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Evidence map

Updated

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.

Ingredients

8

Outcomes

5

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 Ease diabetic nerve symptoms Reduce nerve damage from chemotherapy Reduce nerve damage from chemotherapy Ease nerve pain symptoms Ease nerve pain symptoms Ease neuropathy symptoms Ease neuropathy symptoms Improve function in neuropathy Improve function in neuropathy 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); fill style and color = GRADE certainty (solid = higher certainty, ring = lower).
  • 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 2026-07-30 from 13 contributing trials.

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