Do these vitamins really help?

I rely on what my neurologist has told me about vitamins and supplements. Your PC might also be helpful. I wouldn’t start any vitamins before getting labs done, since it can skew the results and I would consult with your doctor before starting them or any supplement, especially if you have symptoms of neuropathy. Sometimes, deficiencies can cause those symptoms. Other times, it can be too high. In my case, I had low B12 and needed large sublingual doses, as I have absorption problem.

The supplements you mention might be helpful for some, but my neurologist never suggested them. If they were helpful, I would think he would have. But, I was already taking Magnesium when my symptoms started. I was taking it to aid digestion.

@aunttonipage
I have small fiber neuropathy (SFN) confirmed via the gold standard of skin punch biopsy of thigh and ankle. My first symptoms were burning and pins and needles in the bottoms of my feet and then on my left calf. I learned doing research about supplements that help SFN and started taking acetyl l carnitine, alpha Lipoic acid, magnesium and noticed an improvement in symptoms after a month or two. I was also iron deficient at the time and took special iron supplements that are better absorbed and not upsetting to the stomach.

My current combined alpha Lipoic acid and Acetyl l carnitine supplement has 525 mg ALC and 225 mg ALA. you can take more ALA (up to 600 mg) which I did when my symptoms were bad. My current magnesium complex has 500 mg in it.

My neurologist didn’t help treat my SFN and only recommended medication that causes major side effects and when I told him about the supplements I was taking, he said that he haeard they helped some. Why didn’t he mention them to me as an alternative if it could help?

Google Scholar is a good search engine for finding medical research papers. Here's what it shows searching for
"acetyl l carnitine alpha lipoic acid neuropathy" - https://scholar.google.com/scholar?hl=en&as_sdt=0%2C24&q=acetyl+l+carnitine+alpha+lipoic+acid+neuropathy&btnG=

You can select the year at the left column to sort the results to show the most recent papers found.

I have never had a doctor of any sort recommend anything that wasn't surgery, a pharmaceutical, or an FDA-accepted device, unless it was intended to prevent or repair a vitamin or mineral deficiency, or had solid clinical trials behind it. I don't know if they just don't think to go there, don't believe in them, are trained to avoid recommending products that lack government oversight and therefore may or may not actually be what's on the label, don't have time to winnow through all the possibilities, or just don't feel sufficiently well-educated in this aspect of the options to be confident in giving good advice. Neurologists are no exception.

I have found, however, that if you do your research and ask about specific vitamins, supplements, herbals, etc, they are commonly willing to provide whatever insight they might have. Ditto pharmacists. So unless you are going to an alternative medicine practitioner, the conversation really needs to start with the patient. In fact, I've had a neurologist actually ask me about my experience when I've told them I've decided to try an alternative solution, which argues that they may be open to it -- just don't feel competent to make recommendations.

It's really critical to do our best to get products that actually are what they say they are, try them one at a time sufficiently far apart to determine whether each one is making a difference, and find someone who can tell us whether they may interact with one another or any existing drugs we are on. For those of us who are dealing with a cocktail of stuff, interactions can be a real issue, particularly when trying to peel apart side effects and resolve them.

I will offer that I happen to know that oral magnesium can be a real GI side effect magnet for some people (diarrhea, especially), so ramping up from a low dose would not be a bad idea. It's one reason I switched from oral to topical for my migraines. That may or may not be a good idea, depending on how close to the skin the nerves are that you are dealing with. (That last sentence towed me into sheer speculation territory.) Also, I have read something which may or may not be true, which is that topical magnesium penetrates the skin barrier via hair follicles. For that reason, if you use it, you might want to avoid the bottom of the foot.

All of these support the nervous system and our body's ability to heal. Be sure to buy quality brands like PURE Encapsulations or Integrative Therapeutics.

1. Acetyl-carnitine is an amino acid the body makes that supports mitochondrial/metabolic health and can help with nerve pain.

2. Magnesium + l-theanine
- Magnesium glycinate helps with nerve pain, but you will need magnesium chloride for topical use.
- L-theanine, taken together with magnesium glycinate, can improve sleep.

I take magnesium glycinate at night, use magnesium chloride in my baths and hand creams and sprays, and use magnesium citrate in the morning to help with the motility issues of autonomic neuropathy.

L-theanine (amino acid) is a compound of green tea that aids cognitive function and sleep. I take green tea extract daily.

L-threonine (amino acid) is found in plant and meat protein. It supports the nervous system and is in the amino acid powder I use in my smoothies. This is different than l-theanine.

3. R-ALA improves motor nerve function and nerve pain, especially for those with high blood glucose. Don't take ALA; be sure it is R-ALA.

I've never heard of them.

Have you taken them long enough to actually work? I am at the 2 month point, and feel no less pain then I did before I started! I am almost ready to accept the Gabapentin from my doctor.