Cannabis compounds may ease nerve pain

The People’s Pharmacy

Q: I have experienced neuropathy in my feet for many years. For almost as long, I have taken gabapentin, benfotiamine, vitamin B12 and alpha-lipoic acid daily.

I’ve quit drinking completely, and my A1C is around 6.7. I still have problems with burning or tingling in my feet when I go to sleep or wake up.

Capsaicin cream has helped, but here’s what really works: creams that are 1-to-1 THC-CBD. No, you do not get high.

A: Thank you for sharing your experience. High-dose topical capsaicin (8%) appears to be well-tolerated and helpful for easing diabetic neuropathy symptoms (Expert Review of Neurotherapeutics, March 2021).

Scientists have not run many good clinical trials on the cannabis-containing creams you describe. We found one small study in which CBD oil applied topically eased pain due to peripheral neuropathy (Current Pharmaceutical Biotechnology, 2020).

Controlling blood sugar and HbA1c (a measure of blood sugar control over several weeks) is the first step in preventing diabetic neuropathy. Giving up alcohol consumption is also likely to help.

Q: About 15 years ago, I saw an orthopedic surgeon about pain in my left knee. He said the cartilage was worn and offered no solution except to avoid stairs and certain pieces of equipment at the gym.

About that time, I read in The People’s Pharmacy about glucosamine sulfate and thought, “That can’t hurt.” I started taking 500 milligrams twice a day. Within two weeks, the pain was gone and has been gone ever since. I highly recommend at least trying it.

A: Thank you for your recommendation. A review of 18 randomized controlled trials shows that glucosamine sulfate is better than placebo for alleviating knee pain due to osteoarthritis (Clinical Rheumatology, September 2018). Many other readers agree that this approach can be helpful.

People who prefer nondrug options for treating their joint pain may be interested in our eGuide to Alternatives for Arthritis. This online resource may be found under the Health eGuides tab at PeoplesPharmacy.com.

Q: I wish you would write about elderberry. Sambucus nigra (elderberry) extract has helped me recover from the flu many times, and I have taken it for over a decade.

When I recently had bronchitis and found it difficult to breathe, I took a teaspoon of elderberry extract mixed in warm water and found that I was able to breathe better within an hour. I take it once or twice a day when I have a cold, flu or bronchitis, and it works well and fast. Since it is a berry, I feel comfortable taking it and prefer the extract instead of other forms.

A: Elderberry shrubs grow in many parts of the northern hemisphere. Both Sambucus nigra in Europe and Sambucus canadensis in North America have long traditions as healing herbs.

Charlemagne is said to have encouraged the planting of elderberry bushes so that its healthful properties would be widely available. At the time, folk healers used it to promote digestive health, help ward off colds and flu and support resilience during the winter months.

Modern scientists have studied black elderberry and found that it contains numerous polyphenols and terpenoids. At least some of these compounds may be responsible for its antimicrobial (including antiviral) activity, benefits for the cardiovascular system and ability to fight inflammation (Journal of Agricultural and Food Chemistry, April 13, 2022).