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Dr. Grey AI

Condition

Neuropathic Pain

Neuropathic pain comes from damage or disease in the nervous system, which sends faulty signals that feel burning, shooting, stabbing, or like electric shocks. Among supplements, alpha-lipoic acid, especially for diabetic nerve pain, and acetyl-L-carnitine have the strongest support, rated moderate. In four small cannabis studies, people used less pain medication, though that evidence is limited. Those studies enrolled just 34 people in total.

Sources: PMID 18688212; PMID 22483680

Supplements studied
2
Graded outcomes
1
Trials
5
People studied
429

Evidence by supplement

  • Strong
  • Moderate
  • Limited
  • Very limited

2 supplements

Cannabis: outcomes studied for Neuropathic Pain
GradeOutcomeEffectSizeStudiesPeopleStudies list
Analgesic Use

Small Decrease

Improves (the measure goes down)Small effect4 studies34 people
Sleep QualityImproves (the measure goes up)4 studies394 people
Sleep LatencyImproves (the measure goes down)23 people
Astragalus: outcomes studied for Neuropathic Pain
GradeOutcomeEffectSizeStudiesPeopleStudies list
Kidney FunctionImproves (the measure goes up)1 study1 person

Studies that measured kidney function

Key findings

  • Analgesic UseCannabisImproves (the measure goes down)

The Neuropathic Pain Support protocol

2 primary supplements · 3 supporting supplements

  • Alpha-Lipoic Acid600–1,200 mg daily
  • Acetyl-L-Carnitine1,500–3,000 mg daily

See the full protocol

Studies cited

92 studies from PubMed

  1. The effect of Echinacea purpurea, Astragalus membranaceus and Glycyrrhiza glabra on CD25 expression in humans: a pilot studyPhytother Res · PMID 17661330
  2. Aqueous extract of Astragali Radix induces human natriuresis through enhancement of renal response to atrial natriuretic peptideJ Ethnopharmacol · PMID 18243612
  3. Efficacy and safety of Astragalus membranaceus in the treatment of patients with seasonal allergic rhinitisPhytother Res · PMID 19504468
  4. Chinese Herb Astragalus membranaceus Enhances Recovery of Hemorrhagic Stroke: Double-Blind, Placebo-Controlled, Randomized StudyEvid Based Complement Alternat Med · PMID 22474516
  5. Treatment of idiopathic membranous nephropathy with the herb Astragalus membranaceusAm J Kidney Dis · PMID 18037104
  6. A Natural Astragalus-Based Nutritional Supplement Lengthens Telomeres in a Middle-Aged Population: A Randomized, Double-Blind, Placebo-Controlled Study.Nutrients · PMID 39275278
  7. Efficacy of Astragalus Membranaceus (Huang Qi) for Cancer-Related Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Studies.Integr Cancer Ther · PMID 40302232
  8. Effects of oral, smoked, and vaporized cannabis on endocrine pathways related to appetite and metabolism: a randomized, double-blind, placebo-controlled, human laboratory studyTransl Psychiatry · PMID 32075958
  9. 1 -tetrahydrocannabinol, synhexyl and marijuana extract administered orally in man: catecholamine excretion, plasma cortisol levels and platelet serotonin contentPsychopharmacologia · PMID 5523370
  10. Acute effects of natural and synthetic cannabis compounds on prolactin levels in human malesPharmacol Biochem Behav · PMID 6320226
  11. The effects of smoked marijuana on metabolism and respiratory controlAm Rev Respir Dis · PMID 367234
  12. Effect of acute Δ9-tetrahydrocannabinol administration on subjective and metabolic hormone responses to food stimuli and food intake in healthy humans: a randomized, placebo-controlled studyAm J Clin Nutr · PMID 30949710
  13. Explorative Placebo-Controlled Double-Blind Intervention Study with Low Doses of Inhaled Δ9-Tetrahydrocannabinol and Cannabidiol Reveals No Effect on Sweet Taste Intensity Perception and Liking in HumansCannabis Cannabinoid Res · PMID 28861511
  14. Short-term effects of cannabinoids on immune phenotype and function in HIV-1-infected patientsJ Clin Pharmacol · PMID 12412840
  15. A pilot study of the effects of cannabis on appetite hormones in HIV-infected adult menBrain Res · PMID 22133305
  16. Smoked medicinal cannabis for neuropathic pain in HIV: a randomized, crossover clinical trialNeuropsychopharmacology · PMID 18688212
  17. Acute and residual mood and cognitive performance of young adults following smoked cannabisPharmacol Biochem Behav · PMID 32360692
  18. Effects of acute marijuana smoking on pulse rate and mood states in womenPsychopharmacology · PMID 6438677
  19. Assessment of Efficacy and Tolerability of Medicinal Cannabinoids in Patients With Multiple Sclerosis: A Systematic Review and Meta-analysisJAMA Netw Open · PMID 30646241
  20. Sativex ® as add-on therapy vs. further optimized first-line ANTispastics (SAVANT) in resistant multiple sclerosis spasticity: a double-blind, placebo-controlled randomised clinical trialInt J Neurosci · PMID 29792372
  21. Sativex(®) and clinical-neurophysiological measures of spasticity in progressive multiple sclerosisJ Neurol · PMID 26289497
  22. Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow upJ Neurol Neurosurg Psychiatry · PMID 16291891
  23. Multiple sclerosis and extract of cannabis: results of the MUSEC trialJ Neurol Neurosurg Psychiatry · PMID 22791906
  24. A double-blind, randomized, placebo-controlled, parallel-group study of Sativex, in subjects with symptoms of spasticity due to multiple sclerosisNeurol Res · PMID 20307378
  25. Do cannabis-based medicinal extracts have general or specific effects on symptoms in multiple sclerosis? A double-blind, randomized, placebo-controlled study on 160 patientsMult Scler · PMID 15327042
  26. Long-term use of a cannabis-based medicine in the treatment of spasticity and other symptoms in multiple sclerosisMult Scler · PMID 17086911
  27. Psychopathological and cognitive effects of therapeutic cannabinoids in multiple sclerosis: a double-blind, placebo controlled, crossover studyClin Neuropharmacol · PMID 18978501
  28. A placebo-controlled, parallel-group, randomized withdrawal study of subjects with symptoms of spasticity due to multiple sclerosis who are receiving long-term Sativex® (nabiximols)Mult Scler · PMID 21878454
  29. Sativex long-term use: an open-label trial in patients with spasticity due to multiple sclerosisJ Neurol · PMID 22878432
  30. Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trialLancet · PMID 14615106
  31. A double-blind, randomized, placebo-controlled, parallel-group study of THC/CBD oromucosal spray in combination with the existing treatment regimen, in the relief of central neuropathic pain in patients with multiple sclerosisJ Neurol · PMID 23180178
  32. A randomized, double-blind, placebo-controlled, parallel-group, enriched-design study of nabiximols* (Sativex(®) ), as add-on therapy, in subjects with refractory spasticity caused by multiple sclerosisEur J Neurol · PMID 21362108
  33. Tetrahydrocannabinol and cannabidiol oromucosal spray in resistant multiple sclerosis spasticity: consistency of response across subgroups from the SAVANT randomized clinical trialInt J Neurosci · PMID 32065006
  34. Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosisNeurology · PMID 16186518
  35. Efficacy, safety and tolerability of an orally administered cannabis extract in the treatment of spasticity in patients with multiple sclerosis: a randomized, double-blind, placebo-controlled, crossover studyMult Scler · PMID 15327040
  36. Short-term effects of smoking marijuana on balance in patients with multiple sclerosis and normal volunteersClin Pharmacol Ther · PMID 8143398
  37. The effect of cannabis on urge incontinence in patients with multiple sclerosis: a multicentre, randomised placebo-controlled trial (CAMS-LUTS)Int Urogynecol J Pelvic Floor Dysfunct · PMID 16552618
  38. Randomized controlled trial of Sativex to treat detrusor overactivity in multiple sclerosisMult Scler · PMID 20829244
  39. Smoked marijuana effects on tobacco cigarette smoking behaviorJ Pharmacol Exp Ther · PMID 2319477
  40. Abstinence symptoms following smoked marijuana in humansPsychopharmacology · PMID 10090647
  41. Abstinence symptoms following oral THC administration to humansPsychopharmacology · PMID 10090646
  42. Cannabidiol (CBD) content in vaporized cannabis does not prevent tetrahydrocannabinol (THC)-induced impairment of driving and cognitionPsychopharmacology · PMID 31044290
  43. Acute and residual effects of smoked cannabis: Impact on driving speed and lateral control, heart rate, and self-reported drug effectsDrug Alcohol Depend · PMID 31678833
  44. Effect of cannabis use on cognitive functions and driving abilityJ Clin Psychiatry · PMID 10401919
  45. Cannabis smoking impairs driving performance on the simulator and real driving: a randomized, double-blind, placebo-controlled, crossover trialFundam Clin Pharmacol · PMID 29752828
  46. Acute effects of smoking marijuana on hormones, subjective effects and performance in male human subjectsPharmacol Biochem Behav · PMID 3016764
  47. The effects of orally administered delta 9-tetrahydrocannabinol in man on mood and performance measures: a dose-response studyPharmacol Biochem Behav · PMID 2161109
  48. Opioid antagonism enhances marijuana's effects in heavy marijuana smokersPsychopharmacology · PMID 20490465
  49. Cannabis use and driving-related performance in young recreational users: a within-subject randomized clinical trialCMAJ Open · PMID 30323055
  50. Sex differences in the effects of marijuana on simulated driving performanceJ Psychoactive Drugs · PMID 20464803
  51. Effect of Cannabidiol and Δ9-Tetrahydrocannabinol on Driving Performance: A Randomized Clinical TrialJAMA · PMID 33258890
  52. Subjective aggression during alcohol and cannabis intoxication before and after aggression exposurePsychopharmacology · PMID 27422568
  53. Cannabinoids for adult cancer-related pain: systematic review and meta-analysisBMJ Support Palliat Care · PMID 31959586
  54. An open-label extension study to investigate the long-term safety and tolerability of THC/CBD oromucosal spray and oromucosal THC spray in patients with terminal cancer-related pain refractory to strong opioid analgesicsJ Pain Symptom Manage · PMID 23141881
  55. Comparison of the analgesic effects of dronabinol and smoked marijuana in daily marijuana smokersNeuropsychopharmacology · PMID 23609132
  56. Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related painJ Pain Symptom Manage · PMID 19896326
  57. Lack of analgesia by oral standardized cannabis extract on acute inflammatory pain and hyperalgesia in volunteersAnesthesiology · PMID 18580179
  58. Dose-dependent effects of smoked cannabis on capsaicin-induced pain and hyperalgesia in healthy volunteersAnesthesiology · PMID 18073554
  59. Amygdala activity contributes to the dissociative effect of cannabis on pain perceptionPain · PMID 23273106
  60. Nabiximols for opioid-treated cancer patients with poorly-controlled chronic pain: a randomized, placebo-controlled, graded-dose trialJ Pain · PMID 22483680
  61. Sativex oromucosal spray as adjunctive therapy in advanced cancer patients with chronic pain unalleviated by optimized opioid therapy: two double-blind, randomized, placebo-controlled phase 3 studiesBr J Pain · PMID 28785408
  62. Results of a Double-Blind, Randomized, Placebo-Controlled Study of Nabiximols Oromucosal Spray as an Adjunctive Therapy in Advanced Cancer Patients with Chronic Uncontrolled PainJ Pain Symptom Manage · PMID 28923526
  63. The Effects of Dosage-Controlled Cannabis Capsules on Cancer-Related Cachexia and Anorexia Syndrome in Advanced Cancer Patients: Pilot StudyIntegr Cancer Ther · PMID 31595793
  64. Effect of marihuana on intraocular and blood pressure in glaucomaOphthalmology · PMID 7053160
  65. Cannabis for dyskinesia in Parkinson disease: a randomized double-blind crossover studyNeurology · PMID 15477546
  66. Regional cerebral blood flow after marijuana smokingJ Cereb Blood Flow Metab · PMID 1324250
  67. The effects of smoking marihuana on physical performanceMed Sci Sports · PMID 1235156
  68. Marijuana's dose-dependent effects in daily marijuana smokersExp Clin Psychopharmacol · PMID 23937597
  69. Middle cerebral artery velocity during upright posture after marijuana smokingActa Psychiatr Scand · PMID 1529742
  70. Association between marijuana exposure and pulmonary function over 20 yearsJAMA · PMID 22235088
  71. Acute effects of marihuana smoking on maximal exercise performanceMed Sci Sports Exerc · PMID 3097453
  72. Cannabis induces a clinical response in patients with Crohn's disease: a prospective placebo-controlled studyClin Gastroenterol Hepatol · PMID 23648372
  73. Effect of Inhaled Cannabis for Pain in Adults With Sickle Cell Disease: A Randomized Clinical TrialJAMA Netw Open · PMID 32678452
  74. Effect of sublingual application of cannabinoids on intraocular pressure: a pilot studyJ Glaucoma · PMID 16988594
  75. Efficacy of Inhaled Cannabis on Painful Diabetic NeuropathyJ Pain · PMID 25843054
  76. Randomized placebo-controlled double-blind clinical trial of cannabis-based medicinal product (Sativex) in painful diabetic neuropathy: depression is a major confounding factorDiabetes Care · PMID 19808912
  77. Postural syncope after marijuana: a transcranial Doppler study of the hemodynamicsPharmacol Biochem Behav · PMID 12873621
  78. A double-blind, randomized, placebo-controlled, parallel group study of THC/CBD spray in peripheral neuropathic pain treatmentEur J Pain · PMID 24420962
  79. Sativex successfully treats neuropathic pain characterised by allodynia: a randomised, double-blind, placebo-controlled clinical trialPain · PMID 17997224
  80. Smoked cannabis for chronic neuropathic pain: a randomized controlled trialCMAJ · PMID 20805210
  81. Ingestion of a THC-Rich Cannabis Oil in People with Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled Clinical TrialPain Med · PMID 33118602
  82. Systematic review and meta-analysis of cannabis treatment for chronic painPain Med · PMID 19732371
  83. A role for cannabinoids in the treatment of myotonia? Report of compassionate use in a small cohort of patientsJ Neurol · PMID 31655890
  84. An experimental randomized study on the analgesic effects of pharmaceutical-grade cannabis in chronic pain patients with fibromyalgiaPain · PMID 30585986
  85. Oral THC:CBD cannabis extract for refractory chemotherapy-induced nausea and vomiting: a randomised, placebo-controlled, phase II crossover trialAnn Oncol · PMID 32801017
  86. Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysisLancet Psychiatry · PMID 31672337
  87. Acute effects of marihuana on luteinizing hormone in menopausal womenPharmacol Biochem Behav · PMID 3001780
  88. Effect of Delta-9-tetrahydrocannabinol and cannabidiol on nocturnal sleep and early-morning behavior in young adultsJ Clin Psychopharmacol · PMID 15118485
  89. Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-In-Cachexia-Study-GroupJ Clin Oncol · PMID 16849753
  90. Evaluating the Suitability and Potential Efficiency of Cannabis sativa Oil for Patients with Primary Burning Mouth Syndrome: A Prospective, Open-Label, Single-Arm Pilot StudyPain Med · PMID 33123730
  91. Marijuana smoking and reduced pressure in human eyes: drug action or epiphenomenon?Invest Ophthalmol · PMID 1089090
  92. Impact of smoked cannabis on tobacco cigarette smoking intensity and subjective effects: A placebo-controlled, double-blind, within-subjects human laboratory studyExp Clin Psychopharmacol · PMID 32463281