Peripheral Neuropathy: A Naturopath’s Perspective

Peripheral neuropathy (PN) is a very common condition that manifests as numbness, tingling or pain.  It commonly occurs in the hands or feet, but can also occur in other parts of the body.  It may sound confusing, but PN can also cause decreased sensation, increased sensation, or changes in sensation in these areas.  For example, non-painful stimuli such as a light touch can be experienced as intensely uncomfortable or even painful.  These diverse and seemingly contradictory symptoms occur when the nerves beyond the brain and spinal column are irritated or functioning abnormally.


Diagram of the peripheral nervous system

Diagram of the central and peripheral nervous system

One of the challenges of addressing peripheral neuropathy is that there are many possible causes.  Perhaps the most common is diabetes, but others include trauma, Lyme disease, herpes virus infections (shingles or chickenpox virus), poor circulation, carpal tunnel syndrome, auto-immune disease, endocrine disease, and other diseases that alter the body’s ability to maintain electrolytes or waste products of cellular metabolism at healthy levels.  Sometimes, no cause is found for the poor nerve function, while other times it is chalked up to an inherited condition called familial peripheral neuropathy.  Also, PN may be a side effect from a medication, medical procedure or from an exposure to a pollution or toxin.

So, the first step in treating peripheral neuropathy is to try to identify the cause.  This is usually done through taking a thorough medical history, blood tests, and sometimes testing nerve and muscle function with an electromyelograph.

Obviously, a discussion natural approaches for all the causes of peripheral neuropathy is too lengthy for this article.  However, I would like to discuss some of the more important approaches.

Nutrient Deficiencies and PN

Identifying nutrient deficiencies is fundamental to the initial assessment of many medical conditions, including PN.  We know that deficiencies of thiamin (vitamin B-1) and vitamin B-12 can cause PN symptoms.  These nutrients are commonly deficient in people that consume a lot of alcohol on a regular basis.  Testing for vitamin B-12 can be done through blood tests that measure blood levels (serum vitamin B-12) or actual metabolic activity of vitamin B-12 dependent enzymes (methylmalonic acid and homocysteine).  

If you are at risk for these nutrient deficiencies, there are some steps you can take.  Taking a high-dose multivitamin can help prevent these deficiencies and can provide rapid benefit.  For those that want to use food as their medicine, B-12 is found in meat, shellfish, poultry, eggs, and milk while thiamine is found in legumes, whole grains, nuts, spinach, and pork.

Diabetic PN

In cases of diabetic PN, medical studies and my clinical experience show that alpha-lipoic-acid (ALA) and vitamin B-12 can be very effective for improving nerve function.  ALA is a naturally occurring anti-oxidant that is both fat and water soluble.  100-1800mg daily works well in diabetic patients, but care should be monitored because ALA can lower blood sugar levels.  This can be dangerous in a diabetic patient.  Vitamin B-12 is a non-toxic essential nutrient that can be taken orally or injected into the muscle.  Studies on PN and vitamin B-12 have used intramuscular injection, but there is good reason to believe that high oral doses are just as effective.

Chemotherapy Induced PN

Patients undergoing chemotherapy experience PN from the toxicity of the chemotherapy agents.  Glutamine has been shown in several medical studies to dramatically reduce the incidence and severity of chemotherapy induced PN.  Better yet, glutamine is very safe and improves the health of the gastrointestinal mucous membranes and immune function in chemotherapy patients.  Effective doses are very high; as high as 15 grams twice daily!

Circulation and PN

Another important cause of peripheral neuropathy is poor blood flow to the affected nerves.  Vitamin E, ginger, coenzyme Q-10, gotu kola, and other therapies can be effective in these circumstances.  Vitamin E improves circulation in a condition called intermittent claudication; it can be effective at 400-800 IU per day.  

Coenzyme Q-10 does not help to improve circulation as vitamin E, ginger, and gotu kola do.  But it does help the nerves make the most of the circulation it gets by optimizing oxygen usage and acting as an anti-oxidant.  Coenzyme Q-10 is effective at 100-300mg per day.

There are some precautions with these therapies you should be aware of.  First, it’s a good idea to keep vitamin E supplementation below 800IU per day (remember to include all supplements in that calculation) as some studies show side effects above that amount.  Ginger and Gotu kola should not be used with blood thinners like Coumadin and Warfarin.

Effective Therapy for PN

Natural medicines can be very effective for serious medical conditions.  It is so important to first have an accurate diagnosis and then to work with someone that understands these medicines and the body’s physiology to be able to guide you in a plan that is likely to be effective and sure to be safe.

Richard Malik is a licensed naturopathic physician with a practice in Lakeville, CT.  You can find more of his articles at 

This post is a reprint of another blog posting.

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