Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Benfotiamine is a synthetic derivative of thiamine (vitamin B1) with higher bioavailability. Its use in diabetic retinopathy is primarily supported by mechanistic studies and limited clinical research, rather than traditional or purely anecdotal use. The rationale comes from benfotiamine’s ability to activate transketolase, an enzyme that helps redirect harmful glucose metabolites away from damaging pathways implicated in diabetic complications. Preclinical studies, particularly in animal models, have shown that benfotiamine can reduce retinal vascular damage and neurodegeneration associated with diabetes by decreasing advanced glycation end products (AGEs), oxidative stress, and inflammatory responses. A few small human studies and pilot trials have suggested that benfotiamine supplementation may slow the progression of early diabetic retinopathy or reduce biomarkers related to vascular damage. However, robust, large-scale randomized controlled trials in humans are lacking, and current clinical guidelines do not universally recommend its use for diabetic retinopathy. Overall, the scientific basis exists and is biologically plausible, but the evidence remains preliminary and insufficient for strong recommendations. Its use is best described as “scientific,” with an evidence rating of 2 out of 5, reflecting promising but not definitive support.

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