Peripheral Neuropathy

Why it works: Targets oxidative stress & mitochondrial dysfunction. ALA is a mitochondrial cofactor with antioxidant and redox-cycling properties (regenerates glutathione, vitamins C & E; chelat...

Instructions: Regimens with the most evidence. • Short-course IV ALA: 600 mg IV daily for 3 weeks reduced neuropathic symptoms in randomized trials/meta-analyses (often used in Germany). Diabete...

Warnings: Hypoglycemia risk (rare but important):. • Insulin Autoimmune Syndrome (IAS): Case reports (and a re...

Studies: IV ALA 600 mg/day × 3 weeks: Meta-analysis of RCTs (n≈1,258)...

Why it works: Neuroinflammation + pain signaling: EPA/DHA are precursors to “specialized pro-resolving mediators” (e.g., resolvins) that actively turn off inflammatory cascades implicated in neu...

Instructions: There isn’t a universally accepted “neuropathy dose.” Use patterns below are taken from clinical trials; discuss with your clinician—especially if you take anticoagulants or have h...

Warnings: Bleeding/anticoagulants: High-dose omega-3s have antiplatelet effects; most data show no clinically...

Studies: CIPN (paclitaxel): • Positive RCT (2012): DHA-predominant fi...

Why it works: Mitochondrial support & energy metabolism: ALCAR shuttles fatty acids into mitochondria and donates acetyl groups—supporting neuronal energy production in metabolically stressed ne...

Instructions: Dose used most often for diabetic neuropathy (DPN): 1,000 mg three times daily (3,000 mg/day) orally for 52 weeks, which improved pain (in subgroups) and vibratory perception and i...

Warnings: If you’re receiving taxanes (e.g., paclitaxel/docetaxel): avoid ALCAR for CIPN prevention due to RCT...

Studies: Diabetic peripheral neuropathy (DPN)Two large, year-long RCT...

Why it works: GLA → DGLA → anti-inflammatory eicosanoids: EPO supplies gamma-linolenic acid (GLA), which is converted to dihomo-gamma-linolenic acid (DGLA) and then to prostaglandin E1 and other...

Instructions: Form & standardization: Use oral EPO capsules standardized to GLA (typically 8–10%) so dosing is predictable. Drugs.com. Dose used in RCTs:. • Classic trials used ~480 mg GLA/day f...

Warnings: Bleeding risk / surgery: Avoid if you have a bleeding disorder; stop 2 weeks before surgery; may int...

Studies: Positive but mixed—and overall limited—evidence, mostly in d...

Why it works: Targets TRPV1 pain receptors on peripheral nociceptors. Topical capsaicin strongly activates TRPV1 on C/Aδ fibers, which—after an initial burning phase—leads to “defunctionalizatio...

Instructions: A) Over-the-counter / low-strength creams (typically 0.025–0.075%). • Where they’re used: painful areas with neuropathic pain (e.g., post-shingles, diabetic neuropathy under specia...

Warnings: Common/local effects (both creams and patch). • Burning, stinging, erythema, pruritus at the applica...

Studies: High-dose 8% patchCochrane Review (2017; 8 RCTs; n≈2,488): S...

Why it works: Correcting specific deficiencies that cause neuropathy.. • B12 (cobalamin): Deficiency is a classic, reversible cause of peripheral neuropathy; B12 is essential for myelin synthesi...

Instructions: Don’t self-treat first—check the cause. Ask a clinician to look for reversible causes (diabetes control, alcohol use, medications like metformin, thyroid/kidney disease) and test B...

Warnings: Vitamin B6 (pyridoxine) can cause neuropathy at supplemental doses; TGA now mandates a neuropathy wa...

Studies: Systematic reviews & overviews • Cochrane review on B-vi...

Why it works: Anti-inflammatory & antioxidant effects, plus potential neuroprotection. Astragalus polysaccharides and saponins (e.g., astragaloside IV) show anti-inflammatory/antioxidant activit...

Instructions: Form: oral root (capsules/tablets/powdered extract or traditional decoction). Avoid injectable “Huang-qi” products unless prescribed/monitored in healthcare settings that use them;...

Warnings: Insufficient evidence for efficacy (for any condition) and no established therapeutic dose; suppleme...

Studies: Evidence in humans centers on DPN and primarily involves Ast...

Why it works: Improves microcirculation & has antiplatelet effects. Key constituents (e.g., Z-ligustilide, ferulic acid) show vasodilatory, antiplatelet/antithrombotic, and endothelial-protectiv...

Instructions: Important: Use Dang Gui with your clinician, especially if you use blood thinners, have surgery planned, are pregnant, or have hormone-sensitive conditions. See the safety section...

Warnings: Anticoagulants / antiplatelets (e.g., warfarin, clopidogrel, aspirin): reports of increased bleeding...

Studies: Human clinical evidence involving Dang Gui (usually in combi...

Why it works: What the formula does in TCM: Gui Zhi Tang harmonizes Ying/Wei, warms channels, relaxes muscle layer; adding Ge Gen targets neck/shoulder tightness and promotes fluids. Notably, st...

Instructions: Classical composition (Shang Han Lun):. Gui Zhi 6 g, Bai Shao 6 g, Sheng Jiang 9 g, Zhi Gan Cao 6 g, Da Zao 3 dates, Ge Gen 12 g. TCM Wiki. Typical preparation: Decoction once dail...

Warnings: Not for heat-excess or Yin-deficient heat patterns: Because the formula is warming and mildly diapho...

Studies: There are no high-quality trials of Gui Zhi Jia Ge Gen Tang...

Why it works: TCM rationale (pattern-based): BYHWT “supplements Qi and moves Blood, unblocking the channels.” Classically it’s used when PN presents with Qi deficiency + Blood stasis (numbness,...

Instructions: 1) Formula & forms. • Classical composition (decoction): Huang Qi 120 g; Dang Gui 6 g; Chi Shao 6 g (often 4.5 g); Chuan Xiong 3 g; Tao Ren 3 g; Hong Hua 3 g; Di Long 3 g. TCM Wiki...

Warnings: 1) Bleeding risk & drug interactions (important):. • BYHWT contains blood-invigorating herbs (Dang G...

Studies: Peripheral neuropathy (diabetic PN & peripheral nerve in...