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Statistical analysis Statistical analyses were performed using GraphPad Prism (Graphpad Software, version 8.4.3) or R (version 4.5.1)

ALC plays a fundamental role in cellular energy metabolism in the mitochondria.[1][2] and provides neuroprotective and analgesic benefits through multiple mechanisms.[3][4] The relevance of ALC to pain management also stems from its unique epigenetic mechanism of action that prevents spinal sensitization , a key process in central sensitization and nociplastic pain.[4] Importantly, this epigenetic mechanism produces long-lasting analgesic effects that persist for weeks to months after discontinuationa feature that distinguishes ALC from conventional analgesics.[4] ALC has been shown to have benefits in multiple pain conditions, including diabetic peripheral neuropathy (DPN), Peripheral Neuropathic Pain (General, such as sciatica) and fibromyalgia with benefits both as monotherapy and with synergy when combined with palmitoylethanolamide (PEA).[7][8][9]

Baseline plasma and/or feces samples were collected

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