In this issue of the Journal, Fonseca et al report on the effects of Metanx (Pamlab LLC, Covington, La), a nutritional food comprised of methylcobalamin (2 mg), L-methylfolate (3 mg), and pyridoxal 5 phosphate (35 mg) (LMF-MC-PLP), given daily in a 24-week, double-blind, placebo-controlled, multisite study to 24 individuals with established diabetic peripheral neuropathy.The primary end point of the study was vibration perception threshold, which failed to achieve significance. However, the Neuropathy Total Symptom Score-6 (NTSS-6),2 which is a composite quantification of numbness, tingling, and aching, burning, or lancinating pain; and allodynia improved significantly at week 16 (P = .013 vs placebo) and week 24 (P = .033). Moreover, there were significant improvements in the Mental Health component of the Short Form (36) Health Survey, which includes Happiness (feelings of peace, happiness and calm all of the time), Role Emotional (no problems with work or other daily activities), Social Function (performing normal social activities without interference due to physical or emotional problems), and Vitality (feeling full of pep and energy all of the time).
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