R-Lipoic acid, B supplements for Small Nerve Neuropathy (?)

Many reading suggests that R-Lipoic acid may help small fiber neuropathy because it lowers blood sugar levels. That, in-turn, would help those with diabetic small fiber neuropathy.

However, for those with normal blood sugar levels AND idiopathic small fiber neuropathy, is it still helpful in both treating the burning and painful pins and needles, tingling , etc and also rebuilding the small unmyelenated nerve fibers?
I started taking RLA 50mgs, (100 made me jittery) about 2 weeks ago. I was taking metanx but my doctor ran out of samples. I supplement now with my own "formula" ( thanks to MrsD and others Ive met on here!) They are: Methylfolate 800mcg, Methylcobalamin 2000mg (have normal b12 lab result 1250) P5P 50mgs, Benfotiamine 160 2xday, Vit C 500mgs, Chelated Magnesium 200mg, Vit D3 2000mgs, Fish oil.
Its been approx 7 weeks since I started taking the "formula". It has helped with the burning somewhat, but I still have many other symptoms. I started taking B1 3 weeks ago. Does anyone believe these supplements could help for Small nerve idopathic N if I keep taking them? and How long should I wait to see if the are truly helping. confused and in pain..Thank you in advance.

Many people have insulin resistance. The occurs before blood sugars get really elevated, and show up on testing.

I believe the lipoic acid helps with this aspect of blood sugar control...enabling the cells to use glucose better. So in that way it is not really only for diabetics.

B1 is not needed if you take benfotiamine.

There are two basic ways to attack PN...
1) is to replace depleted or lost nutrients

2) is to support mitochondrial functions when they are damaged.

The support nutrients for mito damage are lipoic acid, acetyl carnitine, and CoQ-10. Also biotin helps, because lipoic acid takes up the transporter for biotin and B5, so taking some biotin opposite times from the lipoic acid can help. Magnesium also helps with membrane functions of the mitochondria.

Also some fish oil helps, with inflammation.

Most people need several months to heal, when nutrients are used. It took time to get where you are, and it will therefore take some time to heal up.

MrsD as always Thank You for your response.
I was told Im glucose Intolerant, in fact I didnt do well on my 2 hr GTT, my result was 167. Endo said normal was below 140 at 2nd hour.. So, I am considered "pre-diabetic". I beliveved the neuropathy, which started with burning feet, pins and needles and tingling in my legs was from the pre-d, at that time my A1c was 5.7. All my Doctors includin Endo said My "diabetes" was not bad enough to cause this kind of nerve damage. The neuropathy progressed to my arms , hands, face and mouth within 2 years while I was maintaining good sugar control. Soo needless to say I was Dx with pred and neuropathy at the same time, go figure!! ( guess well never know how high my post meal sugar spikes were before I was dx with pred) BUT meanwhile they say the pred and neuropathy are not related..talk about being confused and frustrating..sorry had to vent.

I use Doctor's Best R Lipoic Acid. The facts label says there are 150 mcg of D-Biotin per serving (.15 mgs doesnt sound like much right? so why does the mfgr bother to put 150mcgs in with the RLA?). I thought it would be enough. Do you believe I should be taking more Biotin or a diff kind? Oh, and I should have written benfotiamine instead of B1, that is what Im taking. Is Mitochondrial function damaged in people with SNN do you know, or does this happen only to diabetics? You didnt mention the methylcobalamin , Im taken 2mgs per day. Does this help with neuropathy? I was getting 4mgs pday with metanx. but after 4 weeks I decided to cut back to 2mgs. I cut back on the methylfolate from 3 mgs (metanx) to 800mgs as you suggested.
I bought the A L carnitine 100mgs (to take with the RLA) but I havent been able to take it, It makes me jittery. Im still only on 50mgs of the R Lipoic acid. Im slowing tryn to get to 100 of RLA. Im so sensitive to everything, so frustrating.
What is B5, Should I add B5 and CoQ-10 to my "cocktail" for small nerve neuropathic pain? Are these pills (vits) for "replacing lost or depleted nutrients" for diabetics and insulin resist only or does one take them even if there bloodwork shows vitamin levels are within "normal range" for other kinds of neuropathy?
Sorry for all the questions, it all gets so confusing. I feel fortunate to have a place to come too. As you probably already know doctors will not talk about this kind of stuff ..Thank you so much...

There has been recent information about the transporter for biotin, lipoic acid and B5 published on the net. It is not cast in stone but I do think it is valid. They all share this transporter which is a peptide that binds each and carries it around.

Because lipoic acid is used in the body, in very small amounts, and same with biotin, there is not much of this transporter made.

The doses we take of lipoic acid are huge in comparison, so expect the other nutrients to not get transported as necessary.
I take 10 MILLIGRAMs of Biotin a day, at night, for this reason.
I take 100mg of Doctor's best R-lipoic stablized...early in the day. There are studies of low biotin with ALA...but putting it in the same capsule seems rather useless to me.

Not everything you see on supplement labels is 100% accurate. In fact B12 has NO recommendations to take on empty stomach except for one research article I found! Studies on micrograms of digoxin and thyroid hormone have found empty stomach essential also for their absorption....so I recommend empty stomach for the B12. The paper I have on the B12 thread states that empty stomach was used for the absorption data that was collected. That is the only published source I have found...and I think it is very very important.

So yes, you would find lipoic acid helpful.

B5 is not typically lost in the body and is very plentiful in many foods, so I don't find anything about it for PN in studies. If you want to use it, fine. It is not harmful in somewhat larger doses.

Yes, the new research is suggesting mito damage for some sensory neuropathies. Some of this comes from AIDs patients, who get damage from the drugs they take.
It might turn out that MOST of PNs are mito damage. We'll have to see how that turns out, however. Some drugs damage DNA and that is another topic. (fluoroquinolones are in that category). Acetyl carnitine is recommended to prevent some Chemo therapy damage as well. So it is a good idea for us. Many PNs are environmental damage, and some are metabolic, and people can have both, you know?

The ranges we have for vitamins and minerals are very outdated, and really most are done on serum levels. Some integrative doctors test INTRAcellular levels, to see what is really going on. Levels in the serum (liquid portion of the blood) are not doing ANYTHING...they are only moving around, or on their way to being excreted.

Marie, "Minding my Mitochondria" is a good book. Talks about food and mitochondria, etc. Very good.

Some of the supplements I take for mitochondria are Quercitin, L Carnitine, CoQ10, magnesium, d ribose, etc. Also, lots of greens and other foods are good.

Here is a link to the mitochondria thread:

http://neurotalk.psychcentral.com/sh...t=mitochondria

Another thing you might try is eliminating the night shade vegetables that Mrs D has talked about (potatoes, tomatoes, eggplant, all peppers, tobacco, paprika, pimento). I didn't realize how much these things were bothering me until I eliminated them and the burning stopped. It's kinda hard to eat Mexican food now, but I'm coping!

I find Baja fresh has items on the menu that I can tolerate.
They put their hot condiments as sides, and are at a separate table for free with little cups, where you can season your own menu selection.

I typically get the quesidillas with shrimp and have no burning from that. Also the Tostada with chicken works for me.
They are also lower in salt compared to other places.
We get carry out there about twice a month.

Hi Sally
Thanks for respomding, I have not been on for a while. Im still struggling with SFN, taking Lyrica 150 day and tramadol as needed.
How much AL Carnitine do you take? I take 100mgs a day, do you think that is enough? I also take 100 mgs CoQ10. Both of these supplements along with R Liopic Acid are "stimulants". Im trying to slowly increase my dosages , but they make me feel jittery, so I can not get up to the "effective" dosages.
How much Magnesium do you take? I take 200mg Doc Best Chelated. I read 800 mgs a day was beneficial for neuropathy. Seems like too much to me. I also eat greens and other good foods. What is D ribose? Do any of these supplements help with your neuopathy? Feels like im losing the neuropathy battle. Thanks....

I like Carniclear. (L-carnitine liquid) http://www.rockwellnutrition.com/Car...FH-_p_863.html


I take about 350mgs of Mag. in the morning and 400 of my Magna Calm by Longevity Science powder each night.

Here is a link about D ribose. http://www.lef.org/magazine/mag2008/...ur-Life_01.htm

A lot of supplements have helped me. Alpha Lipoic Acid, Benfotiamine, Vit D, B12, fish oil and others.

My doctor told me to stop gluten several years ago. I was already not eating that. He told me to stop refined sugar/carbs also. That was harder. I have no problems with glucose levels, but sugar is not good for the nerves so that is a very important thing to stop. I eat very healthful foods, amazing smoothie daily, and I learned a lot from several good books. One I love is "Minding my Mitochondria." All about helping the nerves/mitochondria.