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Methods We searched MEDLINE (19962014), EMBase (19742014), and CENTRAL (May 2014) up to June 27, 2014 for randomized controlled trials (RCTs) comparing ALC with placebo or other active medications in diabetic and non-diabetic PNP patients that reported the change of pain using visual analogue scale (VAS)

SM and MP wrote sections of the manuscript

Self-injection without clinical training introduces unnecessary risk

Endogenous toxins include the metabolic byproducts of our own cellular respiration, such as reactive oxygen species (ROS) and free radicals

The range includes phosphatidylcholine, phospholipid complex oils, butyrate and mineral formulations, with particular focus on membrane and mitochondrial health