People in this group have mentioned using it for that purpose.  You can get
time released capsules, also some take Evening primrose oil along with it.
600mg/day of ALA, I'm not sure how much EPO.  First, you need to keep your
BGs pretty low or it may not help, here's how:
http://www.alt-support-diabetes.org/Newly%20Diagnosed.htm

Bob,

Quite a few people have found that the 600 mg dose of ALA is helpful for
neuropathy.

However, the other thing that has been proven to improve neuropathy in
controlled trials is keeping blood sugar levels as low as possible.
There's good evidence that post-meal blood sugar levels over 140 mg/dl
damage the nerves and that keeping blood sugars at near normal levels
can help them recover.

It's also worth noting that when nerves recover from numbness, they will
hurt, so sometimes the early stages of neuropathic healing feel like it
is getting worse.

So you might try a two pronged approach--lowering your post meal blood
sugars to under 140 mg/dl at all times and taking the ALA. ALA combined
with damagingly high blood sugar levels probably won't help all that
much as the damage will be continuing.

I have used 300mg of slow release ALA along with 1300mg of EPO
(containing at least 10% GLA) twice a day for years. The idea was
originally based on medical research conducted in Germany, where ALA is
commonly prescribed for DPN.

Here is a website which explains why. It was written by Stan Angilley,
who has been a poster to this newsgroup. The site is a little long in
the tooth now, but still the basis for my personal regimen.

http://www.geocities.com/bsy53/dn/neuropat.html

If you choose to do further research on ALA, you may get more hits by
substituting the name it is more commonly called in Europe, thioctic acid.

Jim

Hi Bob,

I was diagnosed after finally going to a doctor when neuropathy was
making my life miserable. I knew nothing about diabetes or neuropathy
until that moment, but like you I googled on neuropathy and then on
"alpha lipoic acid and neuropathy."  What appealed to me about it was
that as opposed to everything else out there for treating nueropathy,
this was the only thing that seemed to address the cause of neuropathy
rather than the symptoms. ALA, and of course, lowering your blood
sugar.

My doctor did not have any objection, so I started taking tha ALA, at
600 mgs per day orally, and my neuropathy did 95% reverse itself. No
more pain, burning, itching, dead legs, fidgeting, restless legs--I
have occasional numbness and cold feet now.  I certainly can't say for
sure that it was the ALA that accomplisehd that, because at the same
time I brought down my A1c from 11.4 to 5.0 and have held it there for
the last couple of years, although I am fairly certain that I have not
kept my post prandials under 140 at all times.  So it could be either
or both of these things in my case.  But I do know other people who
have equal control of their blood sugar who are still bothered by the
neuropathy in a big way, and I do know others who have taken ALA with
very good results. (By know I mean that we have all posted to threads
on the subject elsewhere). And other posters have said it did not help
them.

As you have noticed ALA is commonly prescribed in Europe for neuropathy
but not here.  One reason is that it has not been approved by the FDA.
Nobody has subjected it to a battery of long-term double-blind studies
and presented it to the FDA for a license to distribute it.  This is
because these tests are expensive and there is no patent on ALA--anyone
can make and distribute it. So spending the money on testing will not
gurarntee a profit on it. Unfortunately that is the way our system
works--even though the internet is full of studies that show that it
does work!

Another claim for ALA is that it will lower blood sugar. In my
experience this did not work for me. When I started and stopped and
started it again, there was no real change in my blood sugar. But for
that use I think the recommendation was 200 mg per day, which is
probably why the Rexall bottle says that amount. And I have seen posts
saying that some bottles say that diabetics should not take ALA.  This
could be because of the fear of being sued because someone's blood
sugar, carefully controlled with insulin, might go hypo if they
introduce a new factor that pushes it lower.

As to your "rhetoric or mild flaming" on doctors, it seems to me we
need them to prescribe things we could not otherwise get, and we need
their knowledge to point us in the right direction when our experience
is insufficient to know where to go. Before diagnosis I didn't know
diabetes from a whole in the wall, but my doctor recognized the
symptoms immediately--even if he didn't know about ALA.  Once we are
pointed in the right direction, however, it can only help us to search
as far and wide as we can, to learn as much as we can, because if we
expect a doctor to know everything about what is ailing us, as well as
everything about what is ailing all of their other patients, there will
be times when we will be disappointed.

<snip>

Yep.  I did have one Dr. tell me to take Evening Primrose Oil, 2,000 mg
twice daily for neuropathy.  That really seems to help.  I've tried ALA off
and on and don't notice that it does anything for me.

I've heard of it.  I've taken it in pill form.  Don't know about
intravenous.  I also tried vitamin B intravenous.  Seemed to help the first
time, but then not after that.

<snip>

Hi Bob Travis,
I am T2 on metformine , have a lot of pain in my feet.

Used alpha-Lipoic Acid (ALA) , 600mg/day , slow release from iHerb , for
about 6 month
Did not do much  :(

Found out thet there may be two related problems :
1) periferal neuropathy
2)Peripheral Vascular Disease (PVD) or Peripheral Artery Desease (PAD) or
Raynaud's disease or Critical Leg Ischemia

Both are caused by high blood glucose

see the thread :
Ike <Retired@last.com>
Saturday, October 22, 2005 4:19 PM
alt.support.diabetes
Peripheral Artery Disease (or Critical Leg Ischemia)

Dave Stampe   Oct 8 2000, 9:00 am
Newsgroups: misc.health.diabetes
From: "Dave Stampe" <dsta...@psych.utoronto.ca>
Date: 2000/10/08
Subject: Re: Evening Primrose Oil (GLA)

See this link , posted by Quentin Grady :
http://www.lapinskas.com
and
http://www.lapinskas.com/publications/3679.ppt

Started Evening Primrose Oil (EPO) a week ago
No I am on 600mg/day ALA and 2000mg/day EPO
Now for the first time I can clearly feel some relief  :)

So....
ALA is reported to help for periferal neuropathy
EPO is reported to help for Peripheral Vascular Disease

The active ingredient in EPO is believed to be gamma linoleic acid , however
, the primrose oil does more than the pure substance AND there is a much
higer effect if the EPO is taken together with ALA  see the link to the
power point presentation above.

If you Google for evening primrose oil and alpha lipoic cid you will find a
large number of posts. for me there were a lot of helpfull ones by Quentin
Grady

hth
Gys

Hi there Bob,

As others have pointed out, there are quiet a few reasons why no-one had
told you much about these kinds of treatments for diabetic neuropathy, one
of the main ones being that quite a few of the "helps" are classified as
supplements in the US and some other countries. Doctors may recommend them,
but cannot prescribe them as medicines. It simply isn't legal (or safe in
many cases).

Others are in the border-line area, for example the magnetic sole treatment.
It is very difficult to do double-blind studies to determine if the benefits
are from the placebo affect or genuine, medically sound and repeatable
improvements.
This particular problem, (amongst others), is discussed in this article from
Medscape;
http://www.medscape.com/viewprogram/3342
From Medscape General MedicineT
Advances in Diabetes for the Millennium: New Treatments for Diabetic
Neuropathies CME
Author: Aaron I. Vinik, MD, PhD, FCP, FACP

" There are a number of treatments for neuropathy that are based on limited
observations, for example, magnets. Although it is difficult to refute the
power of magnetism, it is almost impossible to test the efficacy in a
double-blind, placebo-controlled manner. One only has to use a compass to
discover whether you are in the active or placebo group."

I suggest that you join Medscape, it is a free and reliable source of much
information regarding studies and research on
medicallly related  matters. The biggest danger is from scams that purport
to do all kinds of wonderful things, without any medically proven basis at
all. Do seek out legitimate research and properly conducted scientific
trials before trusting your body (or your wallet) to scientifically
unsubstantiated claims.  Including any advice from posters to this group,
including me!

BUT do keep in mind that the experience of this group's sufferers supports
legitimate medical advice that the best and primary help for treating
neuropathy and/or other diabetic compications is to gain really good control
of your blood glucose levels. That means an A1c under 6%, for example.

Here are a few sites and discussions by members of this group regarding
helps for Diabetic Neurapathy that you may wish to read and consider.

http://www.medscape.com/viewarticle/496746
Supplemental Carnitine May Be Helpful in Diabetic Neuropathy
Laurie Barclay, MD

http://www.medscape.com/viewarticle/491972
Aldose Reductase Inhibitor Decreases Nerve Sorbitol Accumulation

These extracts are taken from a post by Quentin Grady, a member of the
group, and very knowledgable person regarding metabolic processes and
dietary sources of some helpful substances. This quote discusses the role of
aldose reductase inhibitors in reducing diabetic complication in the eyes,
but applies generally to the same problem elsewhere in the body.

"1.  Control blood glucose tightly.

2.  Glucose in the eye can be converted to sorbitol by an enzyme called
aldose reductase.
 (Re) ...... aldose reductase inhibitors. Onion is an excellent source of
biologically available Quercetin. Quercetin saves the day and stops aldose
reductase from converting glucose to Sorbitol. It doesn't matter if you fry
up the onion in a pan on a camp fire, Quercetin can take it just don't pour
it down the drain.

3. Taurine keeps sorbitol boxed up with osmotic pressure.  Taurine is an
amino acid found in fish especially shellfish and fish hearts etc, meat that
hasn't been over-cooked.  Eat some green lipped mussels or sardines.  Steak
that gallops onto your plate has more taurine than one grilled to death.

This next quote from Quentin I now repeat in total, since it bears on
neuropathy in particular. Basically it is discussing the studies that
indicate that combining Vit C with Gamma Linolenic Acid,(GLA), (found in
Evening Primrose Oil (EPO), borage seed oil, or black current seed oil), on
an empty stomach, may be of benefit.

"Evening Primrose Oil and Neuropathy

In general terms we know the GLA in evening primrose improves nerve
conduction and GLA works better if used in conjunction with alpha
lipoic acid.  GLA is a little unusual for an omega-6 oil in that it is
anti-inflammatory.

There is also a trick to making GLA more effective.
When GLA is taken with Vit C without food the Vit C (ascorbic acid)
and GLA form ascorbyl-GLA.   Now I don't know if you can take GLA and
Vit C on an empty stomach but I guess you could soon find out.
Secondly I have no idea, apart from general principles, that GLA would
work with gastroparesis in the same way it works with other
neuropathy.

I've included an abstract which gives some reference to the increased
efficacy of ascorbyl-GLA over GLA.

1: Diabetes  1997 Sep;46 Suppl 2:S31-7

Metabolic and vascular factors in the pathogenesis of diabetic
neuropathy.

Cameron NE, Cotter MA.

Department of Biomedical Sciences, University of Aberdeen, Scotland,
U.K.

Reduced nerve perfusion is an important factor in the etiology of
diabetic neuropathy. Studies in streptozotocin-induced diabetic rats
show that nerve conduction velocity (NCV) and blood flow deficits are
corrected by treatment with vasodilator drugs, with angiotensin II and
endothelin-1 antagonists being particularly important. The AT1
antagonist ZD7155 also prevents diabetic deficits in regeneration
following nerve damage, indicating that hypoperfusion is an important
limitation for nerve repair. Metabolic changes include high polyol
pathway flux, increased advanced glycosylation, elevated oxidative
stress, and impaired omega-6 essential fatty acid metabolism. Aldose
reductase inhibitors (ARIs) restore NCV via their effects on
perfusion. ARI action probably depends on blocking the conversion of
glucose to sorbitol, thus preventing depletion of vasa nervorum
glutathione, an important endogenous free radical scavenger. Free
radicals cause vascular endothelium damage and reduced nitric oxide
vasodilation. Inhibition of advanced glycosylation and autoxidation
(autoxidative glycosylation), major sources of free radicals, by
aminoguanidine or transition metal chelators, corrects neurovascular
dysfunction. Evening primrose oil supplies gamma-linolenic acid (GLA)
to improve vasodilator eicosanoid synthesis in diabetes, correcting
nerve blood flow and NCV deficits. Interactions between some of these
mechanisms have therapeutic implications. Thus, combined ARI and
evening primrose oil treatment produced a 10-fold amplification of NCV
and blood flow responses. Similarly, GLA effects are markedly enhanced
when given in combination with ascorbate as ascorbyl-GLA. Thus,
metabolic abnormalities combine to produce deleterious changes in
nerve perfusion that make a major contribution to the etiology of
diabetic neuropathy. The potential importance of multi-action therapy
is stressed.

PMID: 9285496 [PubMed - indexed for MEDLINE]"

Quentin Grady

Finally, there are indications that deficiencies in Vitamin B12 may be
involved, and ingesting more of this member of the B group or it's sources
"may" be helpful in helping to restore nerve function. This is because B12
is very much involved in nerve tissue health and growth generally.

One site that gives a fairly good overall discussion of Vitamin B12 can be
found at;
http://www.diet-and-health.net/Nutrients/Cobalamin.html
Cobalamin (vitamin B12)

Good to see you getting into researching and finding your own solutions!

And regarding your question re intravenous vs oral treatments, many studies
inject the substance of interest in order to be sure of the actual
circulating amounts and their affect in the course of the study. Ingestion
may not provide such accurate data, since people's digestion and absorbtion
may vary, and cannot be relied on to produce reliable and repeatable data.

Take care,

Annette
T2 for over 30 yrs.