From the Guidelines
Vitamin B12 (cobalamin) is the most effective B vitamin for treating peripheral neuropathy, particularly when the neuropathy is caused by B12 deficiency, and should be administered at a dose of 1 mg intramuscularly on alternate days until there is no further improvement, then 1 mg intramuscularly every 2 months for maintenance. This recommendation is based on the most recent and highest quality study available, which emphasizes the importance of prompt treatment of vitamin B12 deficiency to prevent or delay the progression of neuropathy 1. The study also highlights the need for regular monitoring of patients with neurological involvement and seeking urgent specialist advice from a neurologist and hematologist if necessary.
Some key points to consider when treating peripheral neuropathy with vitamin B12 include:
- The importance of treating vitamin B12 deficiency immediately to prevent or delay the progression of neuropathy
- The use of hydroxocobalamin 1 mg intramuscularly on alternate days until there is no further improvement, then 1 mg intramuscularly every 2 months for maintenance
- The need for regular monitoring of patients with neurological involvement and seeking urgent specialist advice from a neurologist and hematologist if necessary
- The potential benefits of a B-complex supplement containing all B vitamins, as they work synergistically to support nerve health and reduce inflammation
It's also important to note that while other B vitamins, such as vitamin B1 (thiamine) and B6 (pyridoxine), may be helpful in certain cases of peripheral neuropathy, excessive intake of these vitamins can actually cause or worsen neuropathy 1. Therefore, it's essential to consult with a healthcare provider to determine the specific cause of the neuropathy and the most appropriate treatment regimen. Additionally, other studies have emphasized the importance of optimizing glucose control and treating pain related to diabetic peripheral neuropathy to improve quality of life 1.
From the FDA Drug Label
CLINICAL PHARMACOLOGY Vitamin B12 is essential to growth, cell reproduction, hematopoiesis, nucleoprotein and myelin synthesis. Prompt parenteral administration of Vitamin B12 prevents progression of neurologic damage.
The vitamin B that works best for peripheral neuropathy is Vitamin B12.
- Vitamin B12 is essential for myelin synthesis, which is important for nerve function and health.
- Prompt administration of Vitamin B12 can prevent progression of neurologic damage, which may be beneficial for patients with peripheral neuropathy 2.
From the Research
Vitamin B for Peripheral Neuropathy
The following vitamins have been studied for their effectiveness in treating peripheral neuropathy:
- Vitamin B12: Studies have shown that vitamin B12, particularly in combination with other treatments, may be effective in improving clinical therapeutic efficacy and nerve conduction velocities (NCVs) for peripheral neuropathy patients 3, 4, 5, 6.
- Vitamin B1 (Thiamine): One study found that treatment with B1 was associated with a significant improvement in symptoms 6.
- Benfotiamine (a derivative of thiamine): A small trial showed a small significant benefit in vibration detection from oral benfotiamine 7.
Efficacy of Vitamin B
The efficacy of vitamin B in treating peripheral neuropathy is not yet fully understood, with some studies showing promise and others finding limited or no benefit:
- A systematic review and meta-analysis found that vitamin B12 treatment showed a non-significant association with symptom improvement, while treatment with B1 was associated with a significant improvement in symptoms 6.
- Another review found that there is currently some evidence for the therapeutic effect of B12 in the treatment of post-herpetic neuralgia and painful peripheral neuropathy 4.
- A Cochrane review found that the evidence is insufficient to determine whether vitamin B is beneficial or harmful for treating peripheral neuropathy 7.
Adverse Effects
Vitamin B is generally well-tolerated, with few minor adverse effects reported: