From the Guidelines

Organic acids can impact peripheral nervous system (PNS) function, although the evidence is mixed and not entirely conclusive.

Alpha-lipoic acid has been studied for its potential to prevent chemotherapy-induced peripheral neuropathy, but a randomized, double-blinded clinical trial found that it did not have a statistically significant ameliorating effect on neuropathy scores, pain scores, or functional test scores 1.
However, another study suggests that alpha-lipoic acid may be effective in treating painful diabetic peripheral neuropathy (DPN) 1.
Vitamin B6 deficiency has been linked to an increased risk of peripheral neuropathy, with studies showing that inadequate intake can lead to ultrastructural changes in neurons and disruptions in axoplasmic ground substance 1.
Other organic acids, such as glutamine and omega-3 fatty acids, have been studied for their potential to reduce the incidence and severity of peripheral neuropathy, but the evidence is limited and inconclusive 1.

The mechanisms by which organic acids impact PNS function are not fully understood, but may involve direct toxicity to nerve axons, disruptions in mitochondrial function, and alterations in collagen synthesis and bone metabolism 1.
The evidence suggests that vitamin B6 plays a crucial role in maintaining healthy peripheral nerves, and that deficiency may contribute to the development of peripheral neuropathy 1.
Further research is needed to fully understand the relationships between organic acids and PNS function, and to determine the potential benefits and risks of supplementation or other interventions 1.

From the Research

Organic acids have been shown to have both positive and negative effects on PNS function, depending on the type and context of exposure 2, 3, 4, 5, 6.
Some organic acids, such as retinoic acid, have been found to reduce solvent-induced neuropathy and promote neural regeneration in mice 2.
Other organic acids, such as phytic acid, have been shown to maintain peripheral neuron integrity and enhance survivability against platinum-induced degeneration via reducing reactive oxygen species and enhancing mitochondrial membrane potential 4.
Exposure to certain organic solvents, such as toluene and styrene, has been linked to sensorineural hearing loss and acquired color vision disturbances in workers, as well as cerebral atrophy and patchy periventricular hyperintensities in the basal ganglia 3.
Fatty acids have also been implicated in the pathogenesis of peripheral neuropathy associated with type 2 diabetes and prediabetes, with saturated and unsaturated fatty acids differentially regulating the nerve lipid profile and nerve function 6.
Nerve conduction studies have shown significant changes in workers exposed to a mixture of organic solvents, including white spirit, toluene, butyl acetate, ethyl acetate, and xylene, compared to control groups 5.

The mechanisms by which organic acids impact PNS function are complex and multifaceted, involving changes in nerve conduction velocity, terminal latency, and neural regeneration 2, 4, 5.
Reactive oxygen species and mitochondrial membrane potential have been identified as key factors in the neuroprotective effects of certain organic acids, such as phytic acid 4.
Dyslipidemia and abnormal plasma lipid profiles have been linked to peripheral neuropathy in type 2 diabetes and prediabetes, with fatty acids playing a role in regulating nerve function and lipid metabolism 6.

The findings of these studies have important implications for the prevention and treatment of peripheral neuropathy, particularly in the context of occupational exposure to organic solvents and type 2 diabetes and prediabetes 2, 3, 4, 5, 6.
Further research is needed to fully understand the mechanisms by which organic acids impact PNS function and to develop effective targeted therapies for the treatment of peripheral neuropathy 4, 6.