Vitamin Deficiencies and Nerve Damage: What to Check (and Why)

johnhayesjr1
Sep 12
2 min read

One of the most overlooked, and reversible, causes of peripheral neuropathy is vitamin deficiency. While diabetes often dominates the conversation, nutrient depletion is responsible for a significant share of nerve dysfunction, especially in patients with chronic conditions, restrictive diets, or medication-induced malabsorption.

In your direct-pay or independent practice, you're not limited to basic labs and rushed visits. You can dig deeper and help patients who have been told “everything looks fine” finally understand what's going wrong.

The Top Nutrient Deficiencies Linked to Neuropathy

1. Vitamin B12

Vital for myelin sheath integrity and nerve repair
Commonly low in vegetarians, vegans, older adults, and patients on metformin or PPIs
Symptoms: numbness, tingling, weakness, cognitive changes
Labs: B12, methylmalonic acid (MMA), homocysteine

2. Vitamin B6 (Pyridoxine)

Both deficiency and toxicity can cause neuropathy
Found in energy drinks, multivitamins, and pre-workouts
Test serum B6 (pyridoxal phosphate) when symptoms don’t fit typical patterns

3. Vitamin D

Involved in nerve repair and immune modulation
Low levels linked to both pain and poor healing
Often overlooked in standard neuropathy workups

4. Folate (Vitamin B9)

Deficiency may impair methylation and increase homocysteine
Especially important in patients with MTHFR mutations or poor diet

Clinical Strategy in Private Practice

With more time and personalized care, you can:

Order functional labs that go beyond insurance minimums
Explore diet, supplement use, and gut health
Tailor protocols to replenish deficiencies without overcorrection
Integrate therapies like red light or infrared for nerve repair support

Patients often feel empowered when they learn that their pain is treatable, not just manageable, especially when previous doctors told them “it’s all in your head.”

Want to Bring Root-Cause Neuropathy Testing Into Your Practice?

Reach out for a Strategy Session with John Hayes Jr., MD and discover what protocols help physicians detect and correct nutrient-driven neuropathy before it becomes chronic and stand apart from system-based care.