Dr. Fitz - Nerve Health

Dr. Fitz - Nerve Health Nerve pain or neuropathy?

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06/11/2026

Burning feet? You have probably heard of ALA.

The research behind alpha lipoic acid is real — multiple meta-analyses, 600 mg per day in the landmark trials.

But here is what gets missed: ALA does its best work with cofactors. Nerves do not fail through one pathway. They fail through several.

That is exactly what I built NeuroAxis around. 600 mg R-ALA, the more bioavailable form, plus 11 targeted ingredients.

I would not have put my name on it otherwise.

Full details in the comments below.

"My A1c is normal — so my nerves are fine."That belief is doing real damage.A1c is an average. It can sit comfortably in...
06/10/2026

"My A1c is normal — so my nerves are fine."

That belief is doing real damage.

A1c is an average. It can sit comfortably in the "normal" range while your blood sugar is spiking high after every meal — and those spikes are what injure nerves first.

Here's what the research actually shows:

→ Up to 49% of pre-diabetic adults may already have measurable peripheral nerve dysfunction
→ Nerve damage is often already significant by the time someone gets a formal Type 2 diagnosis
→ Post-meal glucose surges activate the polyol pathway, which depletes the antioxidants nerves need to protect themselves — even when average blood sugar looks fine

The fibers that go first are the small ones — the pain and temperature fibers in your feet and hands. They deteriorate quietly, long before numbness or tingling shows up. And a standard A1c will never see it happening.

The decisive window for nerve preservation is years before a diabetes diagnosis. Not after.

If you've been told your labs look fine but something feels off — occasional foot tingling, burning at night, cold hands that weren't always cold — you're not imagining it. You're early. Which is exactly when this is most reversible.

I put together a free nerve health guide that walks through the early metabolic markers most doctors don't flag, the warning signs to take seriously, and the framework for acting in the pre-diagnostic window. Link in the comments below 👇

06/09/2026

Tingling hands or numb feet? That can be an early sign of low B12 — and it's one of the most missed causes of nerve symptoms in adults over 50.

But here's what most labels won't tell you: the form of B12 matters.

Most B12 on the shelf is cyanocobalamin — synthetic, and your body has to convert it before it can do anything. Methylcobalamin is the active form your nerves use directly. It's central to maintaining the myelin sheath — the insulation your nerve signals depend on.

So if you're taking B12 for your nerves and your label says cyanocobalamin, you may be getting the cheap version of the right idea.

06/08/2026

Most people pick a nerve supplement by the number on the front of the bottle. I get it — cheaper looks like the safer call.

But here's what I learned designing one: a $20 bottle is usually built around a single meaningful ingredient — a basic form of alpha lipoic acid and a couple of B vitamins. You're paying less because you're getting less.

When I built NeuroAxis, the goal wasn't to be cheap or premium. It was to cover the pathways nerves depend on — 12 ingredients across four of them: nerve signaling, mitochondrial energy, oxidative balance, and the tissue environment around the nerve itself.

So before you compare bottles, read the label and compare what's inside them. That's usually where the real cost hides.

— Dr. Michael Fitzmaurice, MD, Fellowship-Trained Peripheral Nerve Surgeon

06/08/2026

If your blood sugar runs high, your nerves pay for it first — and most people never connect the two.

There's one nutrient that targets that exact damage: benfotiamine, a form of vitamin B1. But here's the catch most supplement labels won't tell you.

Regular B1 is water-soluble. Most of it washes out before it ever reaches the nerve. Benfotiamine is the fat-soluble form — it actually gets in and curbs the sugar-driven byproducts that wear on your nerves.

So if you're taking plain B1 hoping to protect your nerves, you may be getting almost nothing. The form is what makes the difference.

Your nerves don't wait for a diabetes diagnosis.Nearly half of prediabetic adults may already be accumulating measurable...
06/07/2026

Your nerves don't wait for a diabetes diagnosis.

Nearly half of prediabetic adults may already be accumulating measurable nerve damage — and the trigger isn't fasting blood sugar.

It's the post-meal spikes. The surges that happen after you eat. The ones a standard glucose test will never see.

In my consultations, I've watched this pattern over and over: patients with "normal" A1c values, slightly elevated triglycerides, and small-fiber nerve loss already underway. Their labs looked fine. Their nerves told a different story.

Here's what the research actually points to:

→ Elevated triglycerides are often a stronger predictor of nerve loss than A1c
→ Postprandial glucose spikes, not fasting levels, drive early small-fiber death
→ Structured exercise can increase nerve fiber density by ~1.5 fibers/mm — that's structural regeneration, not just symptom relief

The good news: early metabolic neuropathy is often reversible. The catch is that the window of maximum leverage is now — before a diagnosis locks the damage in place.

I put together a free guide that walks through the early warning signs and the metabolic markers that actually matter. Link in the comments below 👇

06/07/2026

That burning, tingling feeling in your feet at night isn't in your head — and it isn't your fault.

Alpha lipoic acid is one of the most studied nutrients for nerve health. But here's what most people never hear: the dose is everything.

In the clinical trials, 600 mg was the dose that worked. The 100 mg most cheap supplements use? It didn't beat placebo. Companies underdose it because a real 600 mg costs more to make.

If you're going to take alpha lipoic acid for your nerves, take the dose the research actually used — in the active R-form, not the cheap racemic sprinkle.

06/04/2026

Your nerves may be aging faster than the rest of you — and what's on your plate could be part of the reason.

Here's something most neuropathy patients never hear. Researchers this year found that a consistently inflammatory diet was linked to more nerve damage. When they looked at why, accelerated biological aging explained about a fifth of the connection. So it isn't only that bad food irritates nerves in the moment — over time it appears to speed the clock on the whole system, and peripheral nerves are some of the first tissue to show the wear.

It's a snapshot study, so association rather than proof. But the mechanism lines up with the biology.

The first step doesn't have to be surgery. Start here — link's in the first comment.

Dr. Michael Fitzmaurice, MD
Fellowship-Trained Peripheral Nerve Surgeon

06/03/2026

I performed thousands of nerve surgeries before it really hit me — I'd been fixing these nerves at the wrong end.

The damage always arrived finished: numb feet, burning hands, sensation that wasn't coming back. But the pattern underneath kept repeating. The tissue around the nerve was inflamed, and that inflammation kept tracing back to diet.

A study this year found people eating the most pro-inflammatory diets had roughly 40% higher prevalence of nerve damage. Part of the reason: chronic inflammation appears to age the body faster, and the nerves take some of that hit.

You can't operate your way out of that. But your diet, you can change. Start here — link's in the first comment.

Dr. Michael Fitzmaurice, MD
Fellowship-Trained Peripheral Nerve Surgeon

06/02/2026

A "normal" A1C is not the same as healthy nerves.

A1C is just an average, and averages hide the daily spikes and crashes that quietly wear your nerves down. Every spike drives the polyol pathway, sorbitol builds up inside the nerve cell, and over time that becomes real damage — even while your labs look fine.

It's the swings, not just the number. And catching it early, when symptoms are still mild, is where you actually have leverage.

If you've got tingling, burning, or numbness and keep being told your bloodwork is normal, it's worth a closer look. Free 5-minute nerve risk assessment — link in the comments 👇

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