Nutritional deficiencies in scleroderma and related disorders often include folate and Vit. B12, and as more recently reported, Vit. D and E, due to bacterial overgrowth in the gut. Metanx is sometimes prescribed for these conditions. Metanx is a food which is formulated to be consumed or administered by mouth under the supervision of a physician and which is intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements, based on recognized scientific principles, are established by medical evaluation. Specifically it is formulated for diabetic neuropathy. The usual adult dosage of Metanx® is one tablet twice daily .Each Metanx® tablet contains: L-methylfolate Calcium (as Metafolin®) 3mg, Pyridoxal 5′-phosphate 35mg, Methylcobalamin.
Metanx is a “legend vitamin”. Legend vitamins are specific formulations that are intended to reverse nutritional deficiencies in various conditions. Metanx® tablets are indicated for the distinct nutritional requirements of patients with who present with loss of protective sensation and neuropathic pain in their arms and legs associated with diabetic peripheral neuropathy. Metanx® tablets are indicated for the distinct nutritional requirements of patients with endothelial dysfuction and/or hyperhomocysteinemia who present with lower extremity ulceration(s).
Fiori G, Fiori G, Galluccio F, Braschi F, Amanzi L, Miniati I, Conforti ML, Del Rosso A, Generini S, Candelieri A, Magonio A, Goretti R, Rasero L. “Vitamin E gel reduces time of healing of digital ulcers in systemic sclerosis.” Clin Exp Rheumatol. 2009 27(3 Suppl 54):51-4.
Vacca A, Cormier C, Piras M, Mathieu A, Kahan A, Allanore Y. “Vitamin D deficiency and insufficiency in 2 independent cohorts of patients with systemic sclerosis.” J Rheumatol. 2009 36(9):1924-9.
Scleroderma: From Pathogenesis to Comprehensive Management By John Varga, Christopher P. Denton, Fredrick M. Wigley, Springer 2011
U.-F. Haustein, MD Systemic sclerosis – scleroderma Dermatology Online Journal 8(1): 3