Just recently I had the opportunity to consult with a patient by the name of Andrea who was suffering with carpal tunnel syndrome. Andrea was a 47 year women who was employed as an executive secretary for a Fortune 500 company. Her job responsibilities included typing business documents, scheduling telephone meetings and pretty much everything that is associated with this type of position. Andrea mentioned during our first consult that the tingling and numbness in her fingers and hand, especially her thumb and index, middle and ring fingers was getting so bad that she was afraid she might lose her job. The condition was at a point that she consistently needed to “shake out” her hands after 15 minutes of typing on the computer. She was nervous and worried.
She did her due diligence and did go see an orthopedic hand specialist who initially recommended a nonsteroidal anti-inflammatory drug, corticosteroids and a carpal tunnel splint (also commonly called cock-up splint). Unfortunately, the treatment failed to produce any long-term relief. I confirmed the diagnosis with orthopedic tests called phalen’s and tinel’s tests. I need to mention that review of her past medical records showed a positive nerve conduction test.
My initial treatment consisted of biomechanical and myofascial treatments. Adjustments of her cervical spine, wrist (carpals) , radius and ulnar followed with myofascial release and ultrasound did provide some relief but it was short lived. Worried that she would need to settle for a surgical release to help with her carpal tunnel syndrome, I recommended a simple supplement that proved to solve the case and return Andrea back to a normal functional life. This simple nutrient was B6.
I prescribed the more biological active form called pyridoxal 5′-phosphate. Surgeon Dr. John Ellis wrote extensively about how vitamin B6 cleared the majority of carpal tunnel syndromes, and other clinicians confirmed this. The normal dose of pyridoxal 5′-phosphate for carpal tunnel syndrome is Vitamin B6 50 mg 3 times day for just a month or two to reverse the condition. If you don’t see results consider the fact that B6 requires adequate levels of zinc. Zinc deficiency inhibits conversion of B6 into its active form. B6 is useless until the zinc deficiency is corrected. There is an inexpensive simple test that can be performed in our office to test if you are ZINC DEFICIENT. Going downstream in the functional medicine thinking, it also important to remember to check for low alkaline phosphatase (<70). Levels below 70 is commonly correlated with a zinc deficiency.
I also want to mention that plasticizers or phthalates create hidden zinc deficiencies which in turn could impact the usability of B6. An even more common reason for failure of simple and previously effective therapies is the high level of hidden heavy metals that everyone carries. Mercury, arsenic, lead, cadmium, and aluminum are some of the most common heavy metals that are in all of us. They sit right in enzymes, kicking out the minerals that are required for normal function. It’s not until we have stockpiled enough that we then get symptoms in a place that never bothered us before, like the wrist (carpal tunnel syndrome).
So the take away from today’s article is put your functional medicine hat on when working with patients suffering with carpal tunnel syndrome and consider a trial of the pyridoxal 5′-phosphate. If you are not seeing results after one month, please don’t throw the towel in. Consider a zinc deficiency, plasticizers or phthalates accumulation and heavy metal toxicities.
Folkers K, et al, Biochemical evidence for a deficiency of vitamin B6 in the carpal tunnel syndrome based on a cross-over clinical study, Proc Nat Acad Sci USA 75: 3410-12, 1978
Ellis JM, et al, Response of vitamin B6 deficiency and the carpal tunnel syndrome to pyridoxine, Proc Nat Acad Sci USA 79: 7494-98, 1982
Analysts J. M., Treatment of carpal tunnel syndrome with vitamin B6, South Med J , 80:882-84, 1987
Ellis JM, et al, Clinical aspects of treatment of carpal tunnel syndrome with vitamin B6, Ann New York Acad Sci, 585:302-20, 1990
The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Sandoz and his functional medicine community. Dr. Sandoz encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional.