Neuropathy treatment, cause, alternative and natural therapy, home remedy, complementary medicine, herbs, vitamins, supplements
November 1 2018 by
Ray Sahelian, M.D.

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.
   Med Sci Monit Basic Res. 2015. Effects of thai foot massage on balance performance in diabetic patients with peripheral neuropathy: a randomized parallel-controlled trial. The results of this study suggest that Thai foot massage is a viable alternative treatment for balance performance, ROM of the foot, and the foot sensation in diabetic patients with peripheral neuropathy.
Autoimmune diseases
Alcoholism can cause deficiencies in certain B vitamins.
Celiac disease, gluten allergy - People with the digestive disorder celiac disease are at increased risk for nerve damage, medically known as neuropathy. JAMA Neurology, news release, May 11, 2015
Hereditary disorders
Infections from bacteria, viruses, fungi.
Protein abnormalities
Toxic chemicals
Nutritional deficiencies
Kidney failure
Medications especially those used to treat cancer and HIV/AIDS. Chemotherapy medications can induce peripheral neuropathy.
   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.

Acetyl-l carnitine
Curr Pain Headache Rep. 2015. Emerging Treatments for Neuropathic Pain. Due to the better understanding of the pathophysiology of neuropathic pain, previously unexplored therapies have been used with encouraging results. As such, Acetyl-L-carnitine (ALC), Alpha-lipoic-acid (ALA), cannabinoids, Clonidine, EMA401, Botulinum Toxin type A, and new voltage-gated sodium channel blockers, can be cited. Furthermore, new modalities in neuromodulation such as high-frequency spinal cord stimulation, burst stimulation, dorsal root ganglion stimulation, transcranial direct current stimulation, and many others have been showing exciting results.

PLoS One. 2015. Acetyl-L-carnitine in the treatment of peripheral neuropathic pain: a systematic review and meta-analysis of randomized controlled trials. Acetyl-L-carnitine (ALC), a constructive molecule in fatty acid metabolism, is an agent potentially effective for treating peripheral neuropathic pain (PNP). The current evidence suggests that ALC has a moderate effect in reducing pain measured on VAS in PNP patients with acceptable safety.

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.

Pharm Biol. 2015. Effect of curcumin in mice model of vincristine-induced neuropathy. Curcumin at 30 and 60 mg/kg dose levels significantly attenuated vincristine-induced neuropathy which may be due to its multiple actions including antinociceptive, calcium inhibitory, and antioxidant effect.

Marijuana for pain relief
Marijuana is slightly effective at reducing this chronic nerve pain.

Chemotherapy induced peripheral neuropathy
Crit Rev Oncol Hematol. 2016. Natural products and complementary therapies for chemotherapy-induced peripheral neuropathy: A systematic review. Chemotherapy-induced peripheral neuropathy (CIPN) is a serious dose-limiting side-effect without any FDA-approved treatment option. Prior reviews focus mostly on pharmacological interventions, but nonpharmaceutical interventions have also been evaluated. A Web of Science and PubMed database search to identify relevant studies included the terms: CIPN, cancer; and supplements, vitamin E, goshajinkigan, kampo, acetyl-L-carnitine, carnitine, alpha-lipoic acid, omega-3, glutamine, or glutamate; or massage, acupuncture, mind-body practice, yoga, meditation, Tai-Chi, physical activity, or exercise. Vitamin E may help prevent CIPN. L-Glutamine, goshajinkigan, and omega-3 are also promising. Acetyl-L-carnitine may worsen CIPN and alpha-lipoic acid activity is unknown. Electroacupuncture was not superior to placebo. No studies were published regarding other complementary therapies, although some studies mention positive incidental findings. Natural products and complementary therapies deserve further investigation, given the lack of effective interventions.

Medications that cause
Ned Tijdschr Geneeskd. 2017. Relapse of chronic inflammatory demyelinating polyneuropathy following treatment with zoledronic acid. Caution is warranted when using nitrogen-containing bisphosphonates such as zoledronic acid, particularly in patients with known neuromuscular disorders.

Progesterone and hormones
Caution is advised using hormones as a form of treatment. Use low doses since hormone treatment has a lot of side effects.

Neuroscience. 2014. Effects of progesterone on neuropathic pain responses in an experimental animal model for peripheral neuropathy in the rat: a behavioral and electrophysiological study. Progesterone is promising as an important protective agent against various injuries to the nervous system. Our study suggests that progeswterone may offer new strategies for the treatment of neuropathic pain.

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.

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.

I have been diagnosed with Small Fiber Neuropathy of unknown origin. I am NOT a diabetic, nor do I have any indicators of why I have this disease. Ive had several MRI and many blood tests. All are normal. Do you think Alpha Lipoid Acid will work with non-diabetic small fiber neuropathy? All the literature Ive read shows in may be used for diabetic neuropathy. If you do think it may well benefit fit, can you tell me what amount should I start with and build up to, and do I need to take with any other supplement? I understand Aceyt l-carnitine might be one, as are B vitamins. My B vitamins in blood tests were all normal.
   A. I have not seen studies regarding the role of ALA in small fiber neuropathy, therefore I do not know if this supplement could be of benefit. If your doctor approves you could begin with 10 to 50 mg of R lipoic acid in the morning for a few weeks. If not effective then try acetyl-l-carnitine 100 to 500 mg for a few weeks. I am not aware of such studies therefore it may be trial and error to find a potential solution.

Q. I have had small fiber neuropathy and monoclonal gammopathy blood abnormality for 16 months now and finally a neurologist made it clear to me what I am dealing with. My GP told me that I will develop leukemia at some point. I have read so much and don't know how to make sense of it all. I am being tested every 6 months by an oncologist. This is the scariest thing I have ever faced and am basically preparing myself for the worst. I have had fibromyalgia for 27 years and this goes way beyond anything I have ever dealt with. Any suggestions for treatment to prevent leukemia from developing? The oncologist offers nothing.
   A. I do have an article on leukemia natural prevention that you may wish to review with your doctor.