Nerve Pain, Peripheral Neuropathy Support

Linda J. Dobberstein, Chiropractor, Board Certified in Clinical Nutrition

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Nerve Pain, Peripheral Neuropathy Support
Pins and needles, burning, sharp, shooting nerve pain is often debilitating, challenging to manage, and chronic. Numerous causes exist for nerve pain or neuropathy ranging from sciatica, carpal tunnel syndrome, shingles, diabetes, cancer treatment, nutritional deficiencies, trigeminal neuralgia, nerve compression and scar tissue injury, gluten intolerance, and autoimmune disorders.

Anti-seizure medications like Lyrica and Neurotin, antidepressants, or major narcotics are the most frequently prescribed drugs for neuropathic pain. These toxic drugs can be mind-numbing, addictive, or simply provide little relief from the unrelenting nerve pain. Medications often fail to address the underlying mechanisms of the nerve injury, but rather apply a symptomatic band-aid. As the focus for cost-effective health care looks more at evidence-based medicine, research shows that nutritional support plays very key roles in preventing and protecting nerves from injury and neuropathy.

[Jump to: Nutritional Options]

Fundamental Nutrients

When it comes to keeping nerves healthy from inflammatory injury and neuropathy, several nutrients fit the job description, each playing a vital role in their own way. A recent study written by pharmacologists and a medical doctor cited several well-known nutrients fundamental to neuropathy management. It is welcoming to see traditional practitioners look outside the failing medical paradigm in order to help the patient with disabling neuropathy.

These well-known nutrients for neuropathy include acetyl-l-carnitine, lipoic acid, B vitamins (B1 (thiamine), B6 (pyridoxal 5 phosphate), B12 (methylcobalamin), and folate), GLA (good omega 6 oil), magnesium, and capsaicin, the ingredient found in hot peppers. There are several other nutrients studied for nerve support and peripheral neuropathy. These include glutathione, N-acetyl-cysteine, biotin, zinc, chromium, curcumin, quercetin, grape seed extract, calcium AEP, niacin and more. Here are some key nutrients for protecting nerves from injury that induces chronic nerve pain.


Acetyl-L-Carnitine (ALC) has been heavily studied for a nerve pain concerns. This is in addition to its well-known benefits for brain health including improving memory and cognitive skills, and protecting the proteins in the brain to prevent Alzheimer’s disease and dementia.

ALC works by helping to make acetylcholine which is essential for the myelin fat sheath around nerves. It also works for memory support as acetylcholine is the main neurotransmitter for memory. Without adequate acetylcholine or if there are methylation defects affecting choline function, nerves are left exposed with challenged repair mechanisms. The risk for neuropathy increases as a result. This was recently identified in individuals with Postural Orthostatic Tachycardia Syndrome (POTS), fibromyalgia, and multiple sclerosis.

Neuropathy not only affects the nerves in the arms and legs, but it also affects the heart as autonomic neuropathy. Autonomic neuropathy is common in diabetics and may be seen as trouble with heart rate, temperature regulation, blood pressure, and blood sugar. One of the main nutrients for protecting autonomic neuropathy and unhealthy heart rate variability is choline. Acetyl-L-Carnitine helps make choline and offers great benefits for stabilization.

ALC can counteract drug-induced mitochondrial damage that affects nerves by its antioxidant effects, improving cellular energy metabolism, or enhancing the response to nerve growth factor. All of these mechanisms must be protected to keep nerves healthy. Common ALC doses for nerve pain and neuropathy support ranges from 1,500 to 3,000 mg per day and is generally very well tolerated. It is a well-researched and excellent primary nutrient for nerve support.

R-Alpha Lipoic Acid

Lipoic acid is among the best well-researched nutrients for peripheral neuropathy and has been used for decades as a natural treatment choice. It is fat and water soluble antioxidant able to regenerate other antioxidants. This mechanism makes it incredibly valuable for protecting and preventing nerve injury, especially diabetic neuropathy. Numerous studies demonstrate substantial improvement in overall nerve pain symptoms including lancinating and burning pain, numbness, and tingling. Lipoic acid 8 has been shown to reduce lipid peroxidation. This severely damaging oxidative stress to delicate nerve tissues is commonly induced by excess blood sugar. Lipoic acid protects against the excess blood sugar that causes nerve injury and stiffness in tissues like capillaries.

Lipoic acid dosage for diabetic neuropathy or other types of neuropathy ranges from 300 to 600 mg per day in divided doses. This dosage primarily reflects the use of plain alpha lipoic acid. However, R-alpha lipoic acid is the most active form of lipoic acid and the natural form. Plain alpha lipoic acid is only 50 percent active. This means that the dose of R-alpha lipoic acid packs twice as much of a therapeutic punch than plain alpha lipoic acid.

Critical B Vitamins

Neuropathy support should always include the essential B vitamins, especially vitamin B1 (thiamin), B6 (pyridoxal 5’-phosphate), B12 (methylcobalamin), folic acid as the bioactive folate, and biotin. 10 Deficiencies in any one of these nutrients can easily lead to nerve pain, numbness, tingling, and chronic neuropathy. Diabetics, in particular, need ample amounts of these nutrients, especially biotin, B1, B12, and folate for nerve health and the underlying impaired sugar metabolism. It is imperative with neuropathy problems to use methylated or coenzyme forms of B6, B12, and folate. Nerve health requires proper methylation or the addition of a methyl group to make and protect nerve tissue. Methylation defects interfere with B6, B12, and folate function making disease risk much higher. Methylated forms of these nutrients help to by-pass this dysfunction.

In a recent real-world patient experience trial, diabetic patients with peripheral neuropathy found relief with supplementation of methylcobalamin, pyridoxal 5’-phosphate, and methyl-folate. The patients had improved quality of life and function with even better medical response.

It’s not just diabetics and the drug treatments that rob the body of nutrients, cancer patients have this need too. Treatments often interfere with B12 and folate or are simply toxic to the mitochondria in nerve tissues and the brain. The very drugs that are used to treat neuropathy symptoms or the disorder causing the neuropathy can actually deplete several essential nutrients required to protect the nerves. That is, the drugs that treat neuropathy can perpetuate the neuropathy because they interfere with the nutritional requirements for the nerves.

Biotin doesn’t get the same attention as some of the other B vitamins, but research shows that it may help eye nerve inflammation problems and even neuropathy changes seen in Alzheimer’s disease. Biotin helps blood sugar function which is especially valuable for Alzheimer’s as it considered type 3 diabetes. Biotin is often used for diabetic neuropathy.

Chemotherapy Induced Neuropathy

Neuropathy from cancer treatments is a real danger. Sometime the nerve damage will slowly resolve on its own once the treatment has stopped. Other times the neuropathy persists. Researchers have identified a number of nutrients that may help protect and reduce the severity of chemotherapy-induced neuropathy.

A review study published in February 2016 screened 1,465 publications for chemotherapy-induced peripheral neuropathy natural treatment options. Of those publications, they focused on twelve randomized, control trials. The nutrients that stood out in those twelve studies that helped to prevent or reduce chemotherapy nerve injury included vitamin E, l-glutamine, and omega-3 essential fatty acids like DHA/EPA. Other nutritional options were not discussed. Dosages were not provided in this publication.

In the case of platinum-induced neuropathy, current research shows that the amino acid glutamine reduced the severity of the neuropathy. Platinum-based therapy is also known as oxaliplatin, or cisplatin therapy, and is commonly used for colon, ovarian, and testicular cancer, small-cell lung cancer, lymphomas, and bladder and cervical cancer treatments. An August 2015 study showed that intravenous glutamine reduced the severity of symptomatic platinum-induced neuropathy. Other nutrients shown effective against cisplatin or other platinum based chemotherapies induced neuropathy includes acetyl-L-carnitine, vitamin E, glutathione, grape seed extract, and NAC. Pretreatment with calcium and magnesium prior to the platinum-based chemotherapy has been shown to reduce complications of neuropathy and even chemo-brain.

Neuropathy in Pregnancy

Neuropathy challenges even affect healthy, expecting moms from enormous changes that occur in the woman’s body during pregnancy. The physical changes and compressive weight of the unborn child during pregnancy and childbirth can make one more susceptible to nerve injury. This may include sciatica, carpal tunnel syndrome, or other nerve entrapment concerns. Medical treatment normally used for neuropathy in adults is contraindicated during pregnancy.

There is, however, solid information that demonstrates lipoic acid is a useful tool for neuropathy during pregnancy. Lipoic acid protects mitochondria found in nerves by providing strong antioxidant and anti-inflammatory activity. Researchers recommended using lipoic acid because of its high safety profile and successful management of nerve pain during pregnancy. Acetyl-L-carnitine, B vitamins, vitamin E, magnesium, calcium AEP, NAC, glutathione, curcumin, and the omega-3 and 6 oils may be used during pregnancy for nerve support and inflammation management.

Hyaluronic Acid, Curcumin, Grape Seed Extract, and Calcium AEP

A handful of studies in recent years demonstrate another benefit of hyaluronic acid in the case of nerve injuries like sciatica (the nerve that causes low back and leg pain) and other nerve entrapments like Morton’s neuroma. Morton’s neuroma is a painful nerve entrapment in the ball of the foot usually between the third and fourth toes. One cellular study showed that hyaluronic acid was able help recovery of a crushed sciatic nerve within 4-8 weeks of nerve injury. Add nerve regeneration to hyaluronic acid benefits.

Wellness Resources has relied on grape seed extract, curcumin and calcium AEP for decades to help manage nerve pain. These ingredients have stood the test of time. Animal studies found that grape seed extract safely decreased the sensation of pain and increased pain tolerance in rodents with nerve compression injuries. The spice, curcumin has extensive research in a multitude of arenas. These include prevention and protection of injured nerves and anti-inflammatory actions in cell, animal, and human studies with ongoing extraordinary results.

Calcium AEP has been used historically in Germany for MS patients. Research has shown that the active ingredient, phosphoethanolamine, or the AEP portion of calcium AEP, is crucial for keeping the nerve sheath intact around nerve cells. Calcium AEP is helpful for a wide variety of nerve related pain issues like shingles, sciatica, diabetic neuropathy, and even simple nerve stress. It is definitely something to have on hand when there is a nerve stress.

Those who are living with nerve injuries often find themselves at wit’s end with the incessant nerve pain. Sometimes, the pain is self-limiting and in other cases, it can drain the quality of life out from under you. Many people find the neuropathy medications so sedating or ineffective. Thankfully, years of research and clinical experience shows that there are several stellar options for nerve pain management. Prevention is ideal, but when life happens and fragile nerves are injured, there are helpful choices.

Make sure your B vitamin status is optimal. Use enough support with the classic nerve nutrients like ALC and R-alpha lipoic acid. We often recommend additional support like DHA, curcumin, magnesium, and calcium AEP. If you need additional heavy hitters for specific types of nerve pain, consider grape seed extract, l-glutamine, vitamin E, choline, NAC, and hyaluronic acid. Repetitively soaking your feet in buckets of ice water to calm down a neuropathy flare-up may not need to take place if one can reduce the underlying inflammation. These nutrients offer powerful healing choices and protection to delicate tissues.

Nutritional Options

Acetyl-L-Carnitine – ALC provides critical nutrients for the formation of the insulation around nerve tissue. It also helps nerves repair and nourishes the mitochondria within nerves. It is a primary nutrient for many different types of neuropathy and nerve health concerns.

R-Alpha Lipoic Acid – R-alpha lipoic acid is the 100% natural form of lipoic acid. This prized antioxidant is the go-to nutrient for pins and needles, sharp, lancinating, burning pain of injured nerves. It is well tolerated and may be easily used with ALC or other nutrients.

B Vitamins – B vitamins like biotin, methylcobalamin, methylated folate, activated B6, thiamin, and niacin are fundamental to nerve health. Simple deficiencies in any one of these B vitamins can lead to nerve pain. Stress, high carb diets, alcohol, methylation gene defects, and numerous medications provoke increased need for B vitamins. Biotin deserves special mention for its critical role in blood sugar function. It helps regulate blood sugar function but also helps protect nerves from injury.

Grape Seed Extract – Grape seed extract, commonly known for its connective tissue support, offers excellent antioxidant protection to nerve tissue. Even in the case of toxic chemotherapy drugs, grape seed extract can help reduce and prevent chemotherapy-induced nerve injury.

Curcumin – Curcumin offers a dazzling array of protection to the human body. Anti-inflammatory, antioxidant, nerve regenerative, and mitochondria support are just some of the known benefits of curcumin.

L-Glutamine – L-glutamine research shows that it offers protection against neuropathy. This amino acid is often primarily thought of as helping the digestive tract lining and muscle tissues. Consider adding this versatile amino acid to your arsenal if facing platinum-based chemotherapy drugs.

Calcium AEP – Calcium AEP has a long-standing track record with clinical use in several types of nerve disorders. It may be used to help simply support the body when stressed out or it may be used as a powerful tool for nerve pain disorders.

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