Acetyl-L-carnitine is a chemical compound naturally produced in the brain, kidneys and liver. Acetyl-L-carnitine plays an important role in reducing oxidative stress, and it's believed to be involved in nerve cell function and regeneration.
A few clinical trials have tested the treatment effect of acetyl-L-carnitine, given either as oral supplements or intravenously. In these studies, people with diabetic neuropathy had reduced pain, improvements in other sensory problems and improvements in nerve function tests. Some of these studies suggest that the treatment effect is greater when started early in the course of the disease.
Acetyl-L-carnitine supplements are generally considered safe when taken as directed. Side effects may include nausea, vomiting or agitation.
Don't use acetyl-L-carnitine if you use warfarin (Coumadin, Jantoven), a blood-thinning medication, because the combination increases warfarin's effect. The use of acetyl-L-carnitine may worsen symptoms in people with hypothyroidism or who have a history of seizures.
Vitamin D has several important functions, which include promoting bone health, regulating nerve function and reducing inflammation. Vitamin D naturally exists in only a few foods, but it's added to many foods. The body also produces vitamin D when skin is exposed to sunlight.
A few recent studies have demonstrated that vitamin D deficiency is strongly linked to diabetic neuropathy, but the reasons for this link aren't yet understood. It isn't known what effect increasing dietary vitamin D would have on diabetic neuropathy. Clinical trials have shown generally no benefit in taking vitamin D supplements to control blood sugar levels.
Vitamin D supplements are generally safe when taken as directed, but vitamin D toxicity can result from high doses. Also, the use of certain medications, such as orlistat (Xenical, Alli) and corticosteroid medications used to treat inflammation (prednisone, hydrocortisone), may interfere with vitamin D absorption and result in low levels of vitamin D.
Fatty fish — salmon, tuna and mackerel — are good sources of vitamin D. And milk, cereals and other foods are often fortified with vitamin D.
A healthy diet is essential
Although research into the relationship between dietary supplements and diabetic neuropathy is ongoing, eating a healthy diet is widely recognized as a key part of managing your blood sugar and diabetes complications such as diabetic neuropathy.
Aim for a healthy-eating plan that's naturally rich in nutrients and low in fat and calories. Healthy meal plans focus on:
- Vegetables, fruits, legumes and whole grains
- Fat-free and low-fat dairy products
- Lean meats
Also, eating a healthy diet often depends on good planning. Plan ahead to buy the right foods, prepare well-balanced meals and eat healthy snacks. Tips that may help you plan include the following:
June 09, 2014
- Ask your doctor to refer you to a dietitian who can help you plan meals.
- Make time for a weekly meal plan that includes scheduled healthy snacks.
- Make a shopping list based on your weekly meal plan.
- Look up meal planning guides and recipes from reliable sources, such as the American Diabetes Association and the National Diabetes Education Program.
See more In-depth
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- Guiding principles for diabetes care: For health care professionals. National Diabetes Education Program. http://ndep.nih.gov/publications/PublicationDetail.aspx?PubId=108. Accessed March 20, 2014.
- Edwards JL, et al. Diabetic neuropathy: Mechanisms to management. Pharmacology & Therapeutics. 2008;120:1.
- Vitamin B12: Dietary supplement fact sheet. National Institutes of Health Office of Dietary Supplements. http://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/. Accessed April 9, 2014.
- Solomon LR. Diabetes as a cause of clinically significant functional cobalamin deficiency. Diabetes Care. 2011;34:1077.
- De Groot-Kamphuis DM, et al. Vitamin B12 deficiency and the lack of its consequences in type 2 diabetes patients using metformin. The Netherlands Journal of Medicine. 2013;71:386.
- Talaei A, et al. Vitamin B12 may be more effective than nortriptyline in improving painful diabetic neuropathy. International Journal of Food Sciences and Nutrition. 2009;60(suppl):71.
- Fonseca VA, et al. Metanx in type 2 diabetes with peripheral neuropathy: A randomized trial. The American Journal of Medicine. 2013;126:141.
- Vitamin B12. Natural Medicines Comprehensive Database. http://naturaldatabase.therapeuticresearch.com/home.aspx?cs=&s=ND. Accessed May 1, 2014.
- Han T, et al. A systematic review and meta-analysis of alpha-lipoic acid in the treatment of diabetic peripheral neuropathy. European Journal of Endocrinology. 2012;167:465.
- Xu Q, et al. Meta-analysis of methylcobalamin alone and in combination with lipoic acid in patients with diabetic peripheral neuropathy. Diabetes Research and Clinical Practice. 2013;101:99.
- Alpha-lipoic acid. Natural Medicines Comprehensive Database. http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs=MAYO&s=ND&pt=100&id=767&fs=ND&searchid=46002584. Accessed April 10, 2014.
- Vitamin D: Fact sheet for health professionals. National Institutes of Health Office of Dietary Supplements. http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/. Accessed April 8, 2014.
- Soderstrom LH, et al. Association between vitamin D and diabetic neuropathy in a nationally representative sample: Results from 2001-2004 NHANES. Diabetic Medicine. 2012;29:50.
- Shehab D, et al. Does vitamin D deficiency play a role in peripheral neuropathy in type 2 diabetes? Diabetic Medicine. 2012;29:43.
- Small steps, big rewards: Your game plan to prevent type 2 diabetes. National Diabetes Education Program. http://ndep.nih.gov/publications/PublicationDetail.aspx?PubId=71. Accessed March 20, 2014.
- Evans JD. Role of acetyl-L-carnitine in the treatment of diabetic peripheral neuropathy. Annals of Pharmacotherapy. 2008;42:1686.
- Acetyl-L-carnitine. Monograph. Alternative Medicine Review. 2010;15:76.
- Miranda-Massari JR, et al. Metabolic correction in the management of diabetic peripheral neuropathy: Improving clinical results beyond symptom control. Current Clinical Pharmacology. 2011;6:260.
- Acetyl-L-carnitine. Natural Medicine Comprehensive Database. http://www.naturaldatabase.com. Accessed May 15, 2014.