Synopsis

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

Thiamine (vitamin B1), particularly in its active form thiamine diphosphate (also known as thiamine pyrophosphate), is used in the support and treatment of peripheral neuropathy, especially in cases where deficiency is suspected or confirmed. Scientific evidence shows that thiamine deficiency can lead to neurological manifestations, including peripheral neuropathy, as seen in conditions like beriberi and chronic alcoholism. Supplementation with thiamine can reverse neuropathic symptoms in such cases. However, for neuropathy not caused by deficiency, the evidence is limited and inconsistent. Some small studies and clinical reports suggest possible benefits of thiamine or its derivatives (such as benfotiamine) in diabetic neuropathy, but larger, high-quality randomized controlled trials are lacking. Accordingly, clinical guidelines recommend thiamine supplementation primarily in cases where deficiency is present or likely.

In summary, the scientific rationale for using thiamine in peripheral neuropathy is strongest when there is an underlying deficiency. For other types of peripheral neuropathy, particularly diabetic neuropathy, there is some low to moderate quality evidence suggesting a potential benefit, but it is not robust enough to recommend routine use. Therefore, the evidence rating is 2 out of 5.

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