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BlueSkyToday t1_jc8bywe wrote

Reply to comment by quantumgpt in New information about the role of a molecule found in chillis in reducing foot pain by healing damaged nerves. After three months, the team found that those who’d been treated with the capsaicin patch reported that their pain had reduced significantly, compared to those treated with standard care by Wagamaga

I can't find the link right now but there was a very high quality study done a few years ago (IIRC it involved 20 hospitals and several thousand patients) using R-Alpha Lipoic Acid and L-Acetyl Carnitine.

Roughly 40% of the patients reported dramatic reduction in foot pain with a large fraction showing reinervation.

Both ALA and Carnitine have been used individually to teat diabetic neuropathy with mixed results. This study concluded that the trick was to combine them. IIRC they tried three different dosages and found a dose dependent response for the two lowest dosages and little/no benefit at the highest dosage (600mg R-ALA plus 1g L-Acetyl Carnitine, 3x a day).

It's important to use R-ALA. When ALA is synthesized, you get a mix of both isomers (R and S) but R is the only one that seems to be useful to the mitochondria. If you're buying ALA and it doesn't say R-ALA, you're buying a mix of both R-ALA and S-ALA.

https://geronova.com/consumers/different-forms-of-lipoic-acid/

FWIW, my experience (N=1) is that this eliminated my partner's unmanageable foot pain. She's seen all the various specialists at both Stanford and UCSF, done all the tests, and was told that the next (very painful) step was to the pain management clinic.

She told them what she was doing in later follow-ups with Stanford and UCSF Neurologists. They all said, 'Yeah, we use ALA for diabetic neuropathy'.

So, this isn't a guarantee, but it's got about a 40% success rate.

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quantumgpt t1_jc8fdbu wrote

Well this is oddly something I should consider. I take carnitine already for another reason. 1-3g per day.

Ala is probably one of the few things I seriously do not get enough of.

So I do have one other hope here. I noticed the study was with 8%. All of the OTC patches are .025. But some say they burn. Study didn't mention a burn. The study also appears to be branded. Is that the same capsaicin? I have located oils and extracts but still even pure extracts seem under 1%.

So is the study the same stuff?

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BlueSkyToday t1_jc8lzxx wrote

I can't imagine that there's any chemical difference between the capsaicin in the patches and the capsaicin in OTC products.

Here's a link to a paper discussing the 8% patches,

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3755533/

In relation to pain from the patch, this part might be what people are looking for,

> Patients were prepared for the patch with 4% lidocaine cream that was applied for 1 h prior to treatment. The capsaicin 8% patch (NGX-4010) was applied for 60 min to a maximum area of 1000 cm2. In the dose-ranging study, it was applied for 30, 60 and 90 min [Webster et al. 2010]. Treatment-related pain was dealt with by local cooling methods and oral oxycodone (1 mg/ml). In the first week after treatment, hydrocodone bitartrate/acetaminophen (5 mg/500 mg) was allowed as rescue medication up to day 5 only.

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quantumgpt t1_jc8rv0y wrote

I will be ordering an extract and cutting it with coconut oil until it's at my tolerance level and then include (R)ALA in my diet, as well as continue my carnitine. I mean I will to to do what it takes and I don't mind the discomfort during the day. It's when it's 3am and I'm bouncing my foot and tying knots around my toe to help with the pain just to sleep. It's rather annoying.

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BlueSkyToday t1_jc8v67f wrote

I don't know that you'll be able to get anywhere close to 1.8g of R-ALA without supplementing.

I don't remember the three dosage levels that they tested but it was probably factors of two. If that's true, then the lowest dosage was 450mg a day, divided into three doses. And that wasn't as successful as higher doses.

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quantumgpt t1_jc8wefu wrote

I'll definitely supplement. I just meant adding. Since I titrate a few things already. I found a process on how to extract the oil already. I would assume the oil is close to 100% after extraction. But to confirm how does one test something like that? Any idea?

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