8 Neuropathy Supplements for Nerve Pain Relief

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Neuropathy is a debilitating type of pain caused by injury or damage to nerves. Although many factors lead to neuropathy, the imbalance between damaging free radicals and protective antioxidants (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. However, whether research supports the use of these supplements for neuropathy is not well established.

Acetyl-L-carnitine is a naturally occurring amino acid. It reduces the number of pro-inflammatory molecules in the body and helps produce proteins that protect neurons.

Benefits include:

Additional studies are necessary to understand how acetyl-L-carnitine impacts neuropathy and whether the benefit depends on the type of neuropathy. People on hemodialysis regularly supplement with acetyl-L-carnitine to help fight chronic inflammation and oxidative stress.

Supplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian nutritionist (RD or RDN), pharmacist, or healthcare provider. No supplement is intended to treat, cure, or prevent disease.

Alpha-lipoic acid (ALA) is an omega-3 fatty acid and antioxidant. Benefits include:

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 may be safe during pregnancy when taken orally in doses of up to 600 mg daily for up to four weeks, but it is not recommended during breastfeeding.

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.

When choosing a supplement, look for independently tested products and consult a healthcare provider, registered dietitian nutritionist (RDN or RD), or pharmacist.

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 slows blood clotting when taken with blood thinners, and can decrease the effects of your thyroid medication. Similarly, ALA may lower blood sugar levels when taken with an antidiabetic (blood sugar lowering) medication.

B vitamins are essential for countless body reactions. B vitamin deficiencies lead to neuropathy, so getting enough B vitamins is essential to imrpove neuropathy symptoms. 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.

Benefits include:

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 (neuropathy caused by lack of nutrients.

Additional research is required to understand the role of B12 in neuropathy fully. Many studies do not show baseline vitamin B12 levels, so the benefit of supplementation may be due to B12 levels returning to normal.

The following medications impact your B vitamin levels:

Capsaicin is the compound in chili peppers that makes them spicy. 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

Benefits include:

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 the marijuana plant. Unlike other compounds in marijuana, CBD does not cause a sense of euphoria (a "high"). CBD comes from hemp or non-hemp plants. 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.

Benefits include:

Research on cannabidiol is new and evolving, so there is no set recommended intake. Dosage will vary depending on topical or oral CBD use. Exercise caution when consuming CBD because limited data on its safety exists. Possible side effects of CBD include the following:

CBD is not recommended during pregnancy or breastfeeding. It is unclear whether CBD passes to the baby through breast milk. More data is necessary to determine the safety associated with CBD products applied to the skin.

CBD interacts with certain medications, including the following:

CBD also interacts with food. Taking CBD with food may increase the amount absorbed by the body.

Coenzyme Q10 (CoQ10) plays an essential role in supporting mitochondria (the cell's powerhouse) function through its anti-inflammatory and antioxidant properties.

Benefits include:

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:

People consume an average of 3–5 mg of CoQ10 daily through the diet. Food sources of CoQ10 include chicken thighs, herring, and trout. Consult with your healthcare provider before starting CoQ10 to figure out your proper dosage.

Gamma-linolenic acid (GLA) is an omega-6 essential fatty acid. GLA can be obtained from the diet via borage, black currant oil, and evening primrose oil.

Benefits include:

Not enough data exists to support GLA supplementation during pregnancy and breastfeeding.Supplementation is not recommended if you have elevated triglycerides because omega-6 fatty acids can further raise levels.

Magnesium is a mineral involved in many bodily processes, including muscle and nerve function.

Benefits include:

Magnesium interacts with certain medications, including the following:

Multiple types of neuropathy exist depending on the underlying health issue. Neuropathy can result 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:

Besides supplements, lifestyle modifications focusing on diet, stress, and movement alleviate neuropathic pain.

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 and balance training alleviate 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 of aerobic and progressive strength training enhances other treatment methods for HIV-related neuropathy.

Participating in mindfulness 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.

Supplements such as ALA and acetyl-L-carnitine may provide some relief from neuropathic pain. Limited data exists to support the use of other supplements, such as B vitamins, capsaicin, magnesium, GLA, and cannabidiol, 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.

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.

National Institutes of Health. Thiamin.

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.

Gwathmey KG, Grogan J. Nutritional neuropathies. Muscle Nerve. 2020;62(1):13-29. doi:10.1002/mus.26783

National Institutes of Health. Vitamin B6.

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

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

National Center for Complementary and Integrative Health. Coenzyme Q10.

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. 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.

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

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

By Amy Brownstein, MS, RDNAmy Brownstein, MS, RDN, is a private practice dietitian and nutrition consultant based on the West Coast. She is passionate about translating nutrition science into digestible and actionable educational information and recommendations.