The People's Perspective on Medicine

Can You Help Nerve Pain with a Diet Rich in ALA?

Might you control neuropathy by consuming a diet rich in ALA (alpha lipoic acid)? One reader reports better success with diet than supplements.

Doctors often have a hard time treating nerve pain, also called neuropathy. When diabetes causes neuropathy, physicians ask patients to control their blood glucose very strictly. In addition, they may prescribe drugs such as gabapentin (Neurontin) or pregabalin (Lyrica). People who prefer to avoid such medications may turn to supplements for relief. Benfotiamine and alpha lipoic acid (ALA) are often helpful against diabetic neuropathy. One reader found that consuming a diet rich in ALA effectively eased symptoms of nerve pain.

Q. For years, I had idiopathic neuropathy (loss of feeling in feet and severe leg pain at night). I heard that alpha lipoic acid could be helpful, but the supplement did not work for me.

A Diet Rich in ALA:

Then, I experienced cravings for chicken livers. It turns out that organ meats are rich natural sources of lipoic acid. For the past few years I have eaten one organic chicken liver each day. I now have full feeling in my feet and no leg pain.

For me, it seems that a diet rich in ALA is far superior to the supplement. I have recommended this tactic to a few people I know with neuropathy and they have had similar beneficial results.

Does Alpha Lipoic Acid Help Neuropathy?

A. Alpha lipoic acid (ALA) has been studied as a treatment for diabetic neuropathy. A review of nondrug approaches for painful peripheral neuropathy found that supplements of ALA, vitamin B12, acetyl-L-carnitine or vitamin D in deficient patients may be helpful (Current Treatment Options in Neurology, Sept. 2, 2019). 

Your approach of getting ALA from chicken livers is intriguing. To eat a diet rich in ALA, include organ meats on the menu along with vegetables such as spinach and broccoli. In addition, brewer’s yeast is a great source. Brussels sprouts, peas and tomatoes provide lower amounts of this compound.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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Citations
  • Baute V et al, "Complementary and alternative medicine for painful peripheral neuropathy." Current Treatment Options in Neurology, Sept. 2, 2019. DOI: 10.1007/s11940-019-0584-z
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What about NON-diabetic neuropathy?

I would like to know how those chicken livers are prepared. We cook them to add to our dog’s food, and she seems to like them. I am not sure if it helps her neuropathy! She won’t tell me. Seriously I would like to know how to cook and eat them once a day.

I wonder if ALA supplements are not as effective because people are using the wrong form? I’m all for “food as medicine” so I think eating foods rich in ALA is a great option. But if you cannot, for some reason–such as taste preference ( I hate liver) or digestive issues ( I can only eat a tiny amount of broccoli and brussels sprouts due to a digestive condition), supplementing with the proper form of ALA is crucial. Most manufacturers sell a mixture of S-ALA and R-ALA. R-ALA is the beneficial form that our bodies can use. S-ALA is mostly a filler, so they can say it’s a 100% ALA supplement, but it’s a LOT cheaper to make (and therefore usually cheaper to the consumer). But also much less effective. A pure R-ALA supplement has been working great for me–I use it to lower my blood sugar and it works BETTER than metformin or glipizide for me. This also means ALA not only helps neuropathy issues–it PREVENTS them by keeping blood sugars under control.

Are there studies on the efficacy of Alpha lipoic acid to treat neuropathy. ?

Yes, although some of the study designs are not optimal:
https://www.ncbi.nlm.nih.gov/pubmed/30949911. Retrospective and observational
https://www.ncbi.nlm.nih.gov/pubmed/29517942. Not placebo controlled
https://www.ncbi.nlm.nih.gov/pubmed/8786016. This one is randomized and controlled but only three weeks
https://www.ncbi.nlm.nih.gov/pubmed/30295079 Prevention of chemo-induced neuropathy. preliminary results are promising, small numbers
https://www.ncbi.nlm.nih.gov/pubmed/30233145 Effective combined with epalrestat, a compound used in Asia to treat neuropathy

Would the ALA diet help amputation nerve pain not due to diabetes?

We don’t know. There’s some research on ALA supplements but none on an ALA rich diet to control nerve pain.

The studies on ALA for nerve pain typically use professional quality supplements to ensure quality and controlled dosages. When someone tells me that a supplement didn’t help them, I ask them what brand they tried and what dosage. Usually, they tell me that they just picked one up at their local grocery store and didn’t check the dosage. Unfortunately, grocery store brands are probably the most inferior products available. Just know that “your results may vary” significantly when comparing results for inferior products to the products used in a study.

My friend takes an ALA supplement for her nerve pain. She has CRPS, and when she was first diagnosed, she was prescribed Gabapentin, which caused her to have memory loss, and made her very sleepy. Along with staying active, and taking ALA, she no longer needs the drug.

Very interesting and I will try for fibromyalgia pain. ALA, like name suggests, is so acidic it burned my mouth if taken in honey and burned my stomach in capsules. Not sure who can take this.

Does a diet rich in organ meat raise your bad cholesterol?

Also, I asked about you having facebook link on your posts. I do not get them on my copy of your newsletter. FYI

I am using benfotamine and R-lipoic acid instead of alpha-lipoic acid. It really works well for me.

For years I’ve often experienced excruciating pain in my instep and found no solution from either conventional medicine or acupuncture. I’ve found relief from 600mg ALA supplement tablets and always have one in my pocket since I never know when the pain will occur.

This sounds like a wonderful suggestion for neuropathy that accompanies Type 2 diabetes, but what about the increase in blood levels of cholesterol from chicken liver? Please clarify.

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