Spring 1999
Jon Kaiser, M.D., in his Book Healing HIV in the chapter "Preventing and Treating Neuropathy," suggests calcium 500 mg, magnesium 250 mg, and vitamin B6 100 mg, taken twice a day; he recommends this regimen whenever he prescribes d4t. If the neuropathy is already present, he increases the dose of vitamin B6 to 200 mg twice a day. He also uses acupuncture for relief of neuropathy.
Dr. Kaiser noted that while improvement can occur quickly, in some cases it may take several months before there is a noticeable change.
Recently we spoke with another doctor. She recommends more calcium and magnesium, but less vitamin B6-1000mg of calcium and 500mg of magnesium twice a day (once a day may work), but only 100 mg of vitamin B6 once per day, even if the neuropathy has already occurred. She has not seen improvement from increasing the B6. She highly recommends acupuncture.
It may also be necessary to discontinue or reduce the dose of the drug or drugs believed to be causing the problem. If the neuropathy is allowed to become severe, it can cause lasting nerve damage.
Patients should also be aware that large overdoses of vitamin B6 (greater than 1,000 mg per day) can actually cause neuropathy in some cases.