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Bnf5.5
Benfotiamine Research
Likely helps
46 peer-reviewed studies
What the evidence says
Likely helps
Benfotiamine appears to help in 7 of 7 studies with measurable effects — the evidence leans clearly favourable.
Most evidence is from high-quality meta-analyses and randomised trials published 1996–2025 with a typical study size of 39 participants.
Based on 46 studies · 2 meta-analyses · 24 RCTs · 3,854 total participants
Confidence
High confidence
What the studies found
7helped· 39 more without graded effect data
By outcome
Glucose & metabolicReduces AGE formation and supports metabolic resilience · 4-12 weeks
Likely helps40 studies
Therapeutic & clinical
Mostly mechanism / observational9 studies
Safety profile
Mostly mechanism / observational9 studies
Neuroprotection & brain aging
Mostly mechanism / observational5 studies
InflammationReduced glycation and AGE formation · 8-12 weeks
Mostly mechanism / observational5 studies
Heart & blood pressure
Mostly mechanism / observational4 studies
Cognitive function
Mostly mechanism / observational3 studies
Joint pain & arthritis
Too few graded studies1 study
By the numbers
Pulled from 29 studies with measurable effects
Likely real effects
88%
across studies
People studied
3,854
typical study: 39 people
Strongest designs
26
2 pooled, 24 randomised
Showed benefit
100%
7/7 studies
How long studies ran
Under a week
1
1–4 weeks
1
1–3 months
3
3+ months
5
Populations Studied
Patients with diabetic neuropathy2
Patients with diabetic polyneuropathy2
Diabetes patients with polyneuropathy1
Type 2 diabetes patients with angiopathies1
Active research area
15 studies in the last 5 years · Latest meta-analysis: 2022
199620102025
1Meta-Analysisn=1,354 · large study2015
In plain English: There is an absence of evidence to recommend the use of vitamin B therapy alone or combination for delaying progression of DKD.
Raval AD et al. · The Cochrane database of systematic reviews (2015)
There is an absence of evidence to recommend the use of vitamin B therapy alone or combination for delaying progression of DKD.
Thiamine was found to be beneficial for reduction in albuminuria in a single study; however, there was lack of any improvement in kidney function or blood pressure following the use of vitamin B preparations used alone or in combination.
These findings require further confirmation given the limitations of the small number and poor quality of the available studies.
In plain English: Benfotiamine reduced triglyceride level (MD, -1.10; 95% CI: -1.90 to -0.30) in 120 mg/day dose as compared with placebo 150 mg/day, however this was not demonstrated in higher doses.
Muley A et al. · BMJ open (2022)
There was a significant increase in high-density lipoprotein (HDL) (MD, 0.10; 95% CI: 0.10 to 0.20) at 3-month follow-up.
Benfotiamine reduced triglyceride level (MD, -1.10; 95% CI: -1.90 to -0.30) in 120 mg/day dose as compared with placebo 150 mg/day, however this was not demonstrated in higher doses.
In plain English: Painful DSPN is encountered in 13-26% of diabetes patients, while up to 50% of patients with DSPN may be asymptomatic.
Ziegler D et al. · Diabetes research and clinical practice (2022)
Painful DSPN is encountered in 13-26% of diabetes patients, while up to 50% of patients with DSPN may be asymptomatic.
Considering the individual risk profile, pain management should not only aim at pain relief, but also allow for improvement in quality of sleep, functionality, and general quality of life.
In plain English: Among pathogenesis-oriented treatments, α-lipoic acid, actovegin, benfotiamine and epalrestat are currently authorized to treat DSPN in several countries.
Ziegler D et al. · Journal of diabetes investigation (2021)
Huge benefit
← WorseNo effectBetter →
Painful DSPN might be as frequent as 25% in diabetes patients.
Asymptomatic DSPN might reach 50% among patients with this condition.
Symptomatic therapy uses analgesics, notably antidepressants, opioids and anticonvulsants, reducing pain by ≥50% in approximately 50% of individuals, but might be limited, particularly by central nervous system-related adverse events.
In plain English: In this review article, the authors discuss the significance of benfotiamine in the prevention of various pathological complications.
Allowitz KV et al. · Future medicinal chemistry (2022)
In addition to potent antioxidative properties, benfotiamine has also been shown to be a strong anti-inflammatory agent with therapeutic significance to several pathological complications.
Specifically, over the past decade or so, benfotiamine has been shown to prevent not only various secondary diabetic complications but also several inflammatory complications such as uveitis and endotoxemia.
Recent studies also demonstrate that this compound could be used to prevent the symptoms associated with various infectious diseases such as HIV and COVID-19.
8Inflammatory activities in type 2 diabetes with angiopathiesSystematic Review2020
In plain English: Conclusion: Inflammatory activities are implicated in diabetes-related angiopathies; regular exercise, the intake of healthy dietary supplements, and medications with anti-inflammatory properties could result in improved protective risk outcome for diabetes patients by suppressing inflammatory activities and elevating anti-inflammatory events.
Nwadiugwu MC · Frontiers in public health (2020)
Borderline
Use of drugs such as salsalate, pioglitazone, simvastatin, and fenofibrate but not glimepiride or benfotiamine reported a significant decrease in inflammatory events.
Results: Data analysis showed that elevated CRP, TNF-α, and IL-6 were the most commonly found inflammatory indicator in diabetes-related angiopathies, while increased IL-10 and soluble RAGE was an indicator for better outcome.
Regular exercise and consumption of dietary supplements such as ginger, hesperidin which have anti-inflammatory properties, and those containing prebiotic fibers (e.g., raspberries) revealed a consistent significant (p < 0.05) reduction in inflammatory activities.
In plain English: In the present review, we have comprehensively reviewed all the molecular targets modulated by BFT to provide mechanistic perspective to highlight its pleiotropic effects.
Raj V et al. · European review for medical and pharmacological sciences (2018)
The reduction in AGEs subsequently decreases metabolic stress which benefits vascular complications seen in diabetes.
The effects of BFT on the AGE-dependent pathway is well established.
In the present review, we have comprehensively reviewed all the molecular targets modulated by BFT to provide mechanistic perspective to highlight its pleiotropic effects.
11Pharmacotherapeutic targets for diabetic nephropathyReview2016
In plain English: Beside this, some therapeutic agents are still waiting for FDA approval and few drugs without FDA approval are also prescribed in some countries for the management of DN.
Bhattacharjee N et al. · European journal of pharmacology (2016)
Beside this, some therapeutic agents are still waiting for FDA approval and few drugs without FDA approval are also prescribed in some countries for the management of DN.
Despite the medications available in the market to treat DN, the involvement of multiple mechanisms makes it difficult to choose an optimum therapeutic agent.
Therefore, much research is required to find out new therapeutic agent/strategies for an adequate pharmacotherapy of DN.
In plain English: There are only limited data in randomised trials testing the efficacy of vitamin B for treating peripheral neuropathy and the evidence is insufficient to determine whether vitamin B is beneficial or harmful.
Ang CD et al. · The Cochrane database of systematic reviews (2008)
There are only limited data in randomised trials testing the efficacy of vitamin B for treating peripheral neuropathy and the evidence is insufficient to determine whether vitamin B is beneficial or harmful.
One small trial in alcoholic peripheral neuropathy reported slightly greater improvement in vibration perception threshold with oral benfotiamine for eight weeks than placebo.
In another small study, a higher dose of oral vitamin B complex for four weeks was more efficacious than a lower dose in reducing symptoms and signs.
13Neuroprotective effects in neurodegenerative diseasesReview2023
In plain English: The present review aims to summarize existing data on the neuroprotective effects of thiamine thioesters and give a comprehensive account.
Bettendorff L · International journal of molecular sciences (2023)
Recent in vitro studies show that another thiamine thioester, O,S-dibenzoylthiamine (DBT), is even more efficient than BFT, especially with respect to its anti-inflammatory potency, and is effective at lower concentrations.
Thiamine thioesters have pleiotropic properties linked to an increase in circulating thiamine concentrations and possibly in hitherto unidentified open thiazole ring derivatives.
The identification of the active neuroprotective metabolites and the clarification of their mechanism of action open extremely promising perspectives in the field of neurodegenerative, neurodevelopmental, and psychiatric conditions.
15Peripheral nerve functionRCTn=67 · small study2012
In plain English: Our findings suggest that high-dose benfotiamine (300 mg/day) supplementation over 24 months has no significant effects upon peripheral nerve function or soluble markers of inflammation in patients with type 1 diabetes.
Fraser DA et al. · Diabetes care (2012)
Our findings suggest that high-dose benfotiamine (300 mg/day) supplementation over 24 months has no significant effects upon peripheral nerve function or soluble markers of inflammation in patients with type 1 diabetes.
Frank T, Bitsch R, Maiwald J, Stein G · Int J Clin Pharmacol Ther (1999)
18Advanced glycation end-products inhibitionRCTn=30 · small study2013
In plain English: This study shows the efficacy of an AGE inhibitor on decreasing pain and inflammation, and increasing daily activity and mobility in OA patients.
Garg S et al. · The Clinical journal of pain (2013)
Likely real
24-week RCT of an AGE inhibitor (benfotiamine 50 mg + pyridoxamine 50 mg + methylcobalamin 500 µg) versus placebo in 30 osteoarthritis patients
Greater reductions in pain and total WOMAC score in the drug group versus placebo (pain P=0.003; WOMAC P=0.013)
Greater reductions in AGEs, serum nitrite, TBARS and C-reactive protein in the drug group (AGEs P=0.001; CRP P<0.01)
19Postprandial vascular functionCrossovern=31 · small study2013
In plain English: In people with Type 2 diabetes and markedly impaired fasting flow-mediated dilatation, a mixed test meal does not further deteriorate flow-mediated dilatation or variables of microvascular or autonomic nervous function.
Stirban A et al. · Diabetic medicine : a journal of the British Diabetic Association (2013)
Participants had an impaired baseline flow-mediated dilatation (2.63 ± 2.49%).
In people with Type 2 diabetes and markedly impaired fasting flow-mediated dilatation, a mixed test meal does not further deteriorate flow-mediated dilatation or variables of microvascular or autonomic nervous function.