@ray666 In 2020, Mayo gave me a diagnosis of large fiber and small fiber peripheral neuropathy. Mayo said no meds will help with my PN. With doc approval, I started on 600 mg. of ALA - 2 each day. I also take B-12 - 1000 mg. daily and 250 mg. of magnesium - 1 daily and vitamin D. I've been taking these supplements for a least 5 years. I find it hard to tell if anything works but my best guess is the ALA seemed to have effectiveness when I first started. The only way I would know for sure now is to stop ALA and see what happens which to me doesn't make sense. Is it possible the fact that progression has remained below my knees could be a benefit of any of these supplements? To me, that is unknown.