IV Therapy for Diabetic Neuropathy & What Actually Works?

Hello, it's Dr. Ergin from Diabetes, Thyroid and Hormone Center of the Treasure Coast, also your SugarMD and SugarMDS.com. Today, I want to talk to you about something new. All right, patients ask me about TOSME now, IV therapy, and specifically whether it can actually help with diabetic neuropathy, because there is a lot of confusion out there. Some people think it is a miracle cure, and some people think it is a total gimmick. And honestly, the truth is somewhere in between. So, let's get into it. First, let's talk about what is actually happening in your nerves when you have diabetic neuropathy. Most of you have some idea, but let's go over quickly. High blood sugar over the years, especially spikes, you know, I always tell my patients if you're spiking over 180, coming back down to 100 is more damaging than if you are staying 130, 140 at all times. But anyway, these damage happens to your small vessels with the high blood sugars and spikes that your peripheral nerves, obviously, the nerves, like not in your necessarily directly in your brain, it starts more in the distal, like far away sites, like your feet and stuff like that. But it affects every nerve eventually. Now, that is the microvascular, like tiny vessels affecting your nerves. But there is also an oxidative stress component, right? Because chronically elevated glucose generates something called advanced glycation end products. We call them ages in short, and those trigger oxidative damage inside the nerve fiber themselves. That's why neuropathy is not just poor circulation. It is a combination of vascular injury and oxidative injury happening at the same time. So, where does IV therapy fit into the picture? I know a lot of you are taking sugar MD neuropathy support. It's helping for a few. So, if it is helping, you don't need an IV. Some people actually take, instead of one capsule twice a day, they take two capsules twice a day. That actually helps double a lot more. And it's okay to do that, although it's not on the label, but these are vitamins. It's hard to get intoxicated from it. And then oral absorption is not like IV. For example, with IV, we're going to give you alpha lipoic acid. It's so much more, right? But if it is helping you that way, two capsules twice a day, fine. That's great. You don't need an IV. So, I'm going to go over a few scientific nutrients, that have real mechanistic reasons to help. Number one is the alpha lipoic acid. It's probably the best studied one out there. It is a very potent antioxidant. And when it's given intravenously through your veins, it bypasses the absorption limits you would hit taking oral. So, the Alladin trial and a few follow-up studies looked at IV alpha lipoic acid in diabetic neuropathy and found meaningful improvement in neuropathic symptom scores over a period of weeks. Not a cure, but a real measurable reduction in burning, tingling, and pain scores compared to placebo. Then you've got the B vitamin repletion, right? So, you're getting B12, B1 in its active form, thiamine form, B6. This matters because metformin, which most of our type 2 diabetic patients are on long term, is well known to deplete B12 over time. B12 deficiency on its own can cause peripheral neuropathy that looks a lot like diabetic neuropathy. So, if you are deficient, you could be dealing with two overlapping problems at once. Correcting that deficiency through IV administration gets you to therapeutic levels faster than oral supplementation, especially if gut absorption is already compromised, which it often is in long-standing diabetes. And then there is magnesium, right? A huge percentage of type 2 diabetics are magnesium deficient, partly from the disease itself and partly from certain medications. As you know, magnesium plays a direct role in nerve conduction and muscle function. For example, when you're deficient, cramping, restless legs happen, right? Some of that nerve irritability, it's all from magnesium depletion, can meaningfully do that. I mean, you fix it, it can move the needle. Now, what about the other IV therapies we offer in our clinic? Well, we are a diabetes thyroid and hormone center, right? In the treasure coast, but we do offer IV nutrient therapy built around this exact rationale, right? So, what we are trying to do, we are including targeted protocols for patients dealing with neuropathy, but neuropathy is not the only thing IV therapy can help with. And that's why, like, you know, when you go to a hospital, you know, to get you fixed up, what do they do? They give you IV. If you have a bad, you know, infection, right? What do they do? Give you IV antibiotics. They don't give you just pills for antibiotics because they know anything IV is bam, bam. They know it's in there. They know it's high dose. It hits it. It gets it done. So, IV therapy is very strong. Obviously, it requires you to sit down in a chair for an hour, but that's not a big deal. You know, you can watch the TV while you're doing it. Look at your phone, whatever. Watch my YouTube channel, right? But I want to run through the rest of what we offer here because each one has a different job. So, we do offer a Myers cocktail, right? Which is a foundational one because it has B vitamins, vitamin C, magnesium, and calcium together. So, again, B vitamins, vitamin C, magnesium, calcium. That's Myers cocktail. That's usually where I start someone who is generally fatigued or run down, diabetic or not, because it is broad. It is low risk and it gives us a baseline for how they respond before we get more targeted. We also offer high dose vitamin C on its own, separate from a neuropathy protocol. So, at high enough doses given IV, vitamin C behaves differently than it does orally. There's been a study for immune support and in oncology world, in cancer world, as an adjunct therapy, right? As a therapy that can be add-on. For a diabetic patient specifically, the value is mostly about lowering that overall oxidative stress burden that I mentioned earlier. The same age-driven damage, and I say age is the advanced qualification end product, is also stressing your blood vessels and other tissues throughout your body. It's just not just the nerves. Now, glutathione is another one we offer. It is often called the glutathione, the body's master antioxidant, because it supports detoxification through the liver. I see a lot of interest in this one from my patients as well, especially with autoimmune thyroid disease, Hashimoto specifically, where there is a real connection between gut health and liver detox capacity and thyroid autoimmunity. It is not just the diabetes tool, but plenty of our patients are managing more than one of these conditions, right? Typically, all in one sometimes. People have Hashimoto's, diabetes at the same time, for example. So, it fits into the bigger picture than people ask for most of the time. Now, then there is this big boy, which is NAD+, nicotinamide denucleotide, which your mitochondria need desperately to actually produce cellular energy. Now, this one has got a lot of attention in longevity medicine, and I'll be honest with you, the evidence base here is younger than something like Meyer's cocktail and alpha lipoic acid, so I don't oversell it. But for patients dealing with the kind of deep fatigue that comes with years of metabolic dysfunction, old age, etc., it is a reasonable thing to try and see how you respond, you know? Most of the time when people are getting this infusion, they actually feel that something is changing their body, which is kind of cool. So, the way I think about it is alpha lipoic acid, B vitamins, and magnesium are your neuropathy focused combination, right? And the Meyer's, vitamin C, glutathione, and AD are more about the broader metabolic and energy picture, depending on what is going on with you. And you might use one or you might combine a few of these into a single protocol. Now, who should not get IV therapy? That's a big question, right? Because not everybody can get IV therapy. I want to be very clear about this, because this is part of a lot of infusion lounges skip over, right? So, you go to a medical spa, no doctor, a nurse practitioner who didn't study any of these, she was just given a protocol, following it, and medical director, nowhere to be found, etc., etc. Now, IV therapy is not right for everyone, right? There are several reasons to say no. Now, patients with congestive heart failure are at the top of the list, because an IV infusion adds fluid volume to your circulation. And if your heart's pumping poorly, the function is already reduced, that added volume can push you into fluid overload. Now, that can cause shortness of breath, swelling, a genuine emergency, right? So, if you have CHF, especially if it is not well compensated, IV therapy is something we approach with extreme caution, if at all, right? And only with your cardiologist looped in. And obviously, if you have backup, you know, we can, you know, do something if you are overloaded with fluids, but we definitely don't want to cause that to begin with. Now, the second, and this one is specific to high-dose vitamin C, which some neuropathy protocols include for its antioxidant effect. But, patients with G6PD deficiency should not receive high-dose IV vitamin C, because G6PD is an enzyme deficiency, right? It's a problem, genetic problem, more common in certain ethnic backgrounds. And in these patients, high-dose ascorbic acid can trigger hemolysis, which is blood cell breakdown, those red blood cells, right? That's why we screen for G6PD status before anyone gets a high-dose vitamin C infusion. It is a simple blood test, but skipping it is not an option. We also look carefully at kidney function, because fluid and electrolyte loads basically need to be managed differently if you have got any significant degree of renal impairment. So, we review your full medication list before billing your protocol. Now, the bigger picture here is that the IV therapy is a great tool, not a replacement for glucose control. So, if your A1c is sitting around 9 or 10, no alpha lipoic acid is going to fix your neuropathy. So, correcting the underlying blood sugar problem is still your foundation. IV therapy works best as a complementary tool, because it's repleting what has been depleted very quickly and very efficiently, giving your nerves the raw materials to recover, right? While you and I work on glucose piece together. So, if you're in Port St. Lucie, Stewart or Jensen Beach, Vero Beach, Palm City, and you're dealing with diabetic neuropathy symptoms, burning, tingling, numbness in your feet, well, come see us. We will check your labs. We'll make sure you are actually a good candidate, and we are going to build a plan around you and your specific picture, instead of doing the guessing game. Well, that's it for today. If it was helpful, please hit subscribe, share this video, give a thumbs up. I'll see you in the next one.