I have severe neuropathy in my feet and it is slowly creeping to my hands. Dr's think it may be Lupus but nothing definitive. For sure Auto immune.

My question is this, I am taking the following, but I am not sure how much of the non prescription to take and then I am unsure of what can be taken with what; when and with or without food. Can anyone help? I know that some things hinder absorption of others so if you could help me I would appreciate it. Thanks so much!

Maddie

by prescription:

4 grams Lovaza (sp?)
Metanx
Niaspan

Alpha-Lipoic Acid (R-ALA)
Acetyl-L-Carnitine
a 325mg aspirin (daily)
MSM
D3
Serrepeptase

I think the Metanx should be empty stomach, alone because of the B12 content.

The others don't really matter. ALA might be better with food.
Some complain of upset with it.

Lovaza being a fat is best absorbed at mealtimes when your bile is being secreted. Less chance of reflux with it then.

Acetyl carnitine is best divided up into several doses, depending on how high your dose is. It is not absorbed well. 500mg can be taken each time.

Serrepeptase I am not sure about, check the label of your bottle.
Also for the Niaspan, follow the directions given to you from your pharmacy.

Most nutrients can be taken with food. B12 is one exception.

THank you for your answer. Is it true for all the b vitamins or just the B12? I want to add B1, B2 and B6.

Just the B12.... it is very poorly absorbed and may get lost in the food and never reach the bloodstream.

Can you tell me the dosage for the things I listed?

FWIW, Niaspan can be taken at bedtime. During the day the side effects (mostly niacin flush) could be bothersome, but at night - you may be able to sleep right through it.

Doc

Most of the things you listed you have a dosage I think.

Metanx is typically one a day. You might not need 2 if you take it correctly.

The ALA is usually 600mg a day. You can minimize that by using R-lipoic acid, 100mg a day which is the new more potent form.

Acetyl carnitine starts at 500mg a day or so and increase to 2 grams if needed.

MSM is not really necessary... I don't see what it can do for you PN wise.

D3 should be determined by blood testing first. Recommendations for those with no testing are 1000-2000IU D3 daily.

I am not familiar with Serrepeptase, so I cannot advise you there.

Metanx is indicated for one pill BID.

I think BID for Metanx is unnecessary for most people.

That is almost 5mg of methylfolate in 2 Metanx. And most PNs do not respond to folate at all.

To get 5mg of methyl B12 which would be in two Metanx you could do that separately for much less money.

Metanx doesn't even instruct to take on an empty stomach, which the B12 requires.

One Metanx taken properly should "do it" for most people.

For people with high homocysteine.... that is a cardiovascular intervention, and perhaps pertinent. But not necessary for most PNers.