₆ overdose also include an oversensitivity to sunlight, which produces a skin rash and numbness.

"Vitamin B₆ toxicity symptoms are rarely seen in healthy individuals. Moderate supplementation of B₆ will not cause that kind of thing," says Robert A. Jacob, Ph.D., research chemist in micronutrients at the Western Human Nutrition

Research Center. "You'd have to megadose on it. So I don't think that
would happen if you take just a multivitamin/mineral supplement with B₆ or even a 50- or 100-milligram B₆ supplement. It appears only when you chronically take massive amounts."

Doctors recommend 50 to 200 milligrams of vitamin B₆ daily to treat carpal tunnel.

Some Recommend Riboflavin and Biotin

There's some evidence that vitamin B₆
won't work properly unless you're getting adequate amounts of
riboflavin and biotin, other B vitamins. "Each one of these vitamins is
synergistic; each works in concert with the other," says Flora Pettit,
Ph.D., a research scientist at the Biochemical Institute at the
University of Texas at Austin. Doctors suggest aiming for 300
micrograms of biotin and 25 milligrams of riboflavin daily.

By
law, most cereals, flours and other grain products are fortified with
riboflavin; milk, yogurt and cheeses are good sources, too. Biotin is
found in brewer's yeast, soy flour, cereals, egg yolks, milk, nuts and
vegetables.

Older adults, alcoholics and those with nutritionally poor diets
are at particular risk for deficiencies in these vitamins, says Dr.
Tunell. "Generally, the elderly have poor diets, and they have trouble
absorbing B vitamins anyway," says Dr. Tunell. "So they couldn't go
wrong with a B-complex supplement unless they have Parkinson's disease.
In that case, vitamin B₆ may interfere with the absorption of their levodopa medication."

"My patients are getting between 50 and 100 milligrams of vitamin B₆ and riboflavin a day, using a B-complex supplement," says Dr. Kasdan. "And 60 percent of them have gotten better."

Most doctors agree that catching CTS early is a key to successful treatment. "If you have severe carpal tunnel, the vitamin B₆
isn't really going to reverse it," says Dr. Bernstein. "But if you
catch it early, when you're just starting to have pain and tingling,
and if there's no weakness and it bothers you at night but not during
the day, you'll do extremely well."

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Xanya Sofra Weiss