Vitamin B12 can play a crucial role against chronic pelvic pain. This disorder is complex and multifactorial, possibly originating from gynecologic, urologic, or gastrointestinal problems. However, increasingly its neurological nature is being recognized, (as occurs in neuropatia del pudendo or vulvodinia with a strong neuropathic component). Here then is the term neuropathic pain. It is in these conditions of nerve distress that Vitamin B12, often joined by other B vitamins, is considered to support nerve fiber health.
Vitamin B12 for pelvic pain: how it works
Vitamin B12, or cobalamin, is a water-soluble vitamin essential for many vital functions: it plays a crucial role in DNA synthesis, red blood cell formation, and maintaining the integrity of the nervous system. Its importance to neurological health has made it an item of interest in the treatment of various forms of pain, particularly that of a neuropathic nature, which can also occur in the pelvic region. Its administration in pelvic pain is motivated by its mechanisms:
- maintenance of myelin, the protective sheath that lines nerve fibers: B12 ensures proper transmission of nerve impulses, reducing the irritation and abnormal sensitivity typical of neuropathic pain;
- nerve repair: vitamin B12 is involved in the regeneration processes of damaged nerves, and its supplementation can support repair mechanisms;
- anti-inflammatory and antinociceptive action: studies indicate that B12 may modulate pain perception by acting on neurotransmitters such as serotonin and norepinephrine, which are involved in pain inhibition mechanisms, and appears to exert an anti-inflammatory effect by reducing the synthesis of pro-inflammatory mediators;
- deficiency correction: in some individuals with chronic pain, a (often latent) B12 deficiency can amplify pain perception.
Specialist’s comment
“Vitamin B12 administration in cases of pelvic pain of neuropathic origin may make sense only in cases of manifest deficiency and in the form of oral supplementation, with oral or sublingual formulations,” comments Valentina Pecorari, a urologist specializing in pelvic floor health, vulvodinia and incontinence.“In fact, vitamin B12 deficiency has often been noted in patients with neuropathy-associated diseases such as diabetes, alcoholism, Parkinson’s disease, or HIV.
This deficiency could be a modifiable risk factor for neuropathy in these individuals. The improvement of neuropathy after treatment suggests that treatment of nutritional deficiencies should be part of integrative management of neuropathy in general. From this, the possible role in vulvar neuropathy has also been extrapolated, but there are no indexed articles supporting its use.”
Vitamin B12 for pelvic pain: what the guidelines say
Vitamin B12 supplementation is currently included in multidisciplinary treatment protocols for vulvodinia and neuropatia del pudendo, as suggested by many specialists in the field of pelviperineology and gynecology, often in synergy with other substances such as alpha-lipoic acid and Palmitoylethanolamide (PEA).
“The protective role of substances such as lipoic acid is proven,” Pecorari points out. “It increases glutathione, an endogenous antioxidant involved in antioxidant defense, nutrient metabolism, and regulation of cellular events and is a major cause of oxidative stress, which is involved in neuropathy. The effect of lipoic acid in vulvodinia has been documented in indexed studies. PEA, on the other hand, is a molecule with important anti-inflammatory and analgesic properties and should be considered as a real drug rather than a supplement.”
Not just supplements
In some cases of localized vulvodinia, vitamin B12 properties can also be exploited in the form of local preparations (creams, gels, ova), although this route is less supported by clinical studies than systemic, and is often complementary. The goal is to make the active ingredient act directly on the overactive and inflamed nerve endings of the vulvar mucosa. Also in these cases, vitamin B12 is combined with other substances such asalpha-lipoic acid.