R-ALA, Why do neurologists not prescribe this medication/supplement?

Just my non-medical opinion but R-ALA is a supplement and unless you have some sort of vitamin deficiency that shows up in testing and R-ALA would help to eliminate the deficiency, I doubt that any medical doctor or neurologist would recommend it unless maybe they've done some research or testing to show that it helps. The Foundation for Peripheral Neuropathy states it in easy to understand words here:

"Pain Management & Treatments for PN
It is common for people with peripheral neuropathy to experience different degrees of pain. It’s important to identify the type of pain medication that will work best for managing painful peripheral neuropathy symptoms, that also works with your body chemistry, and complements other treatments."
- https://www.foundationforpn.org/treatments/

It is complex, medication or not medication. Since I am not in pain and having read extensively about peripheral neuropathy, I am on neurotherapy, checking my levels of vitamins, especially some of the the B group. I have refused several medications suggested by my primary doctor and my neurologist. I am taking 2 capsules of Alpha Lipolic Acid a day because it is generally recommended . I am 80 years old.
Good luck to you.

My GP recommended it to me a few years ago, and it does seem to help.

@bigjohnscho my guess, and it’s only a guess, is either they don’t know about how much it helps or the pharmaceutical companies are promoting drugs.

As always, follow the money trail…

It works very well for me!

I researched this and put myself on it. We'll see if it helps.

I took alpha lipoic acid for over a year with no improvement. I stopped when I read that it can interfere with those taking thyroid medication, which I do. There isn’t a cure ( yet ) , but I have found the more active I keep my body and brain and try to eat healthy , the less I’m feeling the discomfort. The times it bothers me the most is sitting alone reading or watching TV. I put my feet on a heated massager or vibration plate on the floor, also bought an electrical pulsating plate which they all help in distracting from the discomfort. I set the timer on my phone every half hour and get up and walk . I also lay on my back facing the headboard on my bed with my feet in the air resting against the headboard for about 20 minutes, reversing blood flow. I walk around my neighborhood in the morning and at night. It is a full time job taking care of your health when you have neuropathy, but I know there are far worse problem to have to endure. Both of my sisters, my mother and my husband all battled cancer. I think with the benefit of AI that a understanding of this condition will come at a much faster rate, hopefully.

I am now in my 80s and started with neuropathy about 3 or 4 years ago. The pain at night was unbearable. My internist said that I might want to try alpha lipoic acid. He tends to lean toward natural remedies especially when traditional medicine doesn’t know the cause or has a medically verified treatment. He also said not to expect an immediate help. It would likely take several months if it helped. I decided to start with a lower than recommended dose and researched various available brands. (400 mg/d instead of 600 mg /d). I also started wearing barefoot shoes a month later as my balance was deteriorating. The balance improved immediately and the pain went away almost completely after that. I also exercise every day and rarely sit down during the day and am blessed with good sleep and very rare leg cramps at night.
I think the rest of world, especially Europe, treats symptoms of many ailments with natural remedies before immediately resorting to drugs which may or may not be available to them. Just my personal opinion.
I’m sorry for you and hope you find an answer that ends your pain.

I started taking R Alpha Lipid Acid about seven months ago. As a result, I now take 1200 mg daily (300x4). I have reduced gabapentin from a high of 2400 mg daily to 900 mg.

When I told my primary care doctor of the above, he had a blank stare. While I was sitting there he went on his laptop to look up R ALA. After a few minutes, and apparently satisfied R ALA was legit, he said, you learn something new practising medicine.

I am trying to reduce gabapentin further.

@suzirtist for me, I know that it’s working when I run out of it…

Every doctor I see recommends R-ala. . I read many forums and also groups on FB. I see this supplement being recommended to most people who see a neurologist.