I've been posting about this on and off all year trying to get some answers.
Anyway, I'll keep it short.
I've been unable to tolerate Trimethoprim or Doxycycline without the both causing unbearable neuropathic pain (burning, stinging, tingling, etc). I tried multiple times and failed to continue after 2-3 days. I've had a chronic UTI for a year now.
After experimenting a lot, I figured out that by taking R-Alpha Lipoic Acid (stabalized ALA supplements) I was able to completely prevent the neuropathic pain when taking high dose Trimethoprim. I take it at the same time as the antibiotic, as peak concentrations of both occur about the same time
I reall hope that helps someone!
I had tried the combiation of Benfotiamine, B12, methyl folate, NAC, and ALCAR prior to R-ALA but it did not prevent the neuropathic pain with antibiotics or Hiprex. I am still taking all those, but the addition of R ALA is what completely prevented the severe nerve pain flare up with Trimethoprim.
Been on the antibiotic now for over 2 weeks. No problems!
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Whoa182
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Alpha-lipoic acid is a medication used to manage and treat chronic diseases associated with oxidative stress, such as diabetic neuropathy, and slow down the onset of metabolic syndrome by acting as an antioxidant.
Sounds like we could all benefit from it! But there are some contra indications to be aware of, discussed in the paper.
Still taking the Trimethoprim and it's been 3 weeks almost.
I think the R ALA prevents the nerves from becoming easily hyperexcitable, which is what happens with small fiber neuropathy. Lots of things can trigger flares of neuropathic pain, not just antibiotics.
I think for someone who might need antibiotics in the future and are worried they can't take anything (as I was) this might be a bit of relief that there may be solutions.
If nerves had fully healed, which can take years, then one may tolerate antibiotics just fine again without R ALA. But in this case, it is definitely what did it.
Thanks for the insight Whoa182! I'm about to try Benfotiamine to see if that helps with debilitating neuropathy and nerve pain. Considering R-ALA too but now wondering which I should try first...🤔
I can easily say that it R ALA that benefited the most to at least prevent the flare ups caused by supplements and medication like Trimethoprim. I use Life Extension Super R - ALA.
Make sure it contains "Bio-Enhanced Stabilised Na-RALA Sodium R-Lipoate".
As I said, i take benfotiamine (and other things) as well to enhance nerve quality and repair.
It has been really expensive to experiment with supplements trying deal with both neuropathy and the UTI.
Thanks so much Whoa182. I have been having nerve pain flare after taking supplements, including B12 orals. Please do you advise I should take R-ALA alongside? Thanks again.
Alpha Linoleic Acid is an essential fatty acid thats a required part of the diet. Two tablespoons of (broken) flaxseed covers the requirement. Just a warning that if the flaxseed is not broken or ground it'll just pass right through you without providing the essential fatty acids.
Alpha Lipoic Acid is a powerful anti-oxidant but not an essential nutrient. It is sometimes used at high doses to treat neuropathy. Worth cautious exploration.
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Starting SI without PA or B12 def diagnosis. Anyone else done this? 
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