Specific ALA Recommendations Needed

My neurologist recommended (1) 600 mg ALA per day... not sure if time of day is important or with?without food. My symptoms are so severe in my feet Im not sure if I could feel any benefit. My best OTC product is CBD/THC cream to settle the nerve agitation. Hope this helps.

I have had pheripheral neuropathy for over 30 years but it was diagnosed as gout. Around 4 years ago, after excrutiating pain, I was sent to a rheumatologist who after extensive testing said it wasn't gout and I had never had gout but I better see a neurologist ASAP.
The neurologist put me on Pure Encapsulations (PE) ALA and I take 600 mg 3 times a day. I had an amazing improvement - still numbness but no burning and awful pain. Then two months ago, the pain and burning came back and nothing seemed to help.

Then I realized the burning began when I swiched my multi-vitiamin (PE) Nutrient 950 with Vitamin K because it was out of stock everywhere to PE O.N.E Multivitamin. In going over my papers on neuropathy, there was an article that it was important to get enough B1 to help ALA and other supplements do their work. I checked the amount of B1 in each. My original one had 50 mg and the substitute only had 3 mgs. I immediately took (PE) B-Complex Plus which had 100 mg's in B1 and in 2 days the horrible pain and burning was gone and fortunately Nutrient PE 950 with K is now available again.

I have had pheripheral neuropathy for over 30 years but it was diagnosed as gout. Around 4 years ago, after excrutiating pain, I was sent to a rheumatologist who after extensive testing said it wasn't gout and I had never had gout but I better see a neurologist ASAP.
The neurologist put me on Pure Encapsulations (PE) ALA and I take 600 mg 3 times a day. I had an amazing improvement - still numbness but no burning and awful pain. Then two months ago, the pain and burning came back and nothing seemed to help.

Then I realized the burning began when I swiched my multi-vitiamin (PE) Nutrient 950 with Vitamin K because it was out of stock everywhere to PE O.N.E Multivitamin. In going over my papers on neuropathy, there was an article that it was important to get enough B1 to help ALA and other supplements do their work. I checked the amount of B1 in each. My original one had 50 mg and the substitute only had 3 mgs. I immediately took (PE) B-Complex Plus which had 100 mg's in B1 and in 2 days the horrible pain and burning was gone and fortunately Nutrient PE 950 with K is now available again.

Thank you for your help. I have a topical from Mary’s Medicinals but it is more of a balm than a cream and hard to spread. Could you tell me what brand of cream this is?

I have heard the R form is better and have been taking ALA of all forms for almost 8 years. It has helped me. I take mine at night to help minimize symptoms while sleeping. Capsaicin neuropathy creams have helped but can’t recall the brand names. There are lidocaine creams and Rollins that can help temporarily, too. I like the Salonpas brand. I also take Acetyl L Carnitine supplements which are known to help neuropathy, too.

Here are the creams I just ordered on Amazon.
https://a.co/d/fcZrbNH
Here is the brand of combined alpha Lipoic acid and Acetyl l carnitine supplements I also recently bought.
https://a.co/d/6bk913I

I have had pheripheral neuropathy for over 30 years but it was diagnosed as gout. Around 4 years ago, after excrutiating pain, I was sent to a rheumatologist who after extensive testing said it wasn't gout and I had never had gout but I better see a neurologist ASAP.
The neurologist put me on Pure Encapsulations (PE) ALA and I take 600 mg 3 times a day. I had an amazing improvement - still numbness but no burning and awful pain. Then two months ago, the pain and burning came back and nothing seemed to help.

Then I realized the burning began when I swiched my multi-vitiamin (PE) Nutrient 950 with Vitamin K because it was out of stock everywhere to PE O.N.E Multivitamin. In going over my papers on neuropathy, there was an article that it was important to get enough B1 to help ALA and other supplements do their work. I checked the amount of B1 in each. My original one had 50 mg and the substitute only had 3 mgs. I immediately took (PE) B-Complex Plus which had 100 mg's in B1 and in 2 days the horrible pain and burning was gone and fortunately Nutrient PE 950 with K is now available again.

I’m curious, is yours diabetic neuropathy? What mg of R-ALA do you take daily?

@aunttonipage
No, my small fiber neuropathy is idiopathic (no known cause). When my feet were really bad and burning/tingling/pins and needles pretty regularly, I started taking 600 mg of alpha Lipoic acid. It started working after a month and my symptoms started to improve. I also noticed my feet were worse in warmer weather and when walking (not sure if due to swelling/inflammation aggravating the nerves more). Compression socks and cooling my feet helped and I also used nerve pain creams.