Evidence supporting the use of: Vitamin B1 (benfotiamine)
For the health condition: Peripheral Neuropathy

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Benfotiamine is a synthetic derivative of thiamine (vitamin B1) designed for better bioavailability. Its use in supporting or treating peripheral neuropathy—particularly diabetic neuropathy—is based on both mechanistic rationale and clinical research. Thiamine is essential for glucose metabolism, and deficiencies can cause neurological symptoms, including neuropathy. Benfotiamine is thought to reduce the formation of advanced glycation end products (AGEs) and oxidative stress, both of which are implicated in diabetic neuropathy pathogenesis.

Several randomized controlled trials and meta-analyses conducted in the past two decades suggest that benfotiamine supplementation can reduce neuropathic symptoms such as pain, paresthesia, and numbness in diabetic patients. For example, a 2008 double-blind, placebo-controlled study (Stracke et al.) found significant improvement in neuropathic symptoms in diabetic patients taking benfotiamine compared to placebo. However, these studies often have limitations, including small sample sizes, short durations, and variability in outcome measures.

Systematic reviews (e.g., Haupt et al., 2005; Fraser et al., 2013) have concluded that while there is moderate evidence for symptomatic relief, there is insufficient evidence to suggest that benfotiamine can halt or reverse nerve damage. Larger, longer-term studies are needed for definitive recommendations. Nonetheless, benfotiamine is widely used in clinical practice for diabetic neuropathy, and its safety profile is generally favorable.

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