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Evidence map

Peripheral Neuropathy

Ingredients

8

Outcomes

5

Studied pairs

15/40

38% covered

Trials

13

Evidence map: Peripheral Neuropathy

Peripheral neuropathy is damage to the nerves that carry signals between your body and your brain. It causes burning, tingling, weakness, or numbness — most often in the hands and feet — and is most commonly driven by diabetes, chemotherapy, or vitamin deficiencies.

Across 8 ingredients and 5 outcomes, this map shows 15 studied pairs covering 13 distinct clinical trials.

Where cells are blank, the (ingredient, outcome) pair has not been studied — 25 such gaps remain on this map.

Coverage matrix

Where the evidence is — and where it isn't

Ease diabetic nerve symptoms Reduce nerve damage from c… Ease nerve pain symptoms Ease neuropathy symptoms Improve function in neurop… Acetyl L-Carnitine Alpha Lipoic Acid Cannabinoids Carnitine Methylcobalamin Palmitoylethanolamide Tetrahydrocannabinol Vitamin B12 1 Acetyl L-Carnitine × Ease diabetic nerve symptoms — 1 studies, n=540, GRADE: very_low Acetyl L-Carnitine × Reduce nerve damage from chemotherapy — Not studied Acetyl L-Carnitine × Ease nerve pain symptoms — Not studied 1 Acetyl L-Carnitine × Ease neuropathy symptoms — 1 studies, n=409, GRADE: moderate Acetyl L-Carnitine × Improve function in neuropathy — Not studied 3 Alpha Lipoic Acid × Ease diabetic nerve symptoms — 3 studies, n=1507, GRADE: moderate Alpha Lipoic Acid × Reduce nerve damage from chemotherapy — Not studied 3 Alpha Lipoic Acid × Ease nerve pain symptoms — 3 studies, n=676, GRADE: very_low 4 Alpha Lipoic Acid × Ease neuropathy symptoms — 4 studies, n=3259, GRADE: very_low Alpha Lipoic Acid × Improve function in neuropathy — Not studied 1 Cannabinoids × Ease diabetic nerve symptoms — 1 studies, n=100, GRADE: moderate Cannabinoids × Reduce nerve damage from chemotherapy — Not studied Cannabinoids × Ease nerve pain symptoms — Not studied Cannabinoids × Ease neuropathy symptoms — Not studied Cannabinoids × Improve function in neuropathy — Not studied 1 Carnitine × Ease diabetic nerve symptoms — 1 studies, n=540, GRADE: very_low Carnitine × Reduce nerve damage from chemotherapy — Not studied Carnitine × Ease nerve pain symptoms — Not studied 1 Carnitine × Ease neuropathy symptoms — 1 studies, n=409, GRADE: moderate Carnitine × Improve function in neuropathy — Not studied Methylcobalamin × Ease diabetic nerve symptoms — Not studied Methylcobalamin × Reduce nerve damage from chemotherapy — Not studied 1 Methylcobalamin × Ease nerve pain symptoms — 1 studies, n=90, GRADE: low 1 Methylcobalamin × Ease neuropathy symptoms — 1 studies, n=90, GRADE: low Methylcobalamin × Improve function in neuropathy — Not studied Palmitoylethanolamide × Ease diabetic nerve symptoms — Not studied Palmitoylethanolamide × Reduce nerve damage from chemotherapy — Not studied 1 Palmitoylethanolamide × Ease nerve pain symptoms — 1 studies, n=66, GRADE: low Palmitoylethanolamide × Ease neuropathy symptoms — Not studied Palmitoylethanolamide × Improve function in neuropathy — Not studied Tetrahydrocannabinol × Ease diabetic nerve symptoms — Not studied Tetrahydrocannabinol × Reduce nerve damage from chemotherapy — Not studied 1 Tetrahydrocannabinol × Ease nerve pain symptoms — 1 studies, n=16, GRADE: low 1 Tetrahydrocannabinol × Ease neuropathy symptoms — 1 studies, n=2471, GRADE: moderate Tetrahydrocannabinol × Improve function in neuropathy — Not studied Vitamin B12 × Ease diabetic nerve symptoms — Not studied Vitamin B12 × Reduce nerve damage from chemotherapy — Not studied 1 Vitamin B12 × Ease nerve pain symptoms — 1 studies, n=90, GRADE: low 1 Vitamin B12 × Ease neuropathy symptoms — 1 studies, n=90, GRADE: low Vitamin B12 × Improve function in neuropathy — Not studied
Each cell = one (ingredient, outcome) pair. Number = trial count; shading = GRADE certainty (darker = stronger evidence). Outlined cells have not been studied.
  • High certainty
  • Moderate
  • Low
  • Very low
  • Not studied

Risk-of-bias

Cochrane RoB2 across the contributing trials

Randomization Deviations Missing data Measurement Reporting Overall Ziegler D 2011 + Ziegler D 2011 — Randomization: low + Ziegler D 2011 — Deviations: low + Ziegler D 2011 — Missing data: low + Ziegler D 2011 — Measurement: low Ziegler D 2011 — Reporting: no information Ziegler D 2011 — Overall: no information Wallace M 2015 + Wallace M 2015 — Randomization: low + Wallace M 2015 — Deviations: low Wallace M 2015 — Missing data: no information + Wallace M 2015 — Measurement: low Wallace M 2015 — Reporting: no information Wallace M 2015 — Overall: no information Garcia-Alcala H 2015 ? Garcia-Alcala H 2015 — Randomization: some concerns − Garcia-Alcala H 2015 — Deviations: high + Garcia-Alcala H 2015 — Missing data: low − Garcia-Alcala H 2015 — Measurement: high + Garcia-Alcala H 2015 — Reporting: low − Garcia-Alcala H 2015 — Overall: high Hershman D 2018 Hershman D 2018 — Randomization: no information + Hershman D 2018 — Deviations: low ? Hershman D 2018 — Missing data: some concerns + Hershman D 2018 — Measurement: low Hershman D 2018 — Reporting: no information Hershman D 2018 — Overall: no information Passiatore M 2020 ? Passiatore M 2020 — Randomization: some concerns − Passiatore M 2020 — Deviations: high + Passiatore M 2020 — Missing data: low − Passiatore M 2020 — Measurement: high Passiatore M 2020 — Reporting: no information − Passiatore M 2020 — Overall: high Didangelos T 2021 + Didangelos T 2021 — Randomization: low + Didangelos T 2021 — Deviations: low + Didangelos T 2021 — Missing data: low + Didangelos T 2021 — Measurement: low + Didangelos T 2021 — Reporting: low + Didangelos T 2021 — Overall: low Pickering E 2022 + Pickering E 2022 — Randomization: low + Pickering E 2022 — Deviations: low + Pickering E 2022 — Missing data: low + Pickering E 2022 — Measurement: low + Pickering E 2022 — Reporting: low + Pickering E 2022 — Overall: low Seevathee K 2025 + Seevathee K 2025 — Randomization: low + Seevathee K 2025 — Deviations: low + Seevathee K 2025 — Missing data: low + Seevathee K 2025 — Measurement: low + Seevathee K 2025 — Reporting: low + Seevathee K 2025 — Overall: low
Cochrane RoB2 ratings across 8 randomized trials. Each row is one trial; columns are the five RoB2 domains plus the overall judgement.
  • Low risk
  • Some concerns
  • High risk
  • Not reported

Effect-size scatter

Effect direction, sample size, and certainty in one view

-2 -1 -0.5 0 +0.5 +1 +2 Cohen's d (positive = beneficial) 10 30 100 300 1000 Total participants (log scale) Acetyl L-Carnitine × Diabetic Peripheral Neuropathy Symptoms — d=0.10, n=540, 1 studies, GRADE very_low, verdict: preliminary Acetyl L-Carnitine × Neuropathy Symptom Severity — d=0.00, n=409, 1 studies, GRADE moderate, verdict: likely_no_effect Alpha Lipoic Acid × Diabetic Peripheral Neuropathy Symptoms — d=0.11, n=1507, 3 studies, GRADE moderate, verdict: likely_helps Alpha Lipoic Acid × Neuropathic Pain Symptoms — d=0.46, n=676, 3 studies, GRADE very_low, verdict: preliminary Alpha Lipoic Acid × Neuropathy Symptom Severity — d=0.07, n=3259, 4 studies, GRADE very_low, verdict: preliminary Cannabinoids × Diabetic Peripheral Neuropathy Symptoms — d=0.92, n=100, 1 studies, GRADE moderate, verdict: likely_helps Carnitine × Diabetic Peripheral Neuropathy Symptoms — d=0.10, n=540, 1 studies, GRADE very_low, verdict: preliminary Carnitine × Neuropathy Symptom Severity — d=0.00, n=409, 1 studies, GRADE moderate, verdict: likely_no_effect Methylcobalamin × Neuropathic Pain Symptoms — d=0.43, n=90, 1 studies, GRADE low, verdict: preliminary Methylcobalamin × Neuropathy Symptom Severity — d=0.35, n=90, 1 studies, GRADE low, verdict: preliminary Palmitoylethanolamide × Neuropathic Pain Symptoms — d=1.51, n=66, 1 studies, GRADE low, verdict: preliminary Tetrahydrocannabinol × Neuropathic Pain Symptoms — d=0.30, n=16, 1 studies, GRADE low, verdict: preliminary Tetrahydrocannabinol × Neuropathy Symptom Severity — d=0.05, n=2471, 1 studies, GRADE moderate, verdict: likely_helps Vitamin B12 × Neuropathic Pain Symptoms — d=0.43, n=90, 1 studies, GRADE low, verdict: preliminary Vitamin B12 × Neuropathy Symptom Severity — d=0.35, n=90, 1 studies, GRADE low, verdict: preliminary
15 studied pairs. Each dot = one (ingredient, outcome) combination. Distance left/right of zero shows effect direction; vertical axis shows trial sample size (log-scaled); color = GRADE certainty.
  • High
  • Moderate
  • Low
  • Very low

Methodology

Coverage cells, GRADE bands, and Cohen's d values come from suplmnt's evidence-scoring pipeline; risk-of-bias ratings map paper-level extraction signals onto the five Cochrane RoB2 domains per the Cochrane Handbook (2024 edition, §8). Empty cells reflect a true absence of trials, not a missing extraction. Generated 2026-05-08 from 13 contributing trials.

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