Condition
Diabetic Neuropathy
Diabetic neuropathy is nerve damage from long-term high blood sugar, which harms nerves through oxidative stress, sugar-related compounds called AGEs, and poorer blood flow, often causing numbness, tingling or burning in the feet and hands. Among supplements, the evidence is strongest for alpha-lipoic acid, with moderate evidence for benfotiamine and acetyl-L-carnitine. Still, the detailed results were thin: one benfotiamine study of 82 people found no clear difference in AGEs.
Sources: PMID 15767618; PMID 22792314
- Supplements studied
- 6
- Graded outcomes
- 6
- Trials
- 7
- People studied
- 914
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood glucose Small Improvement | Improves (the measure goes down) | Small effect | 5 studies | 232 people | ||
Studies that measured blood glucose
| ||||||
| Diabetic Neuropathy Symptoms | Improves (the measure goes down) | 1 study | 232 people | |||
Studies that measured diabetic neuropathy symptoms | ||||||
| HbA1c | Improves (the measure goes down) | 1 study | 232 people | |||
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood Flow Mixed effect | 2 studies | 64 people | ||||
Studies that measured blood flow | ||||||
| Nitric Oxide | Improves (the measure goes up) | 1 study | 64 people | |||
Studies that measured nitric oxide | ||||||
| Blood glucose | Improves (the measure goes down) | 64 people | ||||
| Kidney Function | Improves (the measure goes up) | 64 people | ||||
| Proteinuria | Improves (the measure goes up) | 64 people | ||||
Alpha-Lipoic Acid
- Blood Pressure
- HbA1c: changes; see studies
- Weight: changes; see studies
Cannabis
- Diabetic Neuropathy Symptoms
- Pain: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Diabetic Neuropathy Symptoms No effect | NoneNo effect | 2 studies | 46 people | |||
| Pain | Improves (the measure goes down) | 6 studies | 30 people | |||
Studies that measured pain
| ||||||
Benfotiamine
- Endogenous Advanced Glycation End Products
- Proteinuria: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Endogenous Advanced Glycation End Products No effect | NoneNo effect | 1 study | 82 people | |||
Studies that measured endogenous advanced glycation end products | ||||||
| Proteinuria | Improves (the measure goes up) | 1 study | 82 people | |||
Studies that measured proteinuria | ||||||
Sulbutiamine
- Blood glucose
- Diabetic Neuropathy Symptoms: improves
- HbA1c: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood glucose No effect | NoneNo effect | 30 people | ||||
| Diabetic Neuropathy Symptoms | Improves (the measure goes down) | 1 study | 30 people | |||
Studies that measured diabetic neuropathy symptoms | ||||||
| HbA1c | Improves (the measure goes down) | 30 people | ||||
Key findings
- Blood glucoseImproves (the measure goes down)
- Blood Flow
- Blood Pressure
The Diabetic Neuropathy Support protocol
2 primary supplements · 7 supporting supplements
- Alpha-Lipoic Acid600–1,800 mg daily (600 mg has most evidence)
- Benfotiamine (Vitamin B1)300–600 mg daily
Shop the evidence-backed picks
Support alongside medical care. These supplements are not a treatment for Diabetic Neuropathy. If you are being treated for it, talk to your clinician before adding one: supplements can interact with medicines.
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Studies cited
29 studies from PubMed
- Effects of sulbutiamine on diabetic polyneuropathy: an open randomised controlled study in type 2 diabetics
- Evidence of the regulatory effect of Ginkgo biloba extract on skin blood flow and study of its effects on urinary metabolites in healthy humans
- Effect of Ginkgo leaf extract on vascular endothelial function in patients with early stage diabetic nephropathy
- Effect of Ginkgo biloba (EGb 761) on treadmill walking time among adults with peripheral artery disease: a randomized clinical trial
- Effects of oral L-carnitine supplementation on insulin sensitivity indices in response to glucose feeding in lean and overweight/obese males
- Safety measures of L-carnitine L-tartrate supplementation in healthy men
- Effects of exercise intensity and altered substrate availability on cardiovascular and metabolic responses to exercise after oral carnitine supplementation in athletes
- The effects of L-carnitine supplementation on glycemic markers in adults: A systematic review and dose-response meta-analysis.
- Effects of acetyl-L-carnitine and methylcobalamin for diabetic peripheral neuropathy: A multicenter, randomized, double-blind, controlled trial
- Ameliorating hypertension and insulin resistance in subjects at increased cardiovascular risk: effects of acetyl-L-carnitine therapy
- L-Carnitine's Effect on the Biomarkers of Metabolic Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- Randomized placebo-controlled double-blind clinical trial of cannabis-based medicinal product (Sativex) in painful diabetic neuropathy: depression is a major confounding factor
- Efficacy of Inhaled Cannabis on Painful Diabetic Neuropathy
- Amygdala activity contributes to the dissociative effect of cannabis on pain perception
- Dose-dependent effects of smoked cannabis on capsaicin-induced pain and hyperalgesia in healthy volunteers
- Lack of analgesia by oral standardized cannabis extract on acute inflammatory pain and hyperalgesia in volunteers
- Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain
- Comparison of the analgesic effects of dronabinol and smoked marijuana in daily marijuana smokers
- An open-label extension study to investigate the long-term safety and tolerability of THC/CBD oromucosal spray and oromucosal THC spray in patients with terminal cancer-related pain refractory to strong opioid analgesics
- Effect of benfotiamine on advanced glycation endproducts and markers of endothelial dysfunction and inflammation in diabetic nephropathy
- A double-blind, randomized, placebo-controlled clinical trial on benfotiamine treatment in patients with diabetic nephropathy
- Efficacy and safety of antioxidant treatment with α-lipoic acid over 4 years in diabetic polyneuropathy: the NATHAN 1 trial
- Effects of supplementation with alpha-lipoic acid on exercise-induced activation of coagulation
- Oral antioxidants and cardiovascular health in the exercise-trained and untrained elderly: a radically different outcome
- Alpha-lipoic acid does not acutely affect resistance and conduit artery function or oxidative stress in healthy men
- Glycemic and oxidative status of patients with type 2 diabetes mellitus following oral administration of alpha-lipoic acid: a randomized double-blinded placebo-controlled study
- A preliminary evaluation of a novel method to monitor a triple antioxidant combination (vitamins E, C and α-lipoic acid) in diabetic volunteers using in vitro methaemoglobin formation
- Effects of alpha-lipoic Acid on body weight in obese subjects
- Alpha-lipoic acid supplementation: a tool for obesity therapy?