II. Indications

  1. Diabetic Neuropathy
    1. NOT recommended (low efficacy - see below)

III. Mechanism

  1. Natural Thiol Supplement
    1. Synthesized in small amounts within plants and animals (including humans)
    2. Higher concentration in some foods (organ meats, spinach, broccoli, peas, brussel sprouts, and rice bran)
  2. Antioxidant properties
    1. Free radical scavenger that may repair oxidative damage
    2. Regenerates endogenous antioxidants (e.g. Vitamin C, Vitamin E, glutathione)
  3. Other functions
    1. Metal-chelating properties
    2. Cofactor in several mitochondrial enzymes that decarboxylate alpha-keto acids

IV. Dosing

  1. Oral: 600 to 1800 mg orally daily

V. Efficacy: Diabetic Neuropathy

  1. NOT recommended for Diabetic Neuropathy
  2. Lack of improvement compared with Placebo over 6-24 months (in Cochrane review)
  3. Low efficacy orally which is its primary use, better efficacy IV
  4. However, minimal to no adverse effects
  5. If prescribed despite poor evidence, discontinue after 1 month if ineffective

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