Synopsis

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

Benfotiamine is a synthetic, fat-soluble derivative of thiamine (vitamin B1) developed to enhance bioavailability. It is used in the support and treatment of peripheral neuropathy, especially diabetic neuropathy. The rationale behind its use is rooted in its superior ability to increase plasma and tissue concentrations of thiamine, which plays a key role in glucose metabolism and neuronal health. Several small-to-moderate-sized randomized controlled trials (RCTs) and open-label studies—primarily conducted in Europe—have shown that benfotiamine supplementation can improve neuropathic symptoms such as pain, paresthesia, and numbness in patients with diabetic neuropathy.

A 2008 meta-analysis (Stracke et al.) reviewed clinical data and found that benfotiamine significantly improved neuropathic symptoms compared to placebo. Additional studies (e.g., Haupt et al., 2005; Ziegler et al., 1998) demonstrated similar symptomatic benefits, particularly at daily doses of 300–600 mg. The proposed mechanism involves reduction of advanced glycation end products (AGEs) and oxidative stress, both implicated in diabetic nerve damage. However, while symptom improvement is documented, evidence for long-term prevention of neuropathy progression or nerve function restoration is limited, and most studies are of relatively short duration and moderate quality.

Overall, scientific evidence supports the symptomatic benefit of benfotiamine for diabetic peripheral neuropathy, though larger and longer-term studies are needed. Its use is included in some clinical guidelines in Europe, but it is less commonly recommended in the United States, pending further research.

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