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Attempts to Validate Nutraceutical Use for Neuropathy

We recently published an article outlining the current difficulty with treating pain related to neuropathy, and how there are no gold-star treatments to reduce discomfort. This frustration has led many to seek out new methods of relieving pain, including “nutraceuticals.” Nutraceuticals can be classified as vitamins, vitamin complexes, and similar nonpharmaceutical compounds aimed at relieving symptoms. While they are generally well-tolerated, and in many cases, beneficial to the body as a whole, there is very little evidence directly linking them to definitive pain relief. Several studies in the past few years have tried to prove the efficacy of nutraceuticals, and nearly all have failed to produce clinically relevant results. However, there have been many reports of overall reduction of many different types of symptoms, showing that there may be at least some benefit to these new treatments.

Vitamin D and Vitamin B Treatments

There has been some definitive evidence that certain vitamins could lead to a remarkable relief from symptoms. However, these results are often found in a small subset of patients that have neuropathy due to vitamin imbalances from the start. For example, neuropathy caused by vitamin D deficiency is relatively common for individuals living in areas that have cold, relatively low-sunlit winters. It would make sense then that giving these individuals vitamin D would effectively eliminate the underlying cause for the symptom in the first place, thus relieving pain. For the vast majority of those struggling with neuropathy, the direct cause is not vitamin-related, and therefore, relief is not so simple.

Studies surrounding the use of vitamin D or vitamin B to treat neuropathy have been published, and have found similar results. Notably, two studies (one on each vitamin) have sparked a lot of interest. The study surrounding vitamin D noticed a significant decrease in pain scores from baseline in 143 individuals with type 2 diabetes; however, the study was relatively short-term, lacked a placebo group, and contained a large proportion of individuals with vitamin D deficiency at baseline. The vitamin B study used a complex called Metanx (with many different types of B vitamins in combination), and included 214 individuals across many states. The primary endpoint of the study, to improve vibration-perception thresholds, was not met; however, many individuals did report an overall reduction in symptoms. Unfortunately, this reduction was not considered significant enough to support the use of Metanx across the board.

Alpha-Lipoic Acid (ALA)

There has also been some buzz surrounding ALA to treat neuropathy symptoms and pain. ALA was even the center of the NATHAN-1 study in Germany recently. Over 460 individuals were included in the trial, and those in the experimental group were given 600 mg/day of ALA for four years. The study did not meet its primary endpoint, to improve nerve conduction; however, just as in the vitamin D and B experiments, many individuals on ALA showed an overall decrease in neuropathy symptoms and symptom progression as compared to placebo. Interestingly, those who were in the worst health (older age, cardiovascular complications, and longer duration of diabetes and neuropathy) were the ones who responded the best to treatment with ALA. These associations, like others before them, were proven to be too weak to meet the clinical standards for FDA approval.

Future Possibilities

Much more research is in the works on the usage and potential benefits of nutraceuticals, but for now, none have received the FDA seal of approval. Let us know if you’ve tried any of these nutraceuticals, and whether or not you noticed an improvement in your neuropathy pain!

  1. Busko, Marlene. “Evidence scant on nutraceuticals for neuropathy in diabetes.” Medscape. 9 Nov 2016. Available from: