Synopsis

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

Vitamin B12 (specifically in its active coenzyme form, 5-deoxyadenosylcobalamin) has scientific support for its use in the prevention and treatment of peripheral neuropathy, particularly when the neuropathy is due to B12 deficiency. A deficiency in vitamin B12 can lead to neurological manifestations, including peripheral neuropathy characterized by numbness, tingling, and weakness, primarily because B12 is essential for normal nerve function and myelin sheath maintenance. Several clinical studies and case reports have documented that supplementation with vitamin B12 can significantly improve or reverse neuropathic symptoms in individuals who are deficient. The strongest evidence exists for populations at risk of B12 deficiency, such as older adults, individuals with malabsorption syndromes, vegans, and patients on long-term metformin or proton pump inhibitors. In these groups, vitamin B12 supplementation leads to symptom improvement and prevention of further nerve damage. However, for peripheral neuropathy not related to B12 deficiency (e.g., diabetic neuropathy without deficiency), the evidence is mixed and generally weaker, with some small studies and meta-analyses suggesting mild benefit but not robustly supporting routine supplementation for all cases. In summary, there is scientific validation for B12 supplementation to treat or prevent peripheral neuropathy in the context of deficiency, but the evidence is less compelling for other etiologies.

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