Synopsis

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

Vitamin B12 (particularly in the forms of hydroxycobalamin, methylcobalamin, and cyanocobalamin) has been investigated for its potential role in the management of neuralgia and neuritis. B12 is crucial for myelin synthesis and neuronal health, and deficiency can cause various forms of neuropathy, including peripheral neuropathy and subacute combined degeneration of the spinal cord. In the context of neuralgia and neuritis, B12 supplementation is scientifically justified and standard in cases where deficiency is present.

Some small-scale studies and clinical reports suggest that B12, especially methylcobalamin, may have analgesic and neurotrophic effects that could benefit patients with neuropathic pain even in the absence of frank deficiency. For example, randomized controlled trials (mostly from Asia) have shown that high-dose methylcobalamin can reduce symptoms of diabetic neuropathy and other peripheral neuropathies.

However, robust, large-scale, placebo-controlled studies are lacking, and the benefit of B12 in neuralgia or neuritis unrelated to deficiency remains uncertain. Most treatment guidelines recommend B12 supplementation only when deficiency is confirmed or suspected. Hydroxycobalamin is a commonly used injectable form, particularly in Europe.

In summary, the use of Vitamin B12 (hydroxycobalamin) for neuralgia and neuritis is scientifically justified when deficiency is present (strong evidence), while its use as a general neurotrophic or analgesic agent in the absence of deficiency is supported by limited and low-quality evidence.

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