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ALPHA-LIPOIC-ACID Has been studied for treatment of diabetic neuropathy Anti-inflammatory effects, reduces oxidative stress Several studies show improvement in neuropathy symptoms with long term use According to one study taking 600 mg orally each day provides optimal risk-to-benefit ratio ACETYL-L-CARNITINE Shown in clinical trials to be effective for diabetic neuropathy In studies of chronic peripheral neuropathy patients treated with 500-1,000 mg 3 times daily showed improvements in pain and improved sensation in fingers and toes Studies of other types of neuropathy have shown mixed results VITAMIN D Studies have identified vitamin D deficiency as a risk factor for diabetic neuropathy Several trials showed improved pain levels in patients with diabetic neuropathy, with one study using an oral dose of 50,000 IU of vitamin D3 weekly Benefit of supplementation is less clear for patients with neuropathy and normal vitamin D levels VITAMIN B1 Studies have shown diabetic patients are more vulnerable to vitamin B1 deficiency Vitamin B1 deficiency can cause peripheral neuropathy Taking vitamin B1 600 mg/day can help improve pain in patients with diabetic neuropathy VITAMIN B12 Vitamin B12 deficiency can cause neuropathy Vitamin B12 deficiency is not uncommon in the USA, particular in older individuals when absorption declines In one study of patients with diabetic neuropathy and normal B12 levels, taking vitamin B12 500 mg 3 times daily helped improve symptoms of neuropathy after 4 months VITAMIN B6 Vitamin B6 toxicity and vitamin B6 deficiency can cause peripheral neuropathy Eating a balanced diet including foods high in B6 (salmon, poultry, chickpeas, dark leafy greens, bananas, cantaloupe) helps prevent vitamin B6 deficiency in most individuals VITAMIN E Powerful antioxidant that reduces levels of free radicals and oxidative stress Studies showed a beneficial effect on the incidence and symptoms related to chemotherapy-induced peripheral neuropathy for patients taking vitamin E 300-600 mg/day OMEGA-3 FATTY ACIDS (FISH OIL) High quantities in cold-water fish (salmon) and widely consumed for antiinflammatory powers Essential fatty acids and important component of cell membranes, myelin sheath that protects nerves Studies are underway (estimated completion date 2025-2026) to determine whether fish oil supplements can be effective in treating diabetic peripheral neuropathy REFERENCES: Chen, Jie, et al