TABLE 4

Over-the-counter treatments for small fiber neuropathy

Treatments	Dosage	Comments
Oral supplements
Acetyl-l-carnitine	1,000 mg 3 times a day	Some benefit seen in diabetic and human immunodeficiency virus neuropathy,^45,47 but may worsen chemotherapy-induced neuropathy⁴⁸
Alpha lipoic acid	600 mg/day	Early studies found benefit with intravenous dosing but no data on optimal oral dose⁴⁶
Glutamine	15 g twice a day	Possible neuroprotective effect in chemotherapy-induced neuropathy with oral dose,⁴⁹ pain reduction with intravenous dosing⁵⁰
Curcumin	Dose varies	Some benefit in pain reduction for diabetic and chemotherapy-induced neuropathy^51,52
Omega-3 fatty acids	1,000–3,000 g/day	Possible pain reduction seen in mouse models; increased nerve growth in patients with diabetic small fiber neuropathy^53,54
Topical products
Vicks VapoRub	Apply as needed	May cause increased pain on initial contact
Horse liniment cream	Apply as needed	May cause increased pain on initial contact
Frankincense oil	Apply as needed	Reduces neuropathic pain in mice⁵⁵
Hemp cream or oil	Apply as needed	Noncannabidiol form legal in all states