02/07/2019    Paul Clint Jones, DPM

Recommendations for Raynaud's Disease (Chris Albritton, DPM)

I would like to extend kudos to Dr. Albritton.
That was very well outlined and clear as to the
standard of care of treatment for Raynaud’s.
Raynaud’s is undoubtedly difficult to get
consistent results. I commend you. I would like
to point out that this outline clarifies that
these drugs are off-label use and have the common
side effect of orthostatic hypotension. In my
experience, it’s also, difficult to convince an
otherwise healthy patient of any age, to begin
taking an anti-hypertensive drug.

That being said, I would like to share a trick I
stumbled upon in northern Idaho, while treating
diabetic miners with peripheral neuropathy. Like
most doctors, I’ve always tried to begin with the
most benign therapy before employing therapy with
higher risks, i.e. conservative care before
surgery.

Metanx( Metafolin L-Methylfolate Ca , B6, B12) is
a popular treatment for Diabetic Neuropathy.
It’s not a perfect therapy, but certainly holds
it place as a quality treatment of diabetic
neuropathy with minimal risk to the patient. As
my diabetics started using the Metafolin,
several with Raynaud’s, noticed improvement in
their Raynaud’s symptoms. Their Raynaud’s
responded surprisingly fast,without side-effects.

As I looked into it further, Metafolin, as an
activated form of Folic Acid, has no limitation
in the patient age group it could be used on. I
have used it on patients as young as 10 years
old. Worked nicely. Also, for those patients
that are seasonally effected, there was no issues
with starting and stopping its use on an as
needed basis. I don’t know when was the last
time I could do that with a “medication.”
Obviously, there are contraindications for its
its use. It should not be used with patients with
known allergies to its ingredients, history of
seizures, or cancer.

As a primary therapy for Raynaud’s, I first
started with once-daily, Mentanx. Then, as I
refined its use, I switched to its sister
medication Deplin. Deplin is labeled as an
antidepressant, but only contains the active
ingredient, Metafolin. The cost is the same as
Metanx, but it has a higher dose of Metafolin. I
will also, supplement the patient with vitamin
B12 to prevent a secondary development of
pernicious anemia. I must reiterate, this is
simply Methylated Folate, the activated form of
folic acid. And yes, I have seen a negative
difference in using regular Folic Acid or
supposed generics.

In my experience, Metafolin has been as a benign
an approach one can take in treating Raynaud’s
symptoms with surprisingly good results. I would
be interested to hear back about the results
others may be having.

Metafolin is the trade-name for the unique
Metafolin L-Methylfolate Ca formulation found in
Metanx & Deplin and it is patented by Merck
Germany. Because it’s a medical food it is
manufactured under FDA guidelines compared to
other over-the-counter supplements.

Paul Clint Jones, DPM

Disclosure: I have no financial connections with
Metanx, Deplin or their manufacture, Alfasigma
USA, Inc.

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