We’ve long been told that we should all be eating less salt, though it is difficult to change everyone’s eating habits. A new study from Belgium suggests that maybe it’s not such a great idea for everybody to cut down on sodium.
Walnuts are delicious, and it turns out they are also exceptionally high in antioxidants. We talk with the chemist who uncovered this fact.
Dozens of minor ailments benefit more from common sense or traditional wisdom than from costly prescription drugs. What are your favorite home remedies?
Guest: Jan Staessen, MD, PhD, FESC, FAHA, is Professor of Medicine and Head of the Studies Coordinating Centre of the Laboratory of Hypertension at the Campus Sint Rafael in Leuven, Belgium. The research on sodium, blood pressure and fatal outcomes was conducted by the European Project on Genes in Hypertension and published in the Journal of the American Medical Association on May 4, 2011. The photo is of Dr. Staessen.
Joe Vinson, PhD, is Professor in the Department of Chemistry at the University of Scranton. His research on antioxidants in walnuts was presented at the meeting of the American Chemical Society.
The podcast of this program will be available the Monday after the broadcast date. Podcasts can be downloaded for free for six weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

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  1. Charles B MD PhD
    Reply

    I have seen a response to Benfotiamine with regard to peripheral neuropathy pain that is not clearly linked to diabetes. I have recommended a trial in “idiopathic” peripheral neuropathy of 300 mg twice a day of benfotiamine. Subjectively, I can only say that the success rate of this approach is less than that of pain diminution in diabetic peripheral neuropathy; but it is worth a try.
    Check with your physician about your other meds and whether s/he agrees to this advice. If your physician says s/he has never heard of benfotiamine AND does not agree with this approach, it is reasonable, in my opinion, to try it on one’s own as long as the physician does not cite a specific medical reason for not trying it.

  2. Valerie H.
    Reply

    This was the first reference I have have found to IDIOPATHIC peripheral neuropathy, which is my problem. I currently take 3600 mg of gabapentin and 50 mg of nortriptyline daily to mitigate the discomfort). Can you comment on this type of neuropathy?

  3. Charles B MD PhD
    Reply

    Yesterday a patient for whom I provided a sample of benfotiamine after unsuccessfully writing a script for thiamine 100 mg twice a day for a peripheral neuropathy asked me for more benfotiamine because of an inability to pay the 30 dollars necessary for a local refill.
    She got relief of her idiopathic peripheral neuropathy – I cannot pinpoint the etiology – with benfotiamine but not regular thiamine. That has been my practice experience. I believe it represents a greater intracellular bioavailability of benfotiamine.
    Benfotiamine goes intracellular and then is phophorolated to yield thiamine pyrophosphate, a form of thiamine that is a cofactor for enzymes such as Transketolase. Transketolase when fully active shunts glucose into productive versus non-productive pathoways. A non-productive glucose metabolite pathway is one in which the glucose metabolite causes “oxidative stress”.
    Ideally there would be an enzyme assay available for measuring intracellular Transketolase activity as a surrogate measure of intracellular thiamine pyrophosphate deficiency. This enzyme level is not generally available except at a very few sites.
    The way I screen for intracellular thiamine deficiency is to give patients trials of benfotiamine. If they symptomatically respond I assume they have intracellular thiamine deficiency that requires supplementation with benfotiamine.
    There have been examples of young people with severe muscle cramps responding to benfotiamine that completely resolves their problem. When Sheldon Mack, the excellent guard of Butler University had to sit out of the Butler – Duke basketball game, I posted a message on ESPN.com that benfotiamine might be an answer to his recurrent problem of severe leg cramps refractory to all sorts of interventions. Whether that suggestion was taken seriously or not, I do not know. What I do know is thereafter he did play without disabling cramps.

  4. Charles B MD PhD
    Reply

    I have limited experience with the rx of chemotherapy induced neuropathy with benfotiamine and the experience I do have lends me to believe that neuropathy caused by chemotherapy is not reversible with benfotiamine. Whether it is preventable is another question about which I can only speculate.
    However, it is worth a try because benfotiamine has very few if any side effects. I did have a very interesting experience in the rx of a compression neuropathy with benfotiamine. A patient saw me weeks into developing a complete foot drop (probably secondary to the compression of the common peroneal nerve due to an injury). I referred the patient immediately to a neurologist who did an EMG and told the patient it would be months before he would see improvement in his foot drop based on the EMG results.
    In an “Oh by the way” comment to the patient before I referred him to the neurologist, I advised him to take benfotiamine right after seeing the neurologist and the patient did so. He returned to me three weeks after seeing the neurologist and was fully recovered from the foot drop, ie, his common peroneal nerve injury had healed much faster than predicted.
    I spoke to the neurologist who confirmed that healing should not have taken place so quickly. I tried to encourage the neurologist to consider doing an EMG study of nerve injuries before and after rx with benfotiamine. Because I retired from the Univerisy and the VA at the same time I am not sure that anything came from that experience.
    I also have an experience of treating the acute onset of a fat wallet induced piriformis syndrome with benfotiamine. It was yours truly who developed the acute onset of right sided pirifomis muscle induced sciatica with sensory and motor components. It was very painful and included weakness of my right leg. Aside from switching my wallet from my back to front pocket, I treated myself with benfotiamine. In 48 hours my sensory and motor symptoms completely resolved. Placebo effect? Perhaps.
    My faith in the therapeutic value of benfotiamine is quite high. However, it also is true that I believe the placebo effect is mediated through neurovascular mechanisms (ie, moderation of regional blood flow abnormalities through neural pathway induced neurovascular changes). These two experiences (foot drop and fat wallet) plus other experiences with benfotiamine have helped me develop a “microvascular myopia” in dealing with a plethora of patient problems. I now conceptualize in almost every patient I see how the microvasculature can play a role in the pathophysiology of the patient’s presentation and act to propose and utilize interventions to moderate that pathophysiology using primarily Pycnogenol (a pine bark extract) and also benfotiamine and Allithiamine, another fat soluble derivative of benfotiamine that crosses the blood brain barrier.
    I have handed out to hundreds of patients samples of Pycnogenol and Benfotiamine and have had zero negative feedback. The problem I do have is that patients who receive the samples and can’t afford refills on their own ask for refills from me. Out of the 20 patients I saw today in an urban FQHC look alike four of them had had very positive experiences with Pycnogenol or Benfotiamine and they asked for refills when they could not afford them.
    BTW, Pycnogenol does not work like Benfotiamine to moderate diabetic peripheral neuropathy but it does moderate “pre-proliferative retinopathy” in patients with diabetes mellitus.

  5. Kathy
    Reply

    Thank you Dr. Charles! Do you have any experience with neuropathy caused by chemo or amyloidosis? I am wondering if it would work in those cases.

  6. Charles B MD, PhD
    Reply

    The name of the OTC that can be used to treat diabetic neuropathic pain and Restless Legs Syndrome is benfotiamine. It was synthesized initially in Germany and has been studied extensively there. The dose is 300 mg twice a day initially and then 150 mg twice a day for maintenance therapy. It is available from multiple sources over the internet.
    Perhaps the best source is from Benfotiamine Inc. in the form of 150 mg veggie caps in bottles of 120, I have no financial tie to this recommendation other than spending my own money to distribute it to patients to try and then encouraging them, if it works, to purchase it for ongoing maintenance therapy.
    Today I distributed it to three patients to try. In my experience it works well to very well in about 75 percent of patients. I try to recommend it to local pharmacies to stock and community pharmacies do so. They charge double what they pay for 120 caps over the internet – ~15 dollars on internet purchase and ~30 dollars in the pharmacy.
    At the last pharmacy that stocked it at my request, an employee at the pharmacy decided to send it to a relative with painful diabetic neuropathy and got a call back from the relative three days after she started to take it when she said: “I can’t believe it but my pain was gone in two days!” – it can work that fast. As I mentioned I have started recommending it for therapy of Restless Legs Syndrome based on patient feedback and have used it personally for painful nocturnal leg cramps with success.
    What unites all of these pathologies is a neurovascular (microvascular dysfunction or “endothelial dysfunction”) pathology. As I tell medical students, “understand the role the microvasculature plays in the suffering of patients and use that understanding to present the patient with remedies that no one else will even think of using”. With regard to benfotiamine, it probably will not relieve microvascular pathology in the brain as it does not cross the blood brain barrier in humans.
    Use the search strategy “Benfotiamine AND endothelial dysfunction” in PubMed to find some very interesting articles about this fat soluble derivative of vitamin B-1 or thiamine. Even though it is fat soluble, it is purported to have no significant side effects by the Germans who studied it. It is starting to take off in the research labs of the US after a medical school research team in NYC showed that benfotiamine reversed to normal levels three biochemical parameters of oxidative stress in Type I diabetes patients.
    Oxidative stress can cause endothelial dysfuncion; endothelial dysfunction can cause microvascular dysfunction; microvascular dysfunction can cause regional blood flow abnormalities; regional blood flow abnormalities can cause pain (eg, microvascular angina, diabetic neuropathy, restless legs, leg cramps….etc).
    Still, I have found it to be a very hard sell to ____ University physicians, probably because it is not at all standard therapy, even if one can explain the biochemistry of its action.

  7. ch
    Reply

    Turmeric (a plant) and benfotiamine (synthetic derivative of vitamin B1) were both mentioned to be effective for the treatment of neuropathic pain.

  8. J.F.R.
    Reply

    I suffer terribly from restless legs nightly. I am on 2 mg of Requip which makes me feel awful. I would love to try this Vit. B1 remedy. Please give me the name of this medicine. Thank you. Sincerely, Janet

  9. jim
    Reply

    Last Saturday, At 1 PM, on Buffalo’s PBS, following the topic on salt, you had a physician who called in about some supplement for neuropathy. I didn’t have a chance to write down the name. Could you spell the name of this supplement, and tell me where it can be bought, health store? drug store? I have numbness in my left foot, off and on. Would like to try this. I live in Toronto. Canada. Thanks.
    Could you send your reply to my email address?

  10. Kathy
    Reply

    I juts listened to the podcast. The supplement for diabetic neuropathy that Dr. Charles has used successfully for the past ten years is called BENFOTIAMINE and there are lots of links on line that tell about it and sell it. It is a fat soluble vitamin B1 derivative. Regular B vitamins are water soluble. According to Dr. Charles it was synthesized in Germany and has been used there for about thirty years.

  11. AB in LA
    Reply

    Years ago we were trying to control my husband’s borderline high blood pressure with diet, so I completely eliminated salt from my cooking. After only a few days I was lightheaded and would get very wobbly whenever I stood up. I added salt back into my food and behold – back to normal!
    Thanks for the validation and for the reminder that we need to take responsibility for what works for each of us individually.

  12. john b.
    Reply

    I have recently had a stent inserted in April. I was given several new medications and have had numerous problems ever since, such as swelling of ankles, tightness in chest area, some blurred vision, trembling of hands, dizziness, light headedness, flush feeling in the face, high pulse rate, & a general loss of pep. Am I taking too medication? Some of these conditions predate the stent.
    Aspirin 81mg once a day, Carvedilol 6.25mg twice a day, Plavix 75mg one a day, Torsemide 10mg once a day, Isosorb/mono 60mg once a day, Synthroid 100mcg one a day, Lisinopril 20mg one a day, Clor/con m10tab10 meqer one a day, Crestor 40mg one a day, Diltiazem 180 mg one a day. I have seen 5 different Cardiologists in our HMO group including my own cardiologist who is assigned to my case. Can you advise me who to turn to for a reevaluation. Any help will be greatly appreciated.
    PEOPLE’S PHARMACY RESPONSE: TELL YOUR CARDIOLOGIST ABOUT THE TROUBLE YOU ARE HAVING AND REQUEST A REFERRAL TO A CLINICAL PHARMACOLOGIST WHO COULD EVALUATE YOUR REGIMEN.

  13. Susan
    Reply

    The Pritikin program in Doral Florida puts people on a low salt, natural foods eating plan and most people are OFF BP medication within a few days eating that way. There is so much sodium added to and hidden in most of the prepared foods we eat today that, on top of the naturally occurring sodium in veggies and fruits, it is hard to reduce sodium adequately. It can be done.
    I’m off medication after 15 years and thrilled. I learned how to identify where sodium is hiding in prepared foods. My blood pressure is 110 over 66 … every single day any time of day! I feel great. No more quarterly visits to my doc, no more prescription meds daily, no more medical costs…. all because I got the sodium out by looking carefully at all prepared foods.
    Good luck to everyone in what ever you try. I highly recommend the Pritikin program if you want to get off BP medications, improve your blood pressure, cholesterol, glucose and for the delightful weight loss and peace of mind that you will also achieve.

  14. Tom B.
    Reply

    I caught the show on Saturday May 23 and was extremely interested in the story about the fat soluble Vitamin B1 derivative that helped with both restless leg syndrome and with diabetic neuropathy issues.
    I could not remember the name of the vitamin B1 compound, but I THINK this is it:
    http://www.naturodoc.com/library/treatments/bloodsugar.htm
    Anyone remember if the name was indeed “Benfotiamine”?
    PEOPLE’S PHARMACY RESPONSE: YES, IT WAS BENFOTIAMINE.
    If anyone can confirm, I would GREATLY appreciate it.

  15. chey
    Reply

    I was the caller using pickle juice for cramps. I took Terry’s advice and found a Texas company online who sells pickle juice made for athletes. I order six each 16 oz bottles. Including S&H it was about $30.00 That amount will probably last me a lifetime! Thanks, Terry & Joe!

  16. Sandra LB
    Reply

    Please inform me of the name of the Vitamin B-1 derivative that was discussed by a physician who called in on the show and said he treats patients who have neuropathy with this derivative of B-1.
    PEOPLE’S PHARMACY RESPONSE: BENFOTIAMINE

  17. Susan
    Reply

    On today’s radio show, a doctor called in to talk about a home remedy for restless leg syndrome but I didn’t get a chance to write down his remedy. Could you send me this info?
    Thank you,
    Susan
    PEOPLE’S PHARMACY RESPONSE: HE SPOKE ABOUT BENFOTIAMINE.

  18. Mary S.
    Reply

    I would like more information concerning the possible relief of neuropathy pain in hands and feet, he mentioned a chemical but I didn’t understand it. I couldn’t tell if it started with a “b” or “d”. Please email me with the correct word. Thank you very much.
    PEOPLE’S PHARMACY RESPONSE: HE WAS TALKING ABOUT BENFOTIAMINE.

  19. Brian
    Reply

    Dear People’s Pharmacy,
    Today on your show a physician called with a remedy for restless legs and neuropathy. It was a fat soluble B1 derivative developed in Germany. Unfortunately, I did not catch what it was called. Could you please give the name? It sounds like something that may be of benefit for me.
    Thanks for your show,
    Brian
    PEOPLE’S PHARMACY RESPONSE: IT WAS BENFOTIAMINE

  20. W.Bagliani
    Reply

    This show was especially meaningful because of the two references to neuropathy. This problem and its tie to statins needs to be emphasized. I had mild problems and my older brother has severe problems. Please pursue this subject.

  21. JL
    Reply

    Well…I love salt, but it doesn’t love me. It’s made my fingers swell up for years, and I’ve been watching how much I eat about that long. I have had a couple spells of breathing difficulties associated with salt, and my father died of kidney failure. However, starting last year, I’ve been dealing with atrial fibrillation (EP study said too much heart area was involved for ablation to work, but the meds seem to be holding it). Should I insist on getting a kidney function study? (I live in a small town where the only way to get some tests is to stomp your foot and turn blue.) My most recent blood pressure (today) was 124/77 (though it used to be 105/65 all the time).
    Inquiring minds want to know about this salt thing (although I did add a supplement with iodine, since I used table salt about three times a year).

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