Laser treatments for nerve damage are not likely to be ‘cost effective’

Dr. Keith Roach

Question: Due to diabetes and radiation treatments for prostate cancer, I have nerve damage to both feet. I was on was Lyrica, and I had to switch to gabapentin 300 mg because of the cost of Lyrica: It was approximately $1,000 for a threemonth supply. I also take Metanx. I would like your input on laser treatments for my nerve damage and on my continuing to take Metanx. — R.E.

Answer: Metanx is a prescription food approved by the Food and Drug Administration. It contains 3 mg of L-methyl folate calcium (an active form of folic acid), and vitamins B-6 and B-12. According to the clinical data, Metanx shows a significant but small improvement in pain and quality-of-life scores. The side effects reported are small. I would not expect many side effects, given the ingredients.

Laser treatment for diabetic neuropathy is the subject of many stud- ies, the results of which are mixed. A 2011 review described laser therapy as “probably not effective.”

It’s not clear to me whether your neuropathy is due to the diabetes, the radiation or a combination. Most of the scientific data pertains to diabetic neuropathy.

Given your reasonable concern about cost, I would say laser treatments are unlikely to be cost-effective, and would recommend continuing Metanx only if it is clearly helping.