Table of ContentsView AllTable of ContentsSupplements for NeuropathyAcetyl-L-CarnitineAlpha-Lipoic AcidB VitaminsCapsaicinCannabidiolCoenzyme Q10Gamma-Linolenic AcidMagnesiumWhat Is Neuropathy?What Else Can You Do?Frequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Supplements for Neuropathy
Acetyl-L-Carnitine
Alpha-Lipoic Acid
B Vitamins
Capsaicin
Cannabidiol
Coenzyme Q10
Gamma-Linolenic Acid
Magnesium
What Is Neuropathy?
What Else Can You Do?
Frequently Asked Questions
Although many factors lead to neuropathy, the imbalance between damagingfree radicalsand protectiveantioxidants(oxidative stress) is a significant contributor.
Some supplements may help manage neuropathic pain. Anti-inflammatory and antioxidant supplements may reduce nerve damage and improve symptoms of neuropathy.
This article will explore supplements for neuropathy and review the research and safety information supporting their use.
Hospitalized older woman in glasses taking medication.Olga Rolenko / Getty Images
Olga Rolenko / Getty Images
What Supplements Are Taken for Neuropathy?
A plethora of supplements for neuropathy exists. However, whether research supports the use of these supplements for neuropathy is not well established.
Supplements that reduce oxidative stress (free radical damage) and inflammation in the body are often used for neuropathy. Such supplements include acetyl-L-carnitine, alpha-lipoic acid, coenzyme Q10, gamma-linolenic acid, and saffron.
Other nutrients associated with nerve formation, function, and the body’s pain response may benefit neuropathic symptoms. These nutrients include B vitamins and magnesium.
Another category of supplements for neuropathy includes those that influence the body’s perception of pain. Cannabidiol and capsaicin exist in this category.
In the United States, the Food and Drug Administration (FDA) does not regulate supplements like prescription drugs. This means some supplement products may not contain what the label says.Whenchoosing a supplement, look for independently tested products and consult a healthcare provider, registered dietitian nutritionist (RDN or RD), or pharmacist.
In the United States, the Food and Drug Administration (FDA) does not regulate supplements like prescription drugs. This means some supplement products may not contain what the label says.
Whenchoosing a supplement, look for independently tested products and consult a healthcare provider, registered dietitian nutritionist (RDN or RD), or pharmacist.
Acetyl-L-carnitineis a naturally occurringamino acid. It reduces the number of pro-inflammatory molecules in the body and helps produce proteins that protect neurons.
Acetyl-L-Carnitine Benefits
Supplementing with acetyl-L-carnitine has a neuroprotective effect.
Some research suggests that taking acetyl-L-carnitine regenerates injured nerves and restores function.
Taking more than 1,500 milligrams (mg) of acetyl-L-carnitine daily reduced pain in people with diabetic neuropathy. However, the benefits did not persist after six to 12 months.
Acetyl-L-carnitine may be ineffective at reducingchemotherapy-induced neuropathy(neuropathy due to chemotherapy). Compared to a placebo (a pill with no actual medicine in it), 3,000 mg daily of acetyl-L-carnitine did not minimize chemotherapy-induced neuropathy.
Additional studies are necessary to understand how acetyl-L-carnitine impacts neuropathy and whether the benefit depends on the type of neuropathy.
Acetyl-L-Carnitine Dosage
Acetyl-L-carnitine can be taken orally, intravenously, or intramuscularly.
Oral doses range from 1,500–3000 mg daily for neuropathy.
Intravenous (through the vein) or intramuscular (through the muscle) doses range from 1,000–2,000 mg of acetyl-L-carnitine daily.
Special Considerations for Acetyl-L-Carnitine
People onhemodialysisregularly supplement with acetyl-L-carnitine to help fight chronic inflammation and oxidative stress. Acetyl-L-carnitine lowers inflammatory markers.
Alpha-lipoic acid (ALA)is anomega-3 fatty acidand antioxidant. ALA reduces inflammation and supports nerve blood flow and signaling.
Alpha-Lipoic Acid Benefits
A randomized controlled trial (the gold standard of clinical trials) using 400–800 mg of ALA daily observed decreased pain intensity and perceived pain. Taking 800 mg compared to 400 mg of ALA improved pain symptoms more.
ALA also reduces symptoms of diabetic neuropathy, specifically burning, pain, and numbness. Research shows taking 600 mg of ALA minimized diabetic neuropathic pain.
However, other research suggests that the reduction in neuropathy symptoms with ALA does not translate to improvements in movement or activities of daily living.
Alpha-Lipoic Acid Dosage
ALA can be administered orally or intravenously (IV, through a vein).
IV doses of 600 mg of ALA administered for three weeks reduced symptoms of diabetic neuropathy.
Although studies show the success of oral ALA for neuropathy at doses of 800 mg, the recommended daily dosage for ALA is 600 mg. Taking 600 mg of ALA daily provided pain relief and improved numbness, burning, and pain symptoms.
Special Considerations for Alpha-Lipoic Acid
ALA is relatively safe and well tolerated, even when taken above the recommended dosage. However, doses greater than 1,200 mg may induce gastrointestinal side effects.
ALA has been safely taken for up to four years.
Although relatively safe for most people, some individuals should be cautious about supplementing with ALA.
ALA may be safe during pregnancy when taken orally in doses of up to 600 mg daily for up to four weeks. ALA is not recommended during breastfeeding.
Children ages 10–17 may safely take ALA orally in doses of up to 600 mg daily for three months. ALA may be unsafe for younger children, especially when administered in larger doses.
ALA interacts with certain medications. ALA slows blood clotting when taken with ananticoagulant(blood thinner). ALA also decreases the effects of your thyroid medication. Similarly, ALA may lower blood sugar levels when taken with anantidiabetic(blood sugar lowering) medication.
B vitamins play an essential role in countless reactions in the body. In particular, B vitamins are essential for energy production and red blood cell formation.
Additionally, B vitamins are crucial forneurotransmitters(messengers that carry information from one nerve to the next) and neuronal membrane synthesis. B vitamin deficiencies lead to neuropathy.
B Vitamin Benefits
There are eight types of B vitamins required for health. In particular, thiamine (B1), pyridoxine (B6), folate (B9), and cobalamin (B12) are linked with neuropathy. Maintaining adequate levels of these B vitamins prevents nutritional neuropathies.
Vitamin B12:Combined with other treatment methods, supplementing withvitamin B12reduces neuropathy symptoms according to some clinical trials. However, how much of an effect B12 has may depend on the type of neuropathy.
Additional research is required to understand the role of B12 in neuropathy fully. Many studies do not show baselinevitamin B12levels, so the benefit of supplementation may be due to B12 levels returning to normal.
The daily Recommended Dietary Allowance (RDA) for vitamin B12 is as follows:
Vitamin B6:People with neuropathy may experience low vitamin B6 levels. However, getting the amount of vitamin B6 just right is vital.Supplementation with too much B6 may bring B6 levels too high and has led to the development ofperipheral neuropathy. Stopping B6 supplementation caused neuropathic symptoms to disappear.
The daily RDA for vitamin B6 is as follows:
Thiamin (B1):Thiaminedeficiency occurs due to poor intake from alcohol use disorder or malabsorption frombariatric surgery. Neuropathy is a symptom of thiamine deficiency.
Supplementing with thiamine restores levels and resolves neuropathy when a deficiency is present. Moreover, for other forms of neuropathy, supplementing with thiamine is associated with symptom improvement.
For thiamine, the daily RDA is as follows:
B vitamins seem to benefit those who have neuropathy best if they have a nutrient deficiency. Consider discussing with your healthcare provider and checking your vitamin B levels before starting a supplement.
Special Considerations
Certain medical conditions warrant the use of B vitamins. Additionally, some of these conditions (such as type 2 diabetes) contribute to neuropathy. Maintaining adequate vitamin B levels is critical.
The following medications impact your B vitamin levels:
Capsaicinis the compound inchili peppersthat makes them spicy.
Capsaicin Benefits
Capsaicin prevents nerves from sending pain signals.
Topical capsaicintreats peripheral neuropathy. Capsaicin increases sensitivity at the time of application. However, after the immediate application, capsaicin reduces sensitivity. And over time, continued use of capsaicin contributes to less pain.
Capsaicin has been particularly beneficial for people with HIV-related orpostherpetic(a common complication of shingles) neuropathy. For these individuals, capsaicin provides moderate pain relief.
Capsaicin Dosage
Capsaicin is typically applied as a cream. Over-the-counter creams containing 0.075% capsaicin or high-dose patches with 8% capsaicin are the most common and effective supplements. Creams containing less than 0.075% capsaicin are ineffective.
High-dose topical creams contain 8% capsaicin, allowing quick treatment delivery to the affected area.
High-dose capsaicin creams are applied as patches in a medical environment. Local anesthesia reduces the intense burning accompanying the patch placement.
Each patch lasts about three months.
Special Considerations for Capsaicin
Capsaicin causes itching, burning, or redness at the application site. But these side effects are generally short term.
Avoid contact with the eyes. Do not apply capsaicin to damaged or burned skin.
Capsaicin interacts with the following medications:
Cannabidiol (CBD)is a compound found in themarijuanaplant. Unlike other compounds in marijuana, CBD does not cause a sense of euphoria (a “high”). CBD comes from hemp or non-hemp plants.
CBD may reduce inflammatory markers associated with neuropathy.
Legal Status
The 2018 Agriculture Improvement Act legalized cannabidiol derived from hemp at the federal level. However, cannabidiol remains on the controlled substances list for some states.
Please be mindful of your state’s laws about CBD use and avoid use if it is not legal in your area.
CBD Benefits
Like other supplements for neuropathy, CBD confers anti-inflammatory and antioxidant benefits to help manage pain.
CBD blocks the inflammatory activity of microglial cells in thespinal cord, reducing the development of neuropathic pain.
One small randomized controlled trial of older adults with neuropathy noticed an improvement in pain with topical CBD. Specifically, participants taking CBD felt a reduction in intense, sharp, cold, and itchy pain sensations.
Taking CBD in capsule form also alleviates neuropathic symptoms. People undergoing chemotherapy treatment who took 150 mg CBD twice daily experienced fewer symptoms of chemotherapy-induced peripheral neuropathy than those who did not take CBD.
CBD Dosage
Some research shows that 150 mg CBD taken twice daily is effective at preventing chemotherapy-induced peripheral neuropathy. However, CBD use was short term.
Other information suggests that CBD is safe in oral doses of up to 200 mg taken daily for 13 weeks.
Research on cannabidiol is new and evolving, so there is no set recommended intake. Moreover, dosage will vary depending on topical or oral CBD use.
Special Considerations for CBD
Please exercise caution when consuming CBD because limited data on its safety exists. Possible side effects of CBD include the following:
A specific prescription CBD product (Epidiolex) may be safe in doses of up to 25 milligrams per kilogram in children 1 and older.
CBD interacts with certain medications, including the following:
More data is necessary to determine the safety associated with CBD products applied to the skin.
Coenzyme Q10 (CoQ10)plays an essential role in supportingmitochondria(the cell’s powerhouse) function through its anti-inflammatory and antioxidant properties.
CoQ10 Benefits
The benefits of CoQ10 on neuropathy are likely attributed to its anti-inflammatory and antioxidant properties. CoQ10 decreases inflammatory molecule levels, increases antioxidant production, and protects neurons from dying.
CoQ10 may provide an additional benefit to prescription medication for neuropathic pain.
Among people with diabetic neuropathy, one study found that taking 300 mg CoQ10 daily for eight weeks improved pain and sleep compared to taking a placebo. Study participants also took prescription medication for neuropathy.
CoQ10 Dosage
People consume an average of 3–5 mg of CoQ10 daily through the diet. Food sources of CoQ10 include chicken thighs, herring, and trout.
The recommended dosage of CoQ10 depends on its use.
For healthy people, the suggested dose is 30–100 mg. But doses can go up to 1,200 mg for specific medical conditions.Most studies evaluate CoQ10 supplementation at dosages ranging from 50–1,200 mg.
Consult your healthcare provider before starting CoQ10 to determine your proper dosage.
Special Considerations for CoQ10
Side effects of CoQ10 are generally mild and include insomnia and digestive issues. Few severe side effects have been reported.
CoQ10 interacts with the following medications:
Gamma-linolenic acid (GLA)is an omega-6 essential fatty acid. GLA must be obtained from the diet.
GLA abounds in borage, black currant oil, andevening primrose oil.
GLA Benefits
GLA may benefit diabetic neuropathy through its antioxidant and vasodilatory effects (meaning it dilates blood vessels and decreases blood pressure).
Diabetes interferes with essential fatty acid metabolism. Specifically, diabetes impacts the conversion of another fatty acid (linoleic acid) to GLA. Supplementing with GLA supports normal levels of GLA.
One study suggests that taking 320 mg daily of GLA reduces the number of neuropathic pain sites in the body and improves movement.
GLA Dosage
There are few studies on GLA for neuropathy.
Overall, insufficient research exists for a specific GLA dosage recommendation that benefits those with neuropathy.
Special Considerations for GLA
Supplementing with GLA is not advisable for people with certain medical histories.
Magnesiumis a mineral involved in many bodily processes, including muscle and nerve function.
Magnesium Benefits
Magnesium blocks theN-methyl-D-aspartate (NMDA) receptor, reducing pain and improving movement.NMDA receptorsplay an important role in many brain processes.
People with diabetes and diabetic neuropathy tend to have lowermagnesiumlevels. Preliminary animal research shows improved neuropathy symptoms with magnesium supplementation.
Magnesium supplementation aids in the treatment of peripheral neuropathy due to herpes zoster (shingles). Some research shows that magnesium sulfate (a specific form of magnesium) injections effectively control neuropathic pain.
Some research suggests magnesium andcalciuminfusions reduce chemotherapy-induced peripheral neuropathy. However, despite promising research, there is insufficient conclusive evidence to determine the effectiveness of magnesium and calcium infusions on chemotherapy-induced peripheral neuropathy.
Magnesium RDA
The daily RDA for magnesium is the following:
Magnesium requirements increase during pregnancy and lactation.
Special Considerations for Magnesium
Magnesium interacts with certain medications, including the following:
Multipletypes of neuropathyexist depending on the underlying health issue. Neuropathy results from the following:
It is also possible for neuropathy to develop without a known cause.
Neuropathy symptoms vary depending on the nerves and the body area affected. Common symptoms include the following:
What Else Can You Do for Neuropathy?
Besides supplements, lifestyle modifications focusing on diet, stress, and movement alleviate neuropathic pain.
Exercise
Exercise has the potential to reduce neuropathic pain. Certain forms of exercise are more effective than others at alleviating symptoms of different neuropathies.
Muscle strengthening andbalance trainingalleviate chemotherapy-induced peripheral neuropathy.Moreover, some research suggests engaging in physical activity at the start of chemotherapy prevents the development of chemotherapy-induced peripheral neuropathy.
Participating in a mix of aerobic and higher-intensity exercise may particularly benefit those with diabetic neuropathy. Exercise may also prevent the development of neuropathy because regular physical activity helps control blood sugar.
A mix ofaerobicand progressive strength training enhances other treatment methods for HIV-related neuropathy.
Mindfulness
Participating inmindfulness therapies,cognitive behavioral therapy (CBT), and pain reprocessing therapy (PRT) has reduced pain and improved the quality of life for people with different kinds of pain.Notably, mindfulness produced long-term pain relief, whereas the benefits of CBT were less apparent after treatment had ended.
Summary
Neuropathy is a painful condition that affects quality of life. Many other conditions, such as diabetes, chemotherapy, and HIV, contribute to neuropathy.
Supplements such as ALA and acetyl-L-carnitine may provide some relief from neuropathic pain. For other supplements, such as B vitamins, capsaicin, magnesium, GLA, and cannabidiol, limited data exists to support their use for neuropathy.
However, maintaining adequate levels of B vitamins and magnesium may prevent the development of neuropathy due to nutrient deficiencies.
Talk with your primary healthcare provider to review the risks and benefits of introducing supplements into your routine.
Frequently Asked QuestionsThere is no best supplement for neuropathy.The supplements with the most research supporting their use for neuropathy are acetyl-L-carnitine and alpha-lipoic acid (ALA). Though these supplements may alleviate some symptoms, their benefits may depend on your type of neuropathy.Always consult your healthcare provider before starting a supplement to determine whether it will be safe and effective for you.Numbness is a possible symptom of neuropathy or of something else entirely. Consult your healthcare provider before opting for supplements to help with numbness.
There is no best supplement for neuropathy.The supplements with the most research supporting their use for neuropathy are acetyl-L-carnitine and alpha-lipoic acid (ALA). Though these supplements may alleviate some symptoms, their benefits may depend on your type of neuropathy.Always consult your healthcare provider before starting a supplement to determine whether it will be safe and effective for you.
There is no best supplement for neuropathy.
The supplements with the most research supporting their use for neuropathy are acetyl-L-carnitine and alpha-lipoic acid (ALA). Though these supplements may alleviate some symptoms, their benefits may depend on your type of neuropathy.
Always consult your healthcare provider before starting a supplement to determine whether it will be safe and effective for you.
Numbness is a possible symptom of neuropathy or of something else entirely. Consult your healthcare provider before opting for supplements to help with numbness.
37 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Viana MDM, Lauria PSS, Almeida de Lima A, et al.Alpha-lipoic acid as an antioxidant strategy for managing neuropathic pain.Antioxidants. 2022; 11(12):2420. doi.org/10.3390/antiox11122420Brami C, Bao T, Deng G.Natural products and complementary therapies for chemotherapy-induced peripheral neuropathy: a systematic review.Crit Rev Oncol Hematol. 2016;98:325-334. doi:10.1016/j.critrevonc.2015.11.014Rolim LCSP, da Silva EM, Flumignan RLG, et al.Acetyl-L-carnitine for the treatment of diabetic peripheral neuropathy.Cochrane Database Syst Rev. 2019;6(6):CD011265. doi:10.1002/14651858.CD011265.pub2Szklener K, Szklener S, Michalski A, et al.Dietary supplements in chemotherapy-induced peripheral neuropathy: a new hope?Nutrients. 2022;14(3):625. 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The role of vitamin B6 in peripheral neuropathy: a systematic review.Nutrients. 2023;15(13):2823. doi:10.3390/nu15132823National Institutes of Health.Vitamin B6.Gwathmey KG, Grogan J.Nutritional neuropathies.Muscle Nerve. 2020;62(1):13-29. doi:10.1002/mus.26783Stein J, Geisel J, Obeid R.Association between neuropathy and B-vitamins: A systematic review and meta-analysis.Eur J Neurol. 2021;28(6):2054-2064. doi:10.1111/ene.14786National Institutes of Health.Thiamin.Derry S, Rice ASC, Cole P, et al.Topical capsaicin (high concentration) for chronic neuropathic pain in adults.Cochrane Database Syst Rev. 2017;1(1):CD007393. doi:10.1002/14651858.CD007393.pub4Derry S, Rice AS, Cole P, et al.Topical capsaicin (high concentration) for chronic neuropathic pain in adults.Cochrane Database Syst Rev. 2017;1(1):CD007393. doi:10.1002/14651858.CD007393.pub4PubChem.Capsaicin.Centers for Disease Control and Prevention.About CBD.Xu DH, Cullen BD, Tang M, et al.The effectiveness of topical cannabidiol oil in symptomatic relief of peripheral neuropathy of the lower extremities.Curr Pharm Biotechnol. 2020;21(5):390-402. doi:10.2174/1389201020666191202111534Nielsen SW, Hasselsteen SD, Dominiak HSH, et al.Oral cannabidiol for prevention of acute and transient chemotherapy-induced peripheral neuropathy.Support Care Cancer. 2022;30(11):9441-9451. doi:10.1007/s00520-022-07312-yMedlinePlus.Cannabidiol (CBD).Bagheri S, Haddadi R, Saki S, et al.Neuroprotective effects of coenzyme Q10 on neurological diseases: a review article.Front Neurosci. 2023;17:1188839. doi:10.3389/fnins.2023.1188839Amini P, Sajedi F, Mirjalili M, et al.Coenzyme Q10 as a potential add-on treatment for patients suffering from painful diabetic neuropathy: results of a placebo-controlled randomized trial.Eur J Clin Pharmacol. 2022;78(12):1899-1910. doi:10.1007/s00228-022-03407-xArenas-Jal M, Suñé-Negre J, García-Montoya E.Coenzyme Q10 supplementation: efficacy, safety and formulation challenges.Compr Rev Food Sci Food Saf. 2020; 19: 574–594. doi:10.1111/1541-4337.12539National Center for Complementary and Integrative Health.Coenzyme Q10.National Center for Complementary and Integrative Health.Evening primrose oil.Tanenberg RJ, Donofrio PD.Neuropathic problems of the lower limbs in diabetic patients.Levin and O’Neal’s The Diabetic Foot. 2008;33-74.MedlinePlus.Omega-6 fatty acids.National Institutes of Health Office of Dietary Supplements.Magnesium.Shin HJ, Na HS, Do SH.Magnesium and pain.Nutrients. 2020;12(8):2184. doi:10.3390/nu12082184Ebrahimi F, Farzaei MH, Bahramsoltani R, et al.Plant-derived medicines for neuropathies: A comprehensive review of clinical evidence.Rev Neurosci. 2019;30(6):671-684. doi:10.1515/revneuro-2018-0097Zhang YH, Hu HY, Xiong YC, et al.Exercise for neuropathic pain: a systematic review and expert consensus.Front Med (Lausanne). 2021;8:756940. doi:10.3389/fmed.2021.756940Lopez-Garzon M, Cantarero-Villanueva I, Postigo-Martin P, et al.Can physical exercise prevent chemotherapy-induced peripheral neuropathy in patients with cancer? A systematic review and meta-analysis.Arch Phys Med Rehabil. 2022;103(11):2197-2208. doi:10.1016/j.apmr.2022.02.008Ashar YK, Gordon A, Schubiner H, et al.Effect of pain reprocessing therapy vs placebo and usual care for patients with chronic back pain: A randomized clinical trial.JAMA Psychiatry. 2022;79(1):13-23. doi:10.1001/jamapsychiatry.2021.2669Bai Y, Ma JH, Yu Y, et al.Effect of cognitive-behavioral therapy or mindfulness therapy on pain and quality of life in patients with diabetic neuropathy: a systematic review and metaanalysis.Pain Manag Nurs. 2022;23(6):861-870. doi:10.1016/j.pmn.2022.05.005
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Viana MDM, Lauria PSS, Almeida de Lima A, et al.Alpha-lipoic acid as an antioxidant strategy for managing neuropathic pain.Antioxidants. 2022; 11(12):2420. doi.org/10.3390/antiox11122420Brami C, Bao T, Deng G.Natural products and complementary therapies for chemotherapy-induced peripheral neuropathy: a systematic review.Crit Rev Oncol Hematol. 2016;98:325-334. doi:10.1016/j.critrevonc.2015.11.014Rolim LCSP, da Silva EM, Flumignan RLG, et al.Acetyl-L-carnitine for the treatment of diabetic peripheral neuropathy.Cochrane Database Syst Rev. 2019;6(6):CD011265. doi:10.1002/14651858.CD011265.pub2Szklener K, Szklener S, Michalski A, et al.Dietary supplements in chemotherapy-induced peripheral neuropathy: a new hope?Nutrients. 2022;14(3):625. Published 2022 Jan 31. doi:10.3390/nu14030625Berger MM, Shenkin A, Schweinlin A, et al.ESPEN micronutrient guideline.Clin Nutr. 2022;41(6):1357-1424. doi:10.1016/j.clnu.2022.02.015Esposito C, Garzarella EU, Santarcangelo C, et al.Safety and efficacy of alpha-lipoic acid oral supplementation in the reduction of pain with unknown etiology: a monocentric, randomized, double-blind, placebo-controlled clinical trial.Biomed Pharmacother. 2021;144:112308. doi:10.1016/j.biopha.2021.112308Nahas R.Type 2 diabetes.Integrative Medicine. 2012;297-311.e3.MedlinePlus.Alpha-lipoic acid.Won JC, Kwon HS, Moon SS, et al.γ-linolenic acid versus α-lipoic acid for treating painful diabetic neuropathy in adults: A 12-week, double-placebo, randomized, noninferiority trial.Diabetes & Metabolism Journal. 2020;44(4):542-554. doi: 10.4093%2Fdmj.2019.0099Julian T, Syeed R, Glascow N, et al.B12 as a treatment for peripheral neuropathic pain: a systematic review.Nutrients. 2020;12(8):2221. doi:10.3390/nu12082221National Institutes of Health.Vitamin B12.Muhamad R, Akrivaki A, Papagiannopoulou G, et al. The role of vitamin B6 in peripheral neuropathy: a systematic review.Nutrients. 2023;15(13):2823. doi:10.3390/nu15132823National Institutes of Health.Vitamin B6.Gwathmey KG, Grogan J.Nutritional neuropathies.Muscle Nerve. 2020;62(1):13-29. doi:10.1002/mus.26783Stein J, Geisel J, Obeid R.Association between neuropathy and B-vitamins: A systematic review and meta-analysis.Eur J Neurol. 2021;28(6):2054-2064. doi:10.1111/ene.14786National Institutes of Health.Thiamin.Derry S, Rice ASC, Cole P, et al.Topical capsaicin (high concentration) for chronic neuropathic pain in adults.Cochrane Database Syst Rev. 2017;1(1):CD007393. doi:10.1002/14651858.CD007393.pub4Derry S, Rice AS, Cole P, et al.Topical capsaicin (high concentration) for chronic neuropathic pain in adults.Cochrane Database Syst Rev. 2017;1(1):CD007393. doi:10.1002/14651858.CD007393.pub4PubChem.Capsaicin.Centers for Disease Control and Prevention.About CBD.Xu DH, Cullen BD, Tang M, et al.The effectiveness of topical cannabidiol oil in symptomatic relief of peripheral neuropathy of the lower extremities.Curr Pharm Biotechnol. 2020;21(5):390-402. doi:10.2174/1389201020666191202111534Nielsen SW, Hasselsteen SD, Dominiak HSH, et al.Oral cannabidiol for prevention of acute and transient chemotherapy-induced peripheral neuropathy.Support Care Cancer. 2022;30(11):9441-9451. doi:10.1007/s00520-022-07312-yMedlinePlus.Cannabidiol (CBD).Bagheri S, Haddadi R, Saki S, et al.Neuroprotective effects of coenzyme Q10 on neurological diseases: a review article.Front Neurosci. 2023;17:1188839. doi:10.3389/fnins.2023.1188839Amini P, Sajedi F, Mirjalili M, et al.Coenzyme Q10 as a potential add-on treatment for patients suffering from painful diabetic neuropathy: results of a placebo-controlled randomized trial.Eur J Clin Pharmacol. 2022;78(12):1899-1910. doi:10.1007/s00228-022-03407-xArenas-Jal M, Suñé-Negre J, García-Montoya E.Coenzyme Q10 supplementation: efficacy, safety and formulation challenges.Compr Rev Food Sci Food Saf. 2020; 19: 574–594. doi:10.1111/1541-4337.12539National Center for Complementary and Integrative Health.Coenzyme Q10.National Center for Complementary and Integrative Health.Evening primrose oil.Tanenberg RJ, Donofrio PD.Neuropathic problems of the lower limbs in diabetic patients.Levin and O’Neal’s The Diabetic Foot. 2008;33-74.MedlinePlus.Omega-6 fatty acids.National Institutes of Health Office of Dietary Supplements.Magnesium.Shin HJ, Na HS, Do SH.Magnesium and pain.Nutrients. 2020;12(8):2184. doi:10.3390/nu12082184Ebrahimi F, Farzaei MH, Bahramsoltani R, et al.Plant-derived medicines for neuropathies: A comprehensive review of clinical evidence.Rev Neurosci. 2019;30(6):671-684. doi:10.1515/revneuro-2018-0097Zhang YH, Hu HY, Xiong YC, et al.Exercise for neuropathic pain: a systematic review and expert consensus.Front Med (Lausanne). 2021;8:756940. doi:10.3389/fmed.2021.756940Lopez-Garzon M, Cantarero-Villanueva I, Postigo-Martin P, et al.Can physical exercise prevent chemotherapy-induced peripheral neuropathy in patients with cancer? A systematic review and meta-analysis.Arch Phys Med Rehabil. 2022;103(11):2197-2208. doi:10.1016/j.apmr.2022.02.008Ashar YK, Gordon A, Schubiner H, et al.Effect of pain reprocessing therapy vs placebo and usual care for patients with chronic back pain: A randomized clinical trial.JAMA Psychiatry. 2022;79(1):13-23. doi:10.1001/jamapsychiatry.2021.2669Bai Y, Ma JH, Yu Y, et al.Effect of cognitive-behavioral therapy or mindfulness therapy on pain and quality of life in patients with diabetic neuropathy: a systematic review and metaanalysis.Pain Manag Nurs. 2022;23(6):861-870. doi:10.1016/j.pmn.2022.05.005
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Viana MDM, Lauria PSS, Almeida de Lima A, et al.Alpha-lipoic acid as an antioxidant strategy for managing neuropathic pain.Antioxidants. 2022; 11(12):2420. doi.org/10.3390/antiox11122420Brami C, Bao T, Deng G.Natural products and complementary therapies for chemotherapy-induced peripheral neuropathy: a systematic review.Crit Rev Oncol Hematol. 2016;98:325-334. doi:10.1016/j.critrevonc.2015.11.014Rolim LCSP, da Silva EM, Flumignan RLG, et al.Acetyl-L-carnitine for the treatment of diabetic peripheral neuropathy.Cochrane Database Syst Rev. 2019;6(6):CD011265. doi:10.1002/14651858.CD011265.pub2Szklener K, Szklener S, Michalski A, et al.Dietary supplements in chemotherapy-induced peripheral neuropathy: a new hope?Nutrients. 2022;14(3):625. Published 2022 Jan 31. doi:10.3390/nu14030625Berger MM, Shenkin A, Schweinlin A, et al.ESPEN micronutrient guideline.Clin Nutr. 2022;41(6):1357-1424. doi:10.1016/j.clnu.2022.02.015Esposito C, Garzarella EU, Santarcangelo C, et al.Safety and efficacy of alpha-lipoic acid oral supplementation in the reduction of pain with unknown etiology: a monocentric, randomized, double-blind, placebo-controlled clinical trial.Biomed Pharmacother. 2021;144:112308. doi:10.1016/j.biopha.2021.112308Nahas R.Type 2 diabetes.Integrative Medicine. 2012;297-311.e3.MedlinePlus.Alpha-lipoic acid.Won JC, Kwon HS, Moon SS, et al.γ-linolenic acid versus α-lipoic acid for treating painful diabetic neuropathy in adults: A 12-week, double-placebo, randomized, noninferiority trial.Diabetes & Metabolism Journal. 2020;44(4):542-554. doi: 10.4093%2Fdmj.2019.0099Julian T, Syeed R, Glascow N, et al.B12 as a treatment for peripheral neuropathic pain: a systematic review.Nutrients. 2020;12(8):2221. doi:10.3390/nu12082221National Institutes of Health.Vitamin B12.Muhamad R, Akrivaki A, Papagiannopoulou G, et al. The role of vitamin B6 in peripheral neuropathy: a systematic review.Nutrients. 2023;15(13):2823. doi:10.3390/nu15132823National Institutes of Health.Vitamin B6.Gwathmey KG, Grogan J.Nutritional neuropathies.Muscle Nerve. 2020;62(1):13-29. doi:10.1002/mus.26783Stein J, Geisel J, Obeid R.Association between neuropathy and B-vitamins: A systematic review and meta-analysis.Eur J Neurol. 2021;28(6):2054-2064. doi:10.1111/ene.14786National Institutes of Health.Thiamin.Derry S, Rice ASC, Cole P, et al.Topical capsaicin (high concentration) for chronic neuropathic pain in adults.Cochrane Database Syst Rev. 2017;1(1):CD007393. doi:10.1002/14651858.CD007393.pub4Derry S, Rice AS, Cole P, et al.Topical capsaicin (high concentration) for chronic neuropathic pain in adults.Cochrane Database Syst Rev. 2017;1(1):CD007393. doi:10.1002/14651858.CD007393.pub4PubChem.Capsaicin.Centers for Disease Control and Prevention.About CBD.Xu DH, Cullen BD, Tang M, et al.The effectiveness of topical cannabidiol oil in symptomatic relief of peripheral neuropathy of the lower extremities.Curr Pharm Biotechnol. 2020;21(5):390-402. doi:10.2174/1389201020666191202111534Nielsen SW, Hasselsteen SD, Dominiak HSH, et al.Oral cannabidiol for prevention of acute and transient chemotherapy-induced peripheral neuropathy.Support Care Cancer. 2022;30(11):9441-9451. doi:10.1007/s00520-022-07312-yMedlinePlus.Cannabidiol (CBD).Bagheri S, Haddadi R, Saki S, et al.Neuroprotective effects of coenzyme Q10 on neurological diseases: a review article.Front Neurosci. 2023;17:1188839. doi:10.3389/fnins.2023.1188839Amini P, Sajedi F, Mirjalili M, et al.Coenzyme Q10 as a potential add-on treatment for patients suffering from painful diabetic neuropathy: results of a placebo-controlled randomized trial.Eur J Clin Pharmacol. 2022;78(12):1899-1910. doi:10.1007/s00228-022-03407-xArenas-Jal M, Suñé-Negre J, García-Montoya E.Coenzyme Q10 supplementation: efficacy, safety and formulation challenges.Compr Rev Food Sci Food Saf. 2020; 19: 574–594. doi:10.1111/1541-4337.12539National Center for Complementary and Integrative Health.Coenzyme Q10.National Center for Complementary and Integrative Health.Evening primrose oil.Tanenberg RJ, Donofrio PD.Neuropathic problems of the lower limbs in diabetic patients.Levin and O’Neal’s The Diabetic Foot. 2008;33-74.MedlinePlus.Omega-6 fatty acids.National Institutes of Health Office of Dietary Supplements.Magnesium.Shin HJ, Na HS, Do SH.Magnesium and pain.Nutrients. 2020;12(8):2184. doi:10.3390/nu12082184Ebrahimi F, Farzaei MH, Bahramsoltani R, et al.Plant-derived medicines for neuropathies: A comprehensive review of clinical evidence.Rev Neurosci. 2019;30(6):671-684. doi:10.1515/revneuro-2018-0097Zhang YH, Hu HY, Xiong YC, et al.Exercise for neuropathic pain: a systematic review and expert consensus.Front Med (Lausanne). 2021;8:756940. doi:10.3389/fmed.2021.756940Lopez-Garzon M, Cantarero-Villanueva I, Postigo-Martin P, et al.Can physical exercise prevent chemotherapy-induced peripheral neuropathy in patients with cancer? A systematic review and meta-analysis.Arch Phys Med Rehabil. 2022;103(11):2197-2208. doi:10.1016/j.apmr.2022.02.008Ashar YK, Gordon A, Schubiner H, et al.Effect of pain reprocessing therapy vs placebo and usual care for patients with chronic back pain: A randomized clinical trial.JAMA Psychiatry. 2022;79(1):13-23. doi:10.1001/jamapsychiatry.2021.2669Bai Y, Ma JH, Yu Y, et al.Effect of cognitive-behavioral therapy or mindfulness therapy on pain and quality of life in patients with diabetic neuropathy: a systematic review and metaanalysis.Pain Manag Nurs. 2022;23(6):861-870. doi:10.1016/j.pmn.2022.05.005
Viana MDM, Lauria PSS, Almeida de Lima A, et al.Alpha-lipoic acid as an antioxidant strategy for managing neuropathic pain.Antioxidants. 2022; 11(12):2420. doi.org/10.3390/antiox11122420
Brami C, Bao T, Deng G.Natural products and complementary therapies for chemotherapy-induced peripheral neuropathy: a systematic review.Crit Rev Oncol Hematol. 2016;98:325-334. doi:10.1016/j.critrevonc.2015.11.014
Rolim LCSP, da Silva EM, Flumignan RLG, et al.Acetyl-L-carnitine for the treatment of diabetic peripheral neuropathy.Cochrane Database Syst Rev. 2019;6(6):CD011265. doi:10.1002/14651858.CD011265.pub2
Szklener K, Szklener S, Michalski A, et al.Dietary supplements in chemotherapy-induced peripheral neuropathy: a new hope?Nutrients. 2022;14(3):625. Published 2022 Jan 31. doi:10.3390/nu14030625
Berger MM, Shenkin A, Schweinlin A, et al.ESPEN micronutrient guideline.Clin Nutr. 2022;41(6):1357-1424. doi:10.1016/j.clnu.2022.02.015
Esposito C, Garzarella EU, Santarcangelo C, et al.Safety and efficacy of alpha-lipoic acid oral supplementation in the reduction of pain with unknown etiology: a monocentric, randomized, double-blind, placebo-controlled clinical trial.Biomed Pharmacother. 2021;144:112308. doi:10.1016/j.biopha.2021.112308
Nahas R.Type 2 diabetes.Integrative Medicine. 2012;297-311.e3.
MedlinePlus.Alpha-lipoic acid.
Won JC, Kwon HS, Moon SS, et al.γ-linolenic acid versus α-lipoic acid for treating painful diabetic neuropathy in adults: A 12-week, double-placebo, randomized, noninferiority trial.Diabetes & Metabolism Journal. 2020;44(4):542-554. doi: 10.4093%2Fdmj.2019.0099
Julian T, Syeed R, Glascow N, et al.B12 as a treatment for peripheral neuropathic pain: a systematic review.Nutrients. 2020;12(8):2221. doi:10.3390/nu12082221
National Institutes of Health.Vitamin B12.
Muhamad R, Akrivaki A, Papagiannopoulou G, et al. The role of vitamin B6 in peripheral neuropathy: a systematic review.Nutrients. 2023;15(13):2823. doi:10.3390/nu15132823
National Institutes of Health.Vitamin B6.
Gwathmey KG, Grogan J.Nutritional neuropathies.Muscle Nerve. 2020;62(1):13-29. doi:10.1002/mus.26783
Stein J, Geisel J, Obeid R.Association between neuropathy and B-vitamins: A systematic review and meta-analysis.Eur J Neurol. 2021;28(6):2054-2064. doi:10.1111/ene.14786
National Institutes of Health.Thiamin.
Derry S, Rice ASC, Cole P, et al.Topical capsaicin (high concentration) for chronic neuropathic pain in adults.Cochrane Database Syst Rev. 2017;1(1):CD007393. doi:10.1002/14651858.CD007393.pub4
Derry S, Rice AS, Cole P, et al.Topical capsaicin (high concentration) for chronic neuropathic pain in adults.Cochrane Database Syst Rev. 2017;1(1):CD007393. doi:10.1002/14651858.CD007393.pub4
PubChem.Capsaicin.
Centers for Disease Control and Prevention.About CBD.
Xu DH, Cullen BD, Tang M, et al.The effectiveness of topical cannabidiol oil in symptomatic relief of peripheral neuropathy of the lower extremities.Curr Pharm Biotechnol. 2020;21(5):390-402. doi:10.2174/1389201020666191202111534
Nielsen SW, Hasselsteen SD, Dominiak HSH, et al.Oral cannabidiol for prevention of acute and transient chemotherapy-induced peripheral neuropathy.Support Care Cancer. 2022;30(11):9441-9451. doi:10.1007/s00520-022-07312-y
MedlinePlus.Cannabidiol (CBD).
Bagheri S, Haddadi R, Saki S, et al.Neuroprotective effects of coenzyme Q10 on neurological diseases: a review article.Front Neurosci. 2023;17:1188839. doi:10.3389/fnins.2023.1188839
Amini P, Sajedi F, Mirjalili M, et al.Coenzyme Q10 as a potential add-on treatment for patients suffering from painful diabetic neuropathy: results of a placebo-controlled randomized trial.Eur J Clin Pharmacol. 2022;78(12):1899-1910. doi:10.1007/s00228-022-03407-x
Arenas-Jal M, Suñé-Negre J, García-Montoya E.Coenzyme Q10 supplementation: efficacy, safety and formulation challenges.Compr Rev Food Sci Food Saf. 2020; 19: 574–594. doi:10.1111/1541-4337.12539
National Center for Complementary and Integrative Health.Coenzyme Q10.
National Center for Complementary and Integrative Health.Evening primrose oil.
Tanenberg RJ, Donofrio PD.Neuropathic problems of the lower limbs in diabetic patients.Levin and O’Neal’s The Diabetic Foot. 2008;33-74.
MedlinePlus.Omega-6 fatty acids.
National Institutes of Health Office of Dietary Supplements.Magnesium.
Shin HJ, Na HS, Do SH.Magnesium and pain.Nutrients. 2020;12(8):2184. doi:10.3390/nu12082184
Ebrahimi F, Farzaei MH, Bahramsoltani R, et al.Plant-derived medicines for neuropathies: A comprehensive review of clinical evidence.Rev Neurosci. 2019;30(6):671-684. doi:10.1515/revneuro-2018-0097
Zhang YH, Hu HY, Xiong YC, et al.Exercise for neuropathic pain: a systematic review and expert consensus.Front Med (Lausanne). 2021;8:756940. doi:10.3389/fmed.2021.756940
Lopez-Garzon M, Cantarero-Villanueva I, Postigo-Martin P, et al.Can physical exercise prevent chemotherapy-induced peripheral neuropathy in patients with cancer? A systematic review and meta-analysis.Arch Phys Med Rehabil. 2022;103(11):2197-2208. doi:10.1016/j.apmr.2022.02.008
Ashar YK, Gordon A, Schubiner H, et al.Effect of pain reprocessing therapy vs placebo and usual care for patients with chronic back pain: A randomized clinical trial.JAMA Psychiatry. 2022;79(1):13-23. doi:10.1001/jamapsychiatry.2021.2669
Bai Y, Ma JH, Yu Y, et al.Effect of cognitive-behavioral therapy or mindfulness therapy on pain and quality of life in patients with diabetic neuropathy: a systematic review and metaanalysis.Pain Manag Nurs. 2022;23(6):861-870. doi:10.1016/j.pmn.2022.05.005
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