Synopsis

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

Vitamin B1 (thiamin), particularly in its active form thiamin pyrophosphate (TPP), has been used in the management of peripheral neuropathy, especially in cases related to thiamin deficiency (such as in chronic alcoholism or malnutrition). Scientific evidence supports its use primarily when neuropathy is caused by or associated with a deficiency of thiamin. In such cases, supplementation can effectively reverse or halt the progression of neurological symptoms, including peripheral neuropathy. Clinical guidelines recommend thiamin supplementation for patients at risk of deficiency, and case reports and observational studies have documented improvement in neuropathic symptoms following repletion.

However, for peripheral neuropathy not related to thiamin deficiency—such as diabetic neuropathy or idiopathic forms—evidence is less robust. Some studies, mostly small or of limited quality, have evaluated thiamin and its derivatives (e.g., benfotiamine) for diabetic neuropathy, with mixed results. While some trials suggest potential symptom improvement, systematic reviews and meta-analyses conclude that the overall quality and quantity of evidence is low. There is no strong consensus for its use outside of clear deficiency states.

In summary, thiamin supplementation is scientifically justified for treating peripheral neuropathy due to thiamin deficiency. For other types of neuropathy, evidence is limited and inconclusive, resulting in a moderate-low evidence rating.

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