by Linda Stevens
My husband has type 2 diabetes. Because he was not diagnosed early enough, he developed neuropathy in his legs and feet, with sharp pains and numbness.
A neurologist suggested sublingual (under-the-tongue) vitamin B12 tablets, which helped somewhat. Later, a health store owner recommended 600 mg of alpha-lipoic acid, telling me it could help repair nerves and their protective coverings.
The improvement seemed remarkable to us: my husband no longer experienced numbness or sharp pains. We told a friend with similar leg and foot symptoms, and he also reported improvement. Within 48 hours, he said he began to regain feeling in his legs.
Our friend also reported better movement in his arm and more energy. We were very encouraged. Have you heard of this before?
Answer by: Dr. Albana Greca, MD, MMedSc
Family Physician, IDF Fellow
Hi Linda,
It is encouraging that your husband feels better. Yes, ALA has been researched for diabetic neuropathy. However, improvement in two people cannot tell us whether the supplement repaired nerve damage. Pain relief and recovery of nerve function are different outcomes.
The five-week SYDNEY 2 trial found improvement in neuropathy symptom scores with oral ALA. The 600 mg daily dose offered a better balance of benefit and side effects than higher doses in that study.
Short-term improvement does not establish lasting benefit. NCCIH describes the research as inconsistent. ALA should not be presented as a treatment proven to rebuild nerve coverings or restore lost sensation.
No. Although 600 mg daily is a researched oral dose, it is not a personal prescription. A doctor or pharmacist should review the diagnosis, medicines, glucose readings and supplement before recommending a dose or trial period.
Increasing the dose because neuropathy is “advanced” is not an established dosing
Vitamin B12 deficiency can cause or worsen numbness, tingling and balance problems. Long-term metformin use can increase the risk of low B12, so discuss this with your husband's clinician.
B12 replacement helps when deficiency is present. His clinician can decide whether a blood count, B12 testing or further investigations are needed. Thyroid disease, kidney disease, nerve compression and other causes may also need consideration.
Learn more about diabetic peripheral neuropathy.
ALA may cause nausea, heartburn, vomiting or headache. It may also affect blood glucose. People taking insulin or medicines that cause hypoglycemia should discuss monitoring with their clinician.
Less pain does not necessarily mean protective sensation has returned. Continue regular foot examinations and daily foot care.
See our diabetic foot-care guide and neuropathy treatment information.
Tell his neurologist about the improvement and the exact supplement he takes. Ask about B12, protective sensation and whether continuing ALA is appropriate. If pain persists, discuss established treatments for neuropathic pain alongside glucose management and foot protection.
His experience is encouraging, but it is best described as reported symptom improvement rather than proof of nerve healing.
Hope this helps.
Click here to post comments or follow up
Ask the Doctor now? Simply click here to return to Type 2 diabetes information.