NeuroMend BIO

NeuroMend BIO is specially designed to support the function of the
microvasculature and the health of peripheral nerves. Bioactive B vitamins,
provided in clinically proven levels, influence homocysteine metabolism and
oxidative stress to positively impact the production of nitric oxide (NO) and
support healthy endothelial function. All of these factors play vital roles in
supporting the flow of blood and oxygen to peripheral nerves.
The underlying pathology of peripheral neuropathy involves a complex
interaction between vascular (eg, NO) and metabolic factors (eg, hyperglycemia, hyperhomocysteinemia) that converge on nerves and the endothelium of the peripheral microvasculature. In addition, increased oxidative stress is a unifying factor seen in the etiologic pathways. 
Patients suffering from peripheral neuropathy can present with loss of
protective sensation, neuropathic pain, and, in some cases, lower extremity
ulcerations.
NeuroMend BIO combats oxidative stress and supports blood flow by promoting
healthy endothelial function and facilitating the production of NO—a potent
vasodilator naturally synthesized in the body. Nitric oxide is required in blood
vessels to relax smooth muscle cells. Relaxation of vascular smooth muscle
allows blood vessels to expand and blood to flow freely. Healthy blood flow
in the microvasculature facilitates the delivery of essential nutrients and
oxygen to the peripheral nerves, allowing them to perform normal functions.

NeuroMend BIO is an orally administered medical food* for use only under the supervision of a physician for patients with metabolic nutritional impairments associated with peripheral neuropathy and microvascular complications. 

RECOMMENDED DOSE Take one capsule twice daily with or without food, or as directed by your physician.

STORAGE Store at 20° to 25°C (68° to 77°F).

WARNING For use under supervision of a physician. Keep this and all medications out of the reach of children.

INGREDIENTS Alpha-lipoic acid, capsule (hypromellose, sodium copper chlorophyllin, and water), pyridoxal 5’-phosphate, vegetable stearic acid, vegetable magnesium stearate, silica, (6S)-5-methyltetrahydrofolic acid glucosamine salt,^S1 microcrystalline cellulose, and methylcobalamin.

*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.

FOR A DEEPER DIVE...

5-Methyltetrahydrofolate (5-MTHF)
5-MTHF is the primary biologically active isomer of folate. Unlike
supplementary folic acid, which requires enzymatic reduction by the
methylenetetrahydrofolate reductase enzyme (MTHFR) to become
biologically active, 5-MTHF is able to penetrate cellular membranes
without being metabolized. This is important because a segment of the
population is unable to effectively convert folate to 5-MTHF due to a genetic
polymorphism.
Therapeutically, 5-MTHF is used to reduce homocysteine levels and improve
vascular endothelial function through its influence on NO. Clinical studies
have shown that direct supplementation with 5-MTHF reduces homocysteine
levels and increases plasma folate levels more effectively than folic acid.
Folic acid supplementation alone has not been shown to reduce intracellular
homocysteine. Inborn genetic variations (polymorphisms) in the MTHFR
gene are the most common genetic causes for elevated homocysteine levels.
Furthermore, research has shown racemic 5-MTHF to be 7 times more
bioavailable than folic acid. In other research, (6S)-5-MTHF was more
effective than folic acid in increasing total plasma folate concentrations in
subjects with the TT and CC genotype of the 677C→T mutation of MTHFR.
5-MTHF has beneficial effects on endothelial function and vascular
superoxide production because it prevents peroxynitrite-mediated oxidation
of tetrahydrobiopterin (BH4) and improves endothelial NO synthase (eNOS)
coupling. Reduced levels of tetrahydrofolate contribute to uncoupling,
and uncoupling turns NO synthase into a superoxide radical-producing
enzyme. The effect of local, intra-arterial administration of 5-MTHF on the
forearm blood flow of 23 patients was studied. Significant NO-mediated
vasodilation was observed, with the M:C% improving from 53 ± 30 M:C%
without 5-MTHF to 88 ± 59 M:C% with 5-MTHF, P < .05. This suggests that
5-MTHF can be used to improve NO status and support healthy endothelial
function. Folate/5-MTHF has been found to exert direct antioxidative
effects—against superoxide and peroxynitrite, for instance—and contribute
to the restoration of impaired NO metabolism.

Quatrefolic®
In NeuroMend BIO, 5-MTHF is provided as Quatrefolic, the glucosamine salt of
5-MTHF. Quatrefolic is a dietary ingredient that shows enhanced stability
and bioavailability when compared with the calcium salt form of 5-MTHF.
In a direct comparison between Quatrefolic, (6S)-5-MTHF calcium salt (CaL-5-MTHF) and folic acid in rats, Quatrefolic demonstrated a much higher
absorption rate within the first 2 hours (1918.8, 1061.9, and 614.0 nmol/L
plasma, respectively). In a single-dose, balanced, 2-sequence, 2-period,
2-treatment, randomized, crossover human study, Quatrefolic showed better
bioavailability (+10%) than Ca-L-5-MTHF.

Vitamins B6 and B12
These B vitamins are provided in their activated forms—B6 as pyridoxal
5’-phosphate (P5P) and B12 as methylcobalamin—for optimal
bioavailability. They are required for the synthesis of nerve-signaling
molecules (amines) and for the facilitation of the body’s normal nerve repair
mechanisms, including the production of the myelin sheath—the lipidenriched membrane that insulates and protects nerve fibers and enhances
nerve impulse conduction. B6 and B12 are commonly used in combination
with folate to support healthy homocysteine metabolism. Both animal
and human studies have demonstrated an inverse correlation between
homocysteine levels and endothelial function, perhaps through impairment
of vasodilation mediated by endothelium-derived NO.
P5P-dependent enzymes are involved in many biochemical reactions, including the transsulfuration of homocysteine and decarboxylation of amino acids that yield biogenic amines (neurotransmitters). Research suggests that P5P may inhibit the formation of advanced glycation end products and has a protective effect under homocysteine-induced oxidative stress.
Methylcobalamin is provided as MecobalActive™, a highly pure form of patented methylcobalamin that does not use any harmful solvents in manufacturing. Methylcobalamin’s neuroprotective effects may be mediated by the methylation cycle. The combination of supplemental folate and vitamin B12 has been shown to reduce homocysteine more than folic acid alone. Clinical trials suggest the combination of 5-MTHF, P5P, and methylcobalamin can reduce symptoms of neuropathy. Furthermore,
research has demonstrated that B12 acts as an efficient intracellular superoxide scavenger and improves glutathione redox status.