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Acetyl-L-carnitine (ALCAR) (500mg per serving) ALCAR is a mitochondrial cofactor that plays a key role in cellular energy production and nerve cell maintenance.48 Its been shown to improve nerve regeneration and reduce neuropathic pain in people with diabetes, particularly at daily doses of 1,0002,000mg.49 While Nerve Defend provides a lower dose, combining ALCAR with ALA and NAC may enhance its therapeutic effect.63 64 N-acetylcysteine (NAC) (600mg per serving) NAC is a precursor to glutathione one of the bodys most important antioxidants.50 In the context of diabetic neuropathy, oxidative stress plays a major role in nerve damage