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The risk of toxicity is essentially negligible, because excess biotin is water-soluble and readily eliminated in urine

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274,275 Therapeutic strategies targeting oxidative stress and mitochondrial dysfunction include using antioxidants like alpha-lipoic acid (ALA), which improves neuropathic symptoms and nerve conduction velocities in patients with DPN

Regulatory status differs for medical use, retail use, and athletic competition

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However, not all cases of neuropathy can be reversed (some end up being permanent)