Dr. Fitz - Nerve Health

Dr. Fitz - Nerve Health Nerve pain or neuropathy?

Get answers from a peripheral nerve surgeon with 3,000+ procedures performed.

✓ FREE discovery call
✓ Virtual 1:1 consultations
✓ NeuroAxis® nerve supplement
✓ Free 104-page Nerve Health Guide

Tap website link to book.

04/30/2026

Most people have never heard of NAC — but the early human data on nerve protection is hard to ignore.

→ A 2024 double-blind trial: NAC produced pain relief comparable to pregabalin in diabetic neuropathy, and beat it on sleep improvement.

→ A 2020 trial of 75 breast cancer patients: high-dose NAC (2,400 mg/day) reduced grade 2 and 3 chemo-induced neuropathy from 100% in the control group to just 28.6%.

→ Two 2025 double-blind trials have replicated the direction.

NAC isn't a first-line intervention yet. But if you're dealing with oxidative stress-driven nerve damage — which describes most diabetic neuropathy — the mechanism and emerging human data are very compelling.

Want to talk through your situation? Free 10-minute discovery call linked in the first comment.

Most people taking ALC for nerve health don't know what it actually does inside the body. As a Fellowship-Trained Periph...
04/27/2026

Most people taking ALC for nerve health don't know what it actually does inside the body. As a Fellowship-Trained Peripheral Nerve Surgeon with 3,000+ nerve procedures — here is the honest breakdown.

What ALC actually is:
The acetylated form of L-carnitine that crosses the blood-brain barrier readily and delivers an immediately usable acetyl group — entering the TCA cycle, supporting membrane lipid synthesis, and contributing to acetylcholine production. Unlike plain L-carnitine, ALC provides direct neurobiological activity.

The carnitine shuttle mechanism:
Carnitine palmitoyltransferase uses ALC to transfer long-chain fatty acyl-CoAs across the inner mitochondrial membrane for beta-oxidation. Without this shuttle, fatty acids accumulate as toxic acyl-CoAs — impairing nerve cell energy production and increasing oxidative damage. ALC buffers acetyl-CoA and CoA pools, regulating metabolic flexibility in nerve tissue.

Why ALC is nerve-specific:
→ Upregulates nerve growth factor and its receptor — addressing NGF deficiency driving sensory neuron loss
→ Provides acetyl groups incorporated into myelin membrane lipids — supporting structural integrity
→ Modulates neuroinflammation and central sensitization in chronic pain pathways

The clinical evidence:
Two 52-week randomized placebo-controlled trials in over 1,200 diabetic neuropathy patients evaluated ALC at 1,500–3,000mg/day. A 2015 PLOS One meta-analysis confirmed a 24.6% reduction in pain scores versus placebo in diabetic neuropathy patients. Actual structural nerve fiber changes on biopsy.

Why NeuroAxis contains 600mg — not 1,500–3,000mg:
NeuroAxis layers ALC alongside R-ALA, benfotiamine, methylcobalamin, and B6 — each targeting a different biological node simultaneously. A moderate 600mg dose contributes meaningfully to mitochondrial fatty-acid transport and acetyl-group availability without reaching the gram-level exposures used in isolated neuropathy monotherapy studies.

Every NeuroAxis order includes the free 104-page Nerve Health Guide. Free 13-page Nerve Optimization Guide at drfitznutrition.com

👉 https://drfitznutrition.com/products/neuroaxis

— Dr. Michael Fitzmaurice, MD · Fellowship-Trained Peripheral Nerve Surgeon & Exercise Physiologist

Not all nerve supplement ingredients are created equal. Here is the honest evidence breakdown — ingredient by ingredient...
04/23/2026

Not all nerve supplement ingredients are created equal. Here is the honest evidence breakdown — ingredient by ingredient.

As a Fellowship-Trained Peripheral Nerve Surgeon with 3,000+ nerve procedures, I reviewed the clinical trials behind every major nerve supplement ingredient using a modified AAN evidence classification framework.

TIER 1 — STRONGEST EVIDENCE (Level B, Multiple RCTs)

Alpha-Lipoic Acid — 600mg/day
Best evidence base in the category for symptomatic diabetic neuropathy. SYDNEY 2 trial showed 51% symptom reduction at 600mg/day. Most supplements contain 50–100mg. The dose is the difference.

Methylcobalamin — 1,500mcg/day
Meaningful evidence in combination formulations. Form matters — methylcobalamin not cyanocobalamin. A 2020 meta-analysis of 15 RCTs in 1,707 patients confirmed improvements in nerve conduction velocity.

TIER 2 — SOLID SHORT-TERM EVIDENCE

Benfotiamine — 300–600mg/day
Reproducible short-term symptom benefit. Fat-soluble B1 with dramatically higher tissue levels than standard thiamine. Long-term disease modification not yet established.

Acetyl-L-Carnitine — 1,500–3,000mg/day
Level B evidence for pain and nerve fiber regeneration in diabetic neuropathy. Important safety note for patients on taxane chemotherapy — discuss with your oncologist.

TIER 3 — MECHANISTICALLY STRONG

NAC — emerging CIPN prevention signal across three RCTs. DPN evidence conflicting but promising.

Curcumin with BioPerine — standard curcumin without piperine is essentially inactive systemically. BioPerine produces a documented 20-fold bioavailability increase.

Vitamin D — Level B evidence in confirmed-deficiency diabetic neuropathy. Check your levels first.

This is the analytical framework I used to build NeuroAxis — evidence-informed doses, active nutrient forms, full transparency.

Every order includes the free 104-page Nerve Health Guide. Free 13-page Nerve Optimization Guide at drfitznutrition.com

👉 https://drfitznutrition.com/products/neuroaxis

— Dr. Michael Fitzmaurice, MD · Fellowship-Trained Peripheral Nerve Surgeon & Exercise Physiologist

04/22/2026

Most nerve supplements are built by marketers.
This one was built by a peripheral nerve surgeon with 3,000+ nerve procedures and peer-reviewed research behind the formula.
If you're dealing with tingling, burning, or numbness — you've probably been told to just take a B-vitamin or grabbed whatever nerve support bottle was cheapest online.
But after performing thousands of nerve procedures, Dr. Michael Fitzmaurice kept seeing the same pattern. The patients who recovered best weren't just good surgical candidates. They had better blood sugar stability, lower inflammation, and fewer micronutrient gaps.
So he built a formula that targets the entire nerve environment — not just generic B-vitamins.
Download the free 13-page Nerve Health Blueprint at https://drfitznutrition.com/pages/nerve-health-blueprint — it walks through exactly what your nerves need and where a supplement actually fits in.
Have you ever tried a nerve supplement and felt like it wasn't doing anything? Drop a comment below 👇
— Michael Fitzmaurice, M.D. · Peripheral Nerve Surgeon

Most nerve supplements look impressive on the label. Until you compare the doses to what the clinical trials actually us...
04/21/2026

Most nerve supplements look impressive on the label. Until you compare the doses to what the clinical trials actually used.

As a Fellowship-Trained Peripheral Nerve Surgeon with 3,000+ nerve procedures, here is what the evidence actually shows for the most common nerve supplement ingredients:

Alpha-Lipoic Acid — evidence-based dose is 600mg/day. Most blends contain 50–100mg. The SYDNEY 2 trial showed 51% symptom reduction at 600mg. Not at 50mg.

Methylcobalamin — the form matters as much as the dose. Cyanocobalamin requires conversion many patients cannot complete. Evidence-based dose: methylcobalamin 1,500mcg/day specifically.

Benfotiamine — fat-soluble B1 that achieves dramatically higher tissue levels than standard thiamine. The BEDIP and BENDIP trials used 300–600mg/day of benfotiamine — not generic B1.

Acetyl-L-Carnitine — Level B evidence for diabetic neuropathy. Critical safety note: the SWOG S0715 trial found ALC significantly worsened chemotherapy-induced neuropathy in taxane patients. If you are on chemotherapy discuss this with your oncologist before taking any supplement containing ALC.

Three questions to ask about any nerve supplement:
01 — What is the dose vs the RCT dose?
02 — What is the specific form of each ingredient?
03 — What level of evidence actually supports it?

This is the framework I used to formulate NeuroAxis — evidence-informed doses, active nutrient forms, full transparency.

Every order includes the free 104-page Nerve Health Guide. Free 13-page Nerve Optimization Guide at drfitznutrition.com

👉 https://drfitznutrition.com

— Dr. Michael Fitzmaurice, MD · Fellowship-Trained Peripheral Nerve Surgeon & Exercise Physiologist

04/21/2026

Peripheral nerve fibers are not frozen in place. They're in a constant tug-of-war between fibers breaking down and fibers trying to regenerate.

And there's one nutrient measurably depleted in nearly every neuropathy patient that most doctors never mention: acetyl-L-carnitine.

This isn't theoretical. Levels are documented as low in diabetic neuropathy, HIV-related neuropathy, and chemotherapy-induced neuropathy — a genuine deficiency state.

It does 3 things nothing else on the standard nerve nutrient list does:

1. Upregulates nerve growth factor (NGF) — directly addressing the deficiency that drives sensory nerve loss.

2. Delivers pain relief through an epigenetic mechanism. The effect develops over several days and persists for 2+ weeks after you stop taking it — fundamentally different from painkillers.

3. Triggers structural nerve regeneration. The SEMA trials — 2 parallel randomized controlled trials in over 1,200 patients — showed significant increases in sural nerve fiber numbers and regenerating nerve fiber clusters on biopsy. Actual structural evidence of nerve fiber regeneration in a human clinical trial.

A meta-analysis showed a 24.6-point reduction in pain scores versus placebo in diabetic neuropathy patients.

If you've been told there's nothing you can do about your neuropathy — the research disagrees.

Free 5-Step Nerve Health Blueprint: https://drfitznutrition.com/pages/nerve-health-blueprint

04/20/2026

Most people don't think about their nerves until something goes wrong — burning feet, tingling hands, numbness that won't go away. But by the time symptoms appear, nerve damage has often been building quietly for years.

After 3,000+ nerve procedures, I discovered something that changed how I practice medicine: the patients who recovered best weren't just good surgical candidates. They were metabolically equipped to heal.

That insight became my free 5-Step Nerve Health Blueprint:

1. Reducing metabolic inflammation
2. Optimizing blood sugar + insulin sensitivity
3. Strategic nutritional support
4. Movement + circulation
5. Targeted supplementation

This is what I wish every patient had read before walking through my door.

Download your free copy: https://drfitznutrition.com/pages/nerve-health-blueprint/

04/19/2026

The B12 in your supplement might be completely useless to your nervous system. Not because it's fake. Not because the label is lying. Because it's in the wrong form and your body can't convert it efficiently enough to matter.

Two supplements can list the same vitamin at the same dose and behave completely differently inside your body. The form determines bioavailability — whether it actually reaches nerve tissue or passes through.

Look for methylcobalamin, not cyanocobalamin. Look for benfotiamine, not thiamine. These are not interchangeable.

Free nerve health guide: https://drfitznutrition.com/pages/nerve-health-blueprint

04/17/2026

If you're dealing with burning, tingling, or numbness in your hands or feet — this is for you.
Most people don't realize that peripheral nerve health depends on three things: proper nutrient delivery, mitochondrial energy, and managing oxidative stress. When any of these break down, your nerves suffer.
That's exactly why I formulated NeuroAxis — a 12-ingredient nerve health supplement built to support all three pathways daily.
Order NeuroAxis and receive a free 104-page Nerve Health Guide with your purchase. Not ready to order yet? Download our free 13-page Nerve Health Blueprint at https://drfitznutrition.com/products/neuroaxis
Have you or someone you know dealt with neuropathy symptoms? Drop a comment below 👇
— Michael Fitzmaurice, M.D. · Peripheral Nerve Surgeon

04/16/2026

Most people with neuropathy are being consistent — and still not improving. Here's what's missing.

Your nerves need omega-3 to maintain cell membrane integrity. They need anti-inflammatory foods — leafy greens, turmeric, berries — to reduce the signaling that actively worsens nerve function. And they need sleep. Not as a lifestyle suggestion. As a biological requirement. Nerve growth factor secretion and myelin repair are sleep-dependent processes. Fragmented or insufficient sleep actively limits your nervous system's repair capacity, regardless of what else you're doing.

Three changes. This week. They cost nothing except intention.

For a full framework on nerve support strategy, visit https://drfitznutrition.com/ — and follow along on YouTube at for the complete clinical breakdown.

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Prescott, AZ
86301

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https://drfitznutrition.com/pages/nerve-health-consultation

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