Neuropathy treatment, cause, alternative and natural therapy by Ray Sahelian, M.D.
October 15 2014

Neuropathy is a disease of the peripheral nervous system that leads to damage to the nerves. When it occurs in the nerves outside the central nervous system is called peripheral neuropathy.

There are many causes of peripheral neuropathy, including the following:

Diabetes - Some patients get relief of their diabetic neuropathy with the use of a natural pill called alpha lipoic acid or other natural supplements. There's been some research with lipoic acid and diabetic neuropathy.
Autoimmune diseases
Alcoholism can cause deficiencies in certain B vitamins.
Hereditary disorders
Infections
Inflammation
Protein abnormalities
Toxic chemicals
Nutritional deficiencies
Kidney failure
Medications especially those used to treat cancer and HIV/AIDS.
   BMC Cancer. 2012. Omega-3 fatty acids are protective against paclitaxel-induced peripheral neuropathy: a randomized double-blind placebo controlled trial.
   Statin drugs can induce myopathy and neuropathy.
   The FDA in 2013 is strengthening its warning that a popular class of antibiotics, called fluoroquinolones, may cause sudden, serious, and potentially permanent nerve damage.

Other causes
Besides diabetes, a neuropathy  may occur due to the following reasons: autoimmune and inflammatory, toxic, neuropathies associated with plasma cell dyscrasias, amyloidosis, and paraneoplastic neuropathies. In some cases, however, even with extensive evaluation, the cause of a person's neuropathy remains unknown this is called idiopathic neuropathy.

Do you have any supplements at all that you recommend or could use for a poly (peripheral) neuropathy condition? (Non-diabetic).
   It's difficult to say since there are many factors that can cause this condition and one has to determine the actual reason before knowing which approach to take. A balance exercise program can be of benefit.

J Ethnopharmacol. 2011. Olive leaf extract attenuates early diabetic neuropathic pain through prevention of high glucose-induced apoptosis: in vitro and in vivo studies.

Redox Biol. 2014 Jan 18. Oxidative stress and nerve damage: Role in chemotherapy induced peripheral neuropathy. Peripheral neuropathy is a severe dose limiting toxicity associated with cancer chemotherapy. Ever since it was identified, the clear pathological mechanisms underlying chemotherapy induced peripheral neuropathy (CIPN) remain sparse and considerable involvement of oxidative stress and neuroinflammation has been realized recently. Despite the empirical use of antioxidants in the therapy of CIPN, the oxidative stress mediated neuronal damage in peripheral neuropathy is still debatable. The current review focuses on nerve damage due to oxidative stress and mitochondrial dysfunction as key pathogenic mechanisms involved in CIPN. Oxidative stress as a central mediator of apoptosis, neuroinflammation, metabolic disturbances and bioenergetic failure in neurons has been highlighted in this review along with a summary of research on dietary antioxidants and other nutraceuticals which have undergone prospective controlled clinical trials in patients undergoing chemotherapy.

More common in men
Tall people, regardless of whether they have diabetes or not, are at increased risk for developing numbness in their feet or legs. The condition, known as peripheral insensate neuropathy, is often a result of nerve damage from diabetes, but it can have other causes. The association with height "largely accounts for the difference in peripheral insensate neuropathy prevalence between men and women," Dr. Yiling J. Cheng and colleagues write in the American Journal of Epidemiology. The findings are based on an analysis of data for more than 5000 people, 40 years of age or older, who participated in the 1999-2002 US National Health and Nutrition Examination Survey. Peripheral insensate neuropathy was defined as one or more areas on the foot where there was no feeling when tested with a light touch. Cheng, from the Centers for Disease Control and Prevention in Atlanta, and colleagues noted peripheral insensate neuropathy in 21 percent of subjects with diabetes, nearly double the 11 percent rate seen in non-diabetics. Men were 70 percent more likely to have the condition than were women, but the difference largely disappeared when height was taken into account.

Questions
I have been taking 200 mg of SAM-e twice daily for several months. I have found it to boost my energy level and diminishing my mild depression. I note you connect SAM-e with repair of myelin sheath of nerve endings which fascinates me. I have "idiopathic small fiber peripheral neuropathy" - all tests for usual causes of peripheral neuropathy negative. I am otherwise a fairly healthy 74-year-old male (ran the Comcast Marathon in 2002). I am experiencing progressive numbness, which started with tingling of the soles of both feet in year 2000. Now the tingling/numbness has progressed to encompass my entire body. Numb scalp, numb face, fingers, hands, forearms, feet, legs, thighs, buttocks. EMGs (three of them over three years) show little or no muscle degeneration, just mild degeneration of nerve endings (myelin sheath). Now if SAM-e builds myelin sheath, shouldn't my taking 400 mg daily (empty stomach am and pm) have had some effect at reversing the degeneration of myelin sheath and restoring feeling? Should I combine the SAM-e with B-complex vitamins and other supplements? Should I increase dosage of SAM-e? I have been tested regularly and the results always show no vitamin deficiencies over the past six years. I follow quasi-vegetarian diet, no dairy, very little sugar, no coffee, no alcohol, no smoking, no white starches, no junk food. Mainly fresh fruits and vegetables, nuts and beans, some salmon, sardines, catfish, and chicken breast (all baked or roasted, never fried). I am slightly overweight (199 pounds at 5 feet, 10 1/2 inches in height). I walk a lot daily, but have not been running regularly since 2002 because the long distance running seemed to have increased the numbness. MRIs (three of them) and many x-rays show no damage to spine, no central nerve problems. SAM-e has given me great energy, I have progressed from taking steps one at a time (due to unreliable knee joints) to running up the stairs without any pain. I am hoping SAM-e will rebuild my small fiber nerves and reverse the peripheral neuropathy.
   It's best to keep SAM-e dosage to a minimum since the effects can accumulate and lead to overstimulation and mania.

Q. My cousin is suffering from neuropathy in her right foot but doesn't have diabetes. Hers seems to be related to kidney transplant  issues. (transplant was several years back and she's 70 something) - Wondering if you think any natural products would help her?
   A. It's difficult to say since there is no exact diagnosis of this neuropathy.

Q. I have neuropathy caused by the drug Taxol. Would alpha lipoic acid benefit?
   A. We have not seen studies regarding the use of lipoic acid in Taxol induced neuropathy.

The use of alpha lipoic acid for nerve pain as a result of diabetic neuropathy, does this apply to nerve pain resulting from surgery. My wife had open heart bypass surgery and they harvested veins from the calf of one leg. Immediately after the surgery, she started having nerve pain from the knee to the foot in that leg. Doctors only seem to recommend various drugs such as Neurontin and she is highly allergic to every drug they have recommended.
   We have not seen research on neuropathy after surgery and lipoic acid.

I work in a health food supplement store and have so many people suffering from neuropathy associated with diabetes. These people suffer horribly and are looking for something that would help ease this pain. Are there any products that would help these people? They already understand that trying a product may or may not work, but they are willing to try anything to get relief from their neuropathy pain, even if it is just a little relief. Thanks for your time and your wonderful web-site!
    We will update this site as we come across more information on the natural treatment of neuropathy.

I saw a web site that suggested using alpha lipoic acid for peripheral neuropathy. It suggested that this supplement would help eliminate the need for Lyrica, a seizure medication which I have been taking for my peripheral neuropathy which was caused by statin medications. Looking at a web site, I noted they had two kinds listed, one R 50, form and another without the R. Could you please advise me on which one you believe would be the appropriate one. I was told that one is synthetic, and the other more natural. If there is anything more or different that you know is better for peripheral neuropathy I would be greatful if you would refer me to that. Lyrica made me sleepy, spacey, forgetful and has helped with the symptoms, but I have had to cut the dosage in half so I can participate better with daytime activities although now I must experience more discomfort at bedtime making falling asleep more difficult. I am also taking Cymbalta which I started initially as it does also help neuropathy and depression which I do have also. I needed something more and started on Lyrica. I tried to cut back on Cymbalta, but became to depressed and now take 60 mg daily. I now take 50mg Lyrica three times daily, and sometimes need an extra capsule during the night. Any assistance would be greatly appreciated. I am a 67 year old retired R.N., and had to quit working due to the neuropathy. I have fallen face down on concrete and limit my activities now.
    R lipoic acid is often the preferred form to use of this supplement.

For the last year I have had moderate to severe foot and leg pain, and have gone to every type doctor imaginable. I was finally diagnosed by a neurologist with peripheral neuropathy, and prescribed Neurontin. I was hesitant to take this drug, so I went to another neurologist at the University of Colorado Hospital for a second opinion. He noticed that I was taking a vitamin B supplement, thought I may be getting too much B6 and that that could be the cause of my pain. He had me tested for B6 levels. They were way above normal, so I stopped taking any B supplements. Within a few weeks of ceasing the B supplements almost all of the pain was gone, and my B6 levels had returned to normal. I don't know how common this is, but in my case I had been incorrectly led to believe that there were no side effects from large doses of B vitamins. The side effect for me was severe, and changed my life.