-IBIS-1.7.6-
tx
musculoskeletal system
carpal tunnel syndrome
Nutrition

dietary guidelines

therapeutic foods:
• foods that tonify the Pericardium and Triple Warmer, foods that invigorate the Qi and Xue (Blood), foods that open channels
• olives, rye, lima beans, rice bran, bananas, sprouts, watercress, apples (Jensen, p. 61)
• foods high in Calcium (Zeff)

fresh juices:
• potato peeling broth (Jensen, p. 61)
• dried olive tea (Jensen, p. 61)
• nut milk and liquid chlorophyll (Jensen, p. 61)

avoid:
• saturated fats


supplements

Vitamin B6 100 mg three times daily, up to 3 g per day, check for toxicity; P5P may also be effective. (Ellis. Am. J. Clin. Nutr. 32:2040-6, 1979); 100 mg per day. (Amadio, 1985, p. 327ff); consider also
Pyridoxal-5’-phosphate (PLP or P5P), the activated form of B6, is considered a potentially more effective alternative when the response to B6 supplementation is inadequate; 50 mg, three times per day.
• Vitamin B3
• Magnesium 500 mg per day.
• Essential fatty acids
Bromelain 2000 mcu 500 - 1000 mg three times daily; note: this is best taken on an empty stomach. (Marz, p. 354, 1997)
• Bioflavonoids 1 g three times daily. (Marz)
• Catechin


footnotes

Amadio PC. Pyridoxine as an adjunct in the treatment of carpal tunnel syndrome. J Hand Surg 1985;10A(2):237-241.

Bernstein AL, Dinesen JS. Brief communication: effect of pharmacologic doses of vitamin B6 on carpal tunnel syndrome, electronencephalographic results, and pain. J Am Coll Nutri 1993;12:73-76.

Browning DM. Carpal tunnel syndrome: clinical or neurophysiological diagnosis? Lancet 1985;i:1104-1105. (Letter)

Driskell JA, Wesley RL, Hess IE. Effectiveness of pyridoxine hydrochloride treatment on carpal tunnel syndrome patients. Nutr Rep Internat 1986;34(4):1031-1039.

D’Souza M. Carpal tunnel syndrome: clinical or neurophysiological diagnosis? Lancet 1985;i:1104-1105.

Ellis JM. Clinical results of a cross over treatment with B6 and placebo of the carpal tunnel syndrome. Am. J. Clin. Nutr. 1979;32:2040-2046.
Abstract: A patient with severe carpal tunnel syndrome and a significant deficiency of B6, as determined by EGOT activity, was studied. The patient was treated with 2 mg per day for 11 weeks, then 100 mg per day for 12 weeks, then placebo for 9 weeks, and again B6 100 mg per day for 11weeks. 2mg/day reduced the EGOT activity deficiency, maintained the P5P levels at a deficiency, and relieved most of the symptoms. 100mg/day caused EGOT to be at maximal activity, and relieved the P5P deficiency levels and all symptoms. Introduction of placebo caused reappearance of EGOT activity, P5P deficiency, and symptoms. Readministration of 100mg/day of B6 eliminated the deficiencies and all of the symptoms.

Ellis JM, Azuma J, Watanbe T, Folkers K. Survey and new data on treatment with pyridoxine of patients having a clinical syndrome including the carpal tunnel and other defects. Res Comm Chem Path Pharm 1977;17(1):165-177.

Ellis JM. Treatment of carpal tunnel syndrome with vitamin B6. Southern Med J 1987;80(7):882-884.

Ellis JM. Vitamin B6 deficiency in patients with a clinical syndrome including the carpal tunnel defect. Biochemical and clinical response to therapy with pyridoxine. Res Comm Chem Path Pharm 1976;13(4):743-757.

Franzblau A, Rock CL, Werner RA, et al. The relationship of vitamin B6 status to median nerve function and carpal tunnel syndrome among active industrial workers. J Occup Environ Med 1996;38:485-491.

Fuhr JF, Farrow A, Nelson HS. Vitamin B6 levels in patients with carpal tunnel syndrome. Arch Surg 1989;124:1329-1330.

Gaby AR. Literature review and commentary. Townsend Letter for Doctors and Patients. 1990;Jun:338-39.

Keniston RC, Nathan PA, Leklem JE, Lockwood RS. Vitamin B6, vitamin C, and carpal tunnel syndrome. J Occup Environ Med 1997;39:949-959.

Parry G, Bredesen DE. Sensory neuropathy with low-dose pyridoxine. Neurology 1985;35:1466-1468.

Schaumburg H, Kaplan J, Windebank A, et al. Sensory neuropathy from pyridoxine abuse. N Engl J Med 1983;309(8):445-448.

Smith GP, et al. Biochemical studies of pyridoxal and pyridoxal phosphate status and therapeutic trial of pyridoxine in patients with carpal tunnel syndrome. Ann Neurol 1984;15:104-107.

Smith GP, Rudge PJ, Peters TJ. Biochemical studies of pyridoxal and pyridoxal phosphate status and therapeutic trial of pyridoxine in patients with carpal tunnel syndrome. Ann Neurol 1984;15:104-107.

Stransky M, et al. Treatment of carpal tunnel syndrome with vitamin B6: a double-blind study. Southern Med J 1989;82(7):841-842.