If you’ve ever had your leg, foot, arm, or hand fall asleep after sitting in an awkward position for too long, you’ve had a tiny glimpse at what people with peripheral neuropathy experience 24/7.
Patients have actually stopped their cancer treatments because they can’t take the neuropathy! There are so many different drugs being thrown at PN in an effort to find something— anything—that helps alleviate or control the pain.
This includes antidepressants, anticonvulsants, and opioids—expensive drugs that come with their own challenging side effects, such as dizziness and drowsiness. More than 70 Americans die per day—and more than 27,000 per year— from unintentional prescription drug overdose, so this is an epidemic problem! Anything that can be done to prevent or reduce the progression of this disease is welcome.
What is Peripheral Neuropathy?
Peripheral neuropathy (PN) is caused by injury or damage to the nerves and the blood vessels surrounding them, usually as a result of trauma, infection, diabetes, chemotherapy, and other drugs. Symptoms include aching, burning, itching, numbness, and pain, and they make something as mundane as buttoning a shirt or even walking around the block difficult (see “How Neuropathy Feels” for more symptoms). Those with diabetes are at especially high risk for neuropathies because high blood sugar levels damage the vessels and nerves.
More than 100 types of peripheral neuropathies have been identified, but physicians tend to focus on three general categories: motor, sensory, and autonomic. Motor nerves send commands from the brain to the muscles, and they manage movements that are under conscious control, like talking, walking, and grasping things. Sensory nerves transmit information about sensory experiences, such as a light touch or pain from a paper cut, from the periphery (outside your body) to the brain.
Autonomic nerves regulate all those things that you don’t consciously control, such as breathing, digesting food, and the pumping of your heart. Most people experience one or two types of neuropathies. Those with diabetes, however, can have all three types if it’s not aggressively controlled.
The most common form in those with type 1 and 2 diabetes is known as diabetic sensorimotor polyneuropathy. It occurs in 10 percent of people with diabetes within the first year of diagnosis and in up to 50 percent of patients after 25 years of living with the disease. Most treatments recommended here are for neuropathies related to sensory nerve tissue, especially diabetic peripheral neuropathy, but supplements that help with one type of neuropathy appear to help other types as well.
Peripheral Neuropathy Home Remedies
1. (tie) Alpha-lipoic acid (ALA) 600 milligrams a day in divided doses
Alpha-lipoic acid is involved with countless functions in every human cell. And ALA is the number one dietary supplement for peripheral neuropathy in terms of the amount of human research that’s been done on it. Part of the reason it has received so much attention is that it’s used as a prescription oral and IV drug in many parts of the world. There have been more than 15 randomized trials looking at the benefit of giving 300 to 600 milligrams of ALA per day for 2 to 4 weeks to patients with PN. It was found to improve nerve conduction and reduce neuropathic symptoms, and it has a great safety record. It is generally the only therapy that can both help prevent and treat PN, along with heart-healthy lifestyle changes and controlling blood sugars.
Patients in the clinical trials experienced reduced neuropathy within as little as 2 weeks, but you should stay on it for at least 2 months to give it a chance to build up and see if it’s working. Daily doses as high as 1,800 milligrams have been used, but that amount can rarely cause nausea, vomiting, headache, vertigo, and itching, and the 600-milligram daily dose seems just as effective.
ALA should be taken on an empty stomach (30 to 60 minutes before or 2 hours after a meal) for better absorption, and the dose can be divided if any side effects are experienced. (Warning: ALA can make your urine smell the same way it does after you eat asparagus; it’s harmless.) Many doctors will combine this supplement with other conventional drug treatments, but the vast majority of the research on ALA for neuropathy is as a monotherapy (by itself). The R-form of ALA appears to be better absorbed than the S-form, so look for a supplement that contains the R-form or at least racemic ALA (a 50/50 mix of R and S).
In humans, ALA is produced by the liver and several other tissues, and it can be obtained from plant and animal sources, such as organ meats. Spinach, broccoli, tomato, Brussels sprouts, garden peas, and rice bran are good sources of the R-form of ALA. Yet, the amount in our diets can never come close to the therapeutic levels that were tested and worked in clinical trials. Plus, as we age, our ability to produce ALA drops (similar to many other compounds in the body).
I don’t think people have heard enough (if anything) about ALA for the treatment of PN. I think we’ll be seeing exciting research about this supplement in the future.
1. (tie) Capsaicin cream (0.075 percent) applied up to four times a day
The active ingredient in chile peppers, capsaicin works by reducing levels of a compound in the body called substance P, which is released when there’s pain. Capsaicin pills are starting to be researched, but I have no faith that they’ll show any benefit for peripheral neuropathy anytime soon; they’re just too irritating for the GI tract. The topical cream is where the research is, and it’s especially effective for more superficial pain, like neuropathies.
The American Association of Neuromuscular and Electrodiagnostic Medicine, the American Academy of Neurology, and the American Academy of Physical Medicine and Rehabilitation all agree that capsaicin cream at 0.075 percent is probably effective and should be considered for treatment of diabetic peripheral neuropathy. Always apply it with gloves or a cotton swab, though; if you get capsaicin on your fingers and then into your eye, the burning sensation can be quite painful and potentially harmful. There’s also a new patch on the market, which makes application easy.
Higher concentrations (up to 8 percent) are going through clinical trials, but you have to obtain these through a prescription and they usually come in patch form (Qutenza). Side effects are generally minimal, but the prescription can cause a rapid change in blood pressure when it’s first applied (that is a lot of concentrated capsaicin, folks!). Keep in mind that capsaicin should not be combined with anything else that can heat the skin, such as a heating pad, because it can burn the skin.
I’m bullish on capsaicin because it provides quick (albeit temporary) relief for PN and can be combined with ALA. I recommend it for arthritis pain, too (many people experience both arthritis and PN).
2. B vitamins only as directed by your doctor
Vitamin B1 (thiamin) deficiency is a common cause of neuropathy in alcoholics and people who’ve had weight loss (bariatric) surgery, and recent research suggests people with diabetes may also lack B1 or other vitamins. An alternate form of B1 (a drug called benfotiamine) has been tested with some success at higher daily doses (25 to 100 milligrams), so there are some experts who believe supplements can be beneficial for people with low levels of vitamin B1. Low
levels of vitamin B6 and especially B12 have also been associated with neuropathies; these vitamins play a role in nerve health, function, and transmission.
Here’s what’s really important, though: Numerous common medications, such as metformin for diabetes and proton pump inhibitors for gastroesophageal reflux disease or ulcers, can reduce blood levels of some B vitamins, so these could be contributing to neuropathy in some people.
I have seen very little neuropathy-relieving benefit from any supplements beyond alpha-lipoic acid and capsaicin, but when it comes to B-vitamin deficiencies, it’s worth the blood test. It provides a quick answer and can save you tons of time and money wasted chasing down other causes. So, if nobody can explain why you’re experiencing neuropathy, ask for a B-vitamin blood panel.
What Are Useless For Treating Peripheral Neuropathy?
Experts have been recommending acetyl-L-carnitine for years for treating PN, but it actually made symptoms significantly worse in a major study of breast cancer patients taking it to reduce the risk of neuropathy from chemotherapy. While this study only looked at chemo, I believe the results suggest this supplement could make PN worse no matter what the cause, so I’d avoid it. Major medical “oops” here, folks!
High doses of vitamin B6
Some people take high doses of B6 (300 milligrams or more) to increase energy, reduce the risk of kidney stones, or simply get more B vitamins because they were told to. Although supplementing at certain doses may help PN, more is not better. Such high doses over several weeks to months can actually cause sensory neuropathy.
“Experts” often recommend large doses of vitamin E for PN because it’s supposed to absorb free radicals that can cause neuropathy. But at higher doses it can create free radicals, lead to toxicity, and perhaps block the effect of some conventional drugs to treat PN. I recommend it only in a few special cases in this article, such as for nonalcoholic fatty liver disease, age- related macular degeneration, and Alzheimer’s.
Other Natural Cures For Peripheral Neuropathy
Heart healthy = nerve healthy
My theory is that anything that reduces your risk of heart disease potentially reduces the risk or occurrence of peripheral neuropathy. This means keeping your cholesterol, blood pressure, and glucose levels within normal ranges, exercising, and avoiding smoking.
Be aware of your surroundings. Since PN can reduce mobility and the ability to sense pain, it is necessary to pay close attention to situations and objects that can be dangerous. Wear gloves and warm socks in the winter, use pot holders, have a family member test the water temperature, remove throw rugs, install a shower chair, and use handrails on stairs.
Try alternative therapies
There’s only a small amount of positive research regarding acupuncture and PN so far, but I think acupuncture is always promising for chronic pain, especially if it can reduce the amount of hard-core pain medication being taken.
A fairly large and well-done study found that magnetic shoe insoles with a strength of 450 G (Gauss) reduced burning, numbness, and tingling, as well as exercise-induced foot pain after 3 to 4 months.
It hasn’t been replicated, and so far minimal to no benefit has been seen for general pain from magnet therapy itself (or being exposed to pulsed electromagnetic fields for brief periods of time), so try it at your own risk. It may just be a great placebo, but who cares? I like anything that can stop the cycle of frequent, high-dose drug use for PN.
What Else to Know About Treating Peripheral Neuropathy?
Heavy metals—such as arsenic, mercury, and lead—in supplements can make neuropathies worse. These are found naturally in the earth, and they inevitably end up in supplements, especially if the manufacturer does not have good quality control and testing standards.
This is just another reason to do your research and know whom you’re buying from. Always look for an NSF, NPA, or USP label on the packaging, which indicates the product meets certain safety and quality standards. And if you’re taking a ton of supplements, be aware that you could be getting unnecessarily high doses of these toxic heavy metals.