Dietary Supplements for Nerve Pain

Nerve pain, especially in the legs, feet, and hands, is common among adults in the United States. Also called peripheral neuropathy, it affects up to 30% of adults, and nearly 10% of those over age 65. There are many causes of peripheral neuropathy, including:

• • diabetes

  • vitamin deficiencies

  • trauma

  • Infection

  • immune diseases

  • medications or chemicals

Chronic nerve pain interferes with daily activities. Symptoms of burning or shooting pain, numbness and tingling in the hands and feet can be debilitating. Numbness in the feet can result in non-healing wounds when a small blister or sore isn't noticed quickly enough. That numbness can also make it hard to know where your feet are in space, making it tough to keep your balance or go up and down steps.

There are quite a few prescription medications that can successfully decrease pain and discomfort. But there's also interest in some dietary supplements. Let's talk about a few of the common supplements you may have heard about.

First things first

Dietary supplements are not strictly regulated by FDA. Manufacturers have to prove they're safe, but there's no need to show they're effective for anything or determine an optimal dose. So supplements can be sold without much research. Research that is done is often poorly designed and conducted, making it difficult to draw firm conclusions. But the way they're marketed can lead us to believe they've been proven to provide health benefits.

In addition, FDA doesn't assure potency and purity of supplement products. Learn more about how to protect yourself when purchasing supplements.

Vitamin B Complex

"Vitamin B" is actually a family of vitamins. Vitamins B1, B6, and B12 that are the most critical for a healthy nervous system. In fact, deficiencies of Vitamins B1 and B12 often cause symptoms of numbness, tingling, and pain in the hands and feet. It makes sense that B vitamins would be effective at treating nerve pain. But when they've been studied, the only firm conclusion is that nerve discomfort caused by vitamin B deficiency can be corrected with supplements. Nerve pain from other causes doesn't seem to respond reliably to vitamin B supplementation. Some studies suggest there is a role, others find that it doesn't seem to make a difference.

There's ongoing research that will hopefully bring better answers. But for right now, studies don't prove either that vitamin B supplementation is effective in treating nerve pain or that it's ineffective. And if it is effective, the optimal dose isn't clear.

On the other hand, most B vitamins cause few side effects and no important drug interactions. The exception is B6, which shouldn't be taken in higher-than-recommended doses as it can cause a variety of side effects. In general there's little risk in using vitamin B supplements. 

Alpha-Lipoic Acid (ALA)

Alpha-lipoic acid (ALA) is a fatty acid. It's produced naturally by our bodies and is available in many foods. The interest in ALA for nerve pain is based mostly on its antioxidant and anti-inflammatory properties. As an antioxidant compound it can prevent or repair damage to nerve cells. And as an anti-inflammatory it can decrease the pain and discomfort of inflammation due to cell damage. So there's lots of curiosity about its ability to treat various types of pain.

ALA has been studied for its effect on nerve pain from various causes. Some studies indicate that it decreases pain and discomfort, other studies indicate that it has no effect. Overall scientists are optimistic about its potential, but there isn't enough information yet to be sure. Many trials used a dose of 600mg daily; some went up to 1800mg daily.

The studies reported few, if any, adverse effects. So ALA seems to be generally safe. It's somewhat troubling that there have been a number of case reports of "insulin autoimmune syndrome" (IAS). IAS causes the pancreas to release more insulin than usual, and can result in a dangerously low blood sugar. IAS is quite rare and seems to happen only in people with a certain genetic makeup. . 

There are a few possible drug interactions, but their significance isn't clear. Ask your pharmacist or go to Rxlist.com to learn more.

Palmitoylethanolamide (PEA)

Palmitoylethanolamide (PEA) is also a type of fatty acid - specifically a fatty acid amide. It's naturally produced by the body in response to pain and inflammation. And it's found in foods like soy beans and egg yolks, though in very low amounts.

Basic research thus far indicates that PEA is both anti-inflammatory and neuroprotective. It turns out that PEA is similar in structure and function to a natural compound made by the body. The natural compound belongs to the endocannabinoid system (ECS), which has a role in regulating immune, digestive, neurological function and more. It's thought that PEA may exert some of its effect through the ECS along with other mechanisms. 

Research points to the possibility that PEA may be helpful for chronic pain conditions, including some types of nerve pain. An analysis of available research indicated that PEA in doses of 300 - 1200mg daily for up to six months seems to reduce chronic pain from various causes. That's certainly promising. But studies that specifically looked at nerve pain weren't well designed, so they don't provide enough information to draw firm conclusions. At this point it's impossible to be sure that all types of pain will respond equally to PEA. But there's a lot of interest in it, so hopefully more to come.

PEA appears to be safe, with few reported side effects or drug interactions.

Balancing the risks and benefits of supplement use

None of the three supplements discussed here is a sure thing when it comes to relieving nerve pain. But all have scientific theory behind them, and suggestions that they might work. We discussed side effects in each case -- for the most part they appear to be safe with a couple of possible adverse effects. So this is where you get to balance risks and benefits for yourself, and decide if you want to give one of them a try.

Remember to make sure the product you choose is reputable, pure, and potent. Look for a seal of approval or talk to your pharmacist -- know what you're purchasing.

As always, we welcome your questions and comments. Post them just below this article for others to respond to, or contact us directly at Better My Meds. We love hearing from you!

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