Treatment
Can neuropathy be reversed? What recovers and what doesn’t
Some neuropathy gets better, occasionally all the way. Whether yours can depends on three things: what caused it, how long the nerves have been damaged, and whether the cause is still at work.
Written by the Managing Neuropathy editorial team under the direction of Dr. Tom Biernacki, DPM, FACFAS · Clinical review pending · Last updated 24 September 2026
The short answer. Sometimes. Neuropathy from a cause that can be removed or corrected often improves once that cause is dealt with. The usual ones are low vitamin B12, too much vitamin B6, alcohol, a medicine, or a nerve being squeezed. The earlier it is caught, the better the recovery. Long-standing diabetic neuropathy is different: no current treatment brings back nerve fibers that have been lost, but steady control of glucose, blood pressure and cholesterol can slow further damage, and the pain can be treated. Where nerves do regrow, they grow about a millimeter a day, so recovery is measured in months, not days.
Neuropathies that can improve
The National Institute of Neurological Disorders and Stroke puts it simply: sometimes, when the cause of a neuropathy is corrected, it resolves as the nerves recover and regrow. These are the causes where that is most likely.
Low vitamin B12
B12 deficiency damages nerves, and it can do so before any anemia shows up in a blood count. Replacing B12 often improves numbness and tingling, but timing matters: the NIH Office of Dietary Supplements stresses early diagnosis and treatment to avoid irreversible damage. Metformin and long-term acid-reducing medicines both lower B12, so anyone taking them who has numb or tingling feet should have a level checked, ideally with methylmalonic acid, which is the more sensitive marker.
Too much vitamin B6
High-dose vitamin B6, almost always from supplements, causes a sensory neuropathy. According to the NIH Office of Dietary Supplements, the symptoms usually stop if the supplement is stopped as soon as they appear. Do not be alarmed if things get a little worse first. In a study of volunteers given high doses, symptoms kept progressing for two to three weeks after the B6 was stopped, a pattern called coasting. The US upper limit for adults is 100 mg a day. Cases have also been reported in people taking far less, and in 2023 Europe’s food safety authority set its limit at 12 mg a day. Check every label, including multivitamins and “nerve support” formulas, which often contain it. Our supplement guide covers the B6 problem in detail.
For the official limits and what recovery looks like, see how much B6 is too much.
Alcohol
Neuropathy from heavy drinking is one of the more recoverable kinds, provided the drinking stops and nutrition is restored, with thiamine and the other B vitamins replaced. StatPearls, a clinical reference, describes improvement on examination and on nerve tests over several months to a few years of abstinence. Many people regain most of their function, though some leftover numbness is common. Stopping is the treatment, and no vitamin replaces it. After long-term heavy drinking, stopping should be medically supervised. How alcohol-related neuropathy progresses, and how it improves.
A medicine
The list of medicines that occasionally damage nerves is longer than most people expect. The NINDS includes drugs for cancer, HIV, heart disease and blood pressure, infections, autoimmune disease, seizures and alcohol dependence. When a drug is the cause, stopping or switching it often lets the nerves recover. That is a decision for the prescriber, never something to do on your own. Recovery is not guaranteed. The FDA warns that nerve damage from fluoroquinolone antibiotics such as ciprofloxacin and levofloxacin can start soon after the drug is taken and can be permanent.
Neuropathy from chemotherapy usually eases with time, but not always completely. A review pooling 31 studies found it in 68% of patients in the first month after chemotherapy, 60% at three months, and 30% at six months or later. Johns Hopkins notes that mild cases tend to improve gradually over months, while more severe nerve injury can last for years or become permanent.
A squeezed nerve
When a single nerve is compressed, relieving the pressure early gives it the best chance. The squeeze might be at the outside of the knee from leg crossing, behind the inner ankle in tarsal tunnel syndrome, or under a tight boot. The mildest compression injury, called neurapraxia, damages the nerve’s insulating coating while the fibers inside survive. StatPearls describes complete recovery on its own within days to weeks. A peroneal nerve palsy at the knee, the kind that can cause foot drop, can improve without surgery. Decompression is considered when it is getting rapidly worse or has not improved after about three months.
Early diabetic and prediabetic neuropathy
“The earlier the better” applies here too. In type 1 diabetes, the landmark Diabetes Control and Complications Trial found that intensive glucose control cut the development of clinical neuropathy by 60% over an average of six and a half years. In a small study of 32 people with neuropathy linked to prediabetes, a year of diet and exercise counseling was followed by regrowth of small nerve fibers in skin biopsies and by less pain. That study had no comparison group, so it is encouraging rather than proof. It fits the general pattern, though: nerves that are injured but not yet lost have the best chance.
When the damage is permanent
Recovery depends on the nerve fiber, or at least the nerve cell it grows from, surviving. Where fibers have been lost over years and the cause is still active, they generally do not come back. The common situations:
- Long-standing diabetic neuropathy, especially once the feet have lost protective sensation.
- Inherited neuropathies such as Charcot–Marie–Tooth disease. The NINDS is clear that there is no cure and that symptoms progress slowly, though therapy, braces and orthopedic surgery all help.
- Severe injuries, where a nerve has been cut or scarred. If regrowing fibers cannot cross the injury, the nerve beyond it stays without a supply, and surgery is needed to restore continuity.
- Correctable causes caught too late. B12 deficiency and toxic exposures can leave permanent damage if they go untreated for long enough.
Permanent numbness does not mean nothing can be done. Protecting the feet, treating pain, strength and balance work and the right shoes change how life with neuropathy goes, even when sensation does not return.
Is diabetic neuropathy reversible?
Not with any treatment available today. The American Diabetes Association’s 2026 Standards of Care state that a specific treatment to reverse the underlying nerve damage in diabetes is not yet available. Good glucose management can prevent neuropathy in type 1 diabetes and may modestly slow it in type 2, but it does not bring back nerve fibers already lost. The same guidance recommends optimizing weight, blood pressure and cholesterol to reduce the risk of neuropathy or slow its progression. In the Look AHEAD trial, a weight-loss lifestyle program improved neuropathy symptoms, though not the examination findings.
What that means in practice:
- The realistic goal is to stop it getting worse, and that is achievable. Every year of slower progression is sensation kept.
- Symptoms can improve even when the damage does not. Nerve-pain medicines reduce pain without changing the nerve damage, and that relief is still worth having. The medicines that work, and how they compare.
- A diagnosis of diabetic neuropathy deserves a check for other causes. The ADA lists B12 deficiency from metformin, thyroid and kidney disease, alcohol and certain medicines among them, and those may be correctable. More on diabetic neuropathy.
How long nerves take to recover
Two different clocks run here, depending on what was damaged.
When pressure has damaged only the nerve’s coating, as in a mild pressure palsy, the fibers are intact and recovery can be complete within days to weeks.
When the fibers themselves have died back, they regrow from the point of damage at about 1 millimeter a day, or roughly an inch a month. Neuropathy damages the far ends of the longest nerves first, so regaining feeling across a foot takes many months.
After a toxic cause stops, symptoms can keep worsening for a while before they improve: two to three weeks after high-dose B6, and sometimes several months after platinum chemotherapy drugs such as oxaliplatin and cisplatin. That is coasting, not failure.
Recovery is more complete the sooner the cause is removed. Nerves that go a long time without reaching their target recover less well, which is the practical case for testing early rather than waiting to see.
What actually helps recovery
- Find the cause. Blood glucose and HbA1c, vitamin B12 with methylmalonic acid, thyroid and kidney function, and serum protein immunofixation cover the common and the treatable. Which tests, and why.
- Remove it. Stop high-dose B6. Stop drinking, with medical support if you drink heavily. Review your medicines with the prescriber, and take the pressure off a squeezed nerve.
- Replace what is missing. B12 if you are deficient, thiamine and the other B vitamins with alcohol-related neuropathy, as your clinician directs.
- Bring glucose, blood pressure and cholesterol into range if you have diabetes or prediabetes. It is slow, unglamorous and the best-evidenced step on this list.
- Keep moving. Walking in good shoes and balance training keep you steady while nerves recover, or when they will not. Neuropathy exercises, and what to skip.
- Protect your feet while you wait. Recovery is slow, and numb feet get hurt without warning. Look at them daily, keep heat sources away, and check your shoes by hand. The two-minute daily foot check.
What does not help: supplements sold to “regenerate” nerves. None sold direct to consumers has been shown to reverse nerve damage. Alpha-lipoic acid has the most research behind it, and it measured symptoms, not regrowth. What alpha-lipoic acid can and cannot do.
Why seven-day cures don’t add up
At about a millimeter a day, a week buys roughly seven millimeters of regrowth. That is under a third of an inch, in nerves that run from the lower back to the toes. Programs that promise reversal in days are measuring something else. It might be a good week, a device that numbs for an hour, or a real deficiency that finally got corrected. Feeling better is worth having. It is not the same as nerves healing. The full breakdown of “reverse neuropathy in 7 days” claims.
Common questions
Can peripheral neuropathy be cured?
Sometimes, when the cause can be removed early: B12 deficiency, excess B6, alcohol, a medicine or a squeezed nerve. Long-standing diabetic and inherited neuropathies have no cure yet. Their progression can often be slowed, and their symptoms treated.
How long does it take for nerves to heal?
It depends on the damage. A mild pressure injury to the nerve’s coating can recover in days to weeks. Fibers that have died back regrow at about a millimeter a day, roughly an inch a month, so recovery takes months to years and may be incomplete.
Can vitamin B12 reverse neuropathy?
When B12 deficiency is the cause, replacing it often improves the neuropathy, and most when it is started early. There is no good evidence that extra B12 reverses neuropathy when your level is normal, which is why testing comes before taking it.
Can neuropathy from chemotherapy go away?
It often eases after treatment ends. In a large review, about two-thirds of patients had it in the first month and about 30% six months or more later. Tell your oncology team as soon as symptoms start, because they may adjust the treatment.
Why do my feet feel worse right after I stopped the cause?
After a toxic cause stops, especially high-dose vitamin B6, symptoms can keep getting worse for two to three weeks before they level off and improve. This is called coasting. Tell your clinician, but it does not mean stopping was the wrong decision.
Related reading
Can you reverse neuropathy in 7 days? · Alcohol-related neuropathy · Supplements for neuropathy · Diabetic neuropathy · Neuropathy treatment, sorted by what it does · Numb feet
Sources and further reading: NINDS, peripheral neuropathy, on recovery when the cause is corrected and the medicines that can cause neuropathy. American Diabetes Association Standards of Care in Diabetes—2026, section 12 (recommendation 12.20, treatment, and the Look AHEAD findings). The Diabetes Control and Complications Trial Research Group, N Engl J Med 1993;329:977–986. Smith AG et al., Lifestyle intervention for pre-diabetic neuropathy, Diabetes Care 2006;29:1294–1299. NIDDK, diabetic peripheral neuropathy. NIH Office of Dietary Supplements, vitamin B12 and vitamin B6. Berger AR et al., coasting in pyridoxine neurotoxicity, Neurology 1992;42:1367–1370. Krishnan D, Kiernan MC, Neurotoxic risks from over-the-counter vitamin supplements, Med J Aust 2023. StatPearls, alcoholic neuropathy, peroneal nerve injury and peripheral nerve injury. FDA Drug Safety Communication on fluoroquinolones and nerve damage (2013). Seretny M et al., prevalence of chemotherapy-induced peripheral neuropathy, Pain 2014;155:2461–2470. Johns Hopkins Medicine, chemotherapy-induced peripheral neuropathy, on coasting after platinum drugs. American Academy of Physical Medicine and Rehabilitation, peripheral nerve recovery and regeneration. NINDS, Charcot–Marie–Tooth disease.
This page is general education and is not a diagnosis, a treatment plan, or advice to start or stop any medicine or supplement. Clinical review by Dr. Biernacki is pending; the review date will be shown here once complete.
For our Michigan neighbors
Wondering whether
yours can improve?
The answer starts with the cause, and several causes are treatable. An examination and the right blood tests find them more often than people expect. Dr. Biernacki’s Michigan practice can start there.
Everywhere else, take this page to your own clinician.
Dr. Tom Biernacki, DPM, FACFAS is a double board-certified foot and ankle surgeon (ABFAS and ABPM) and a Fellow of the American College of Foot & Ankle Surgeons. He is the founder of Balance Foot & Ankle in Howell and Bloomfield Township, Michigan, where peripheral neuropathy, diabetic foot risk and loss of protective sensation are part of his weekly clinic. His patient education videos have drawn more than 950,000 subscribers on YouTube. Managing Neuropathy is written by its editorial team under his direction, to put the explanation he gives in the exam room in front of the people who cannot get to one — including when a product is worth buying and when it is not.