Alpha Lipoic Acid – This is by far the most common cause of burning, tingling and numbness in the feet. I often see it in patients who are “prediabetic.” Many diabetic patients take metformin which can lead to B12 deficiency. It too is a cause of peripheral neuropathy.
For many years I have used alpha lipoic acid which is a potent antioxidant that concentrates in the peripheral nerves up to 200 fold greater than anywhere else in the body. Double blinded placebo controlled trials have shown its effectiveness. A dose of 600 mg/day over five weeks reduced symptoms by 62% in half of one study’s participants. Clinically, patients who maintain this dose long term show ongoing gradual improvement. Doses > 600 mg/day showed no extra benefit and nausea is more likely.
