a foot above several upright thumb tacks

Q. I heard a caller on your radio show talk about a vitamin for peripheral neuropathy and restless leg syndrome. What is it? Can you tell me more?

Benfotiamine for Neuropathy:

A. The compound is benfotiamine, a synthetic form of thiamine (vitamin B1). It has been used in Germany to treat peripheral neuropathy due to diabetes. Our caller, a physician, says the dose is 300 mg twice daily to start with; maintenance is 150 mg twice a day. Benfotiamine is available without a prescription, but not all pharmacies carry it.

When he called, we had forgotten that we’d heard from other listeners several years ago about the same compound:

“I have suffered for about four years from an intermittent, sharp ‘electric’ pain on the sole of my left foot. Recently it became worse and was interfering with my sleep.

“I heard you speaking about peripheral neuropathy and a diabetic caller said her doctor had recommended ‘benfotiamine.’ This had returned feeling to the bottom of her feet for the first time in many years.

“After reading all I could find on the subject, I ordered benfotiamine and began taking it. Within 24 hours my pain had almost completely disappeared and the very isolated recurrences are comparatively mild.”

A placebo-controlled trial for diabetic neuropathy found a significant benefit for pain (Experimental and Clinical Endocrinology and Diabetes, Nov., 2008). We could find no trials of benfotiamine to treat restless leg syndrome, but it could be worth a try.

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  1. hallie

    I suffer from severe neuropathic nerve pain in my feet due to RSD (also known as CRPS). Lyrica and Neurontin barely touch the burning stabbing pain, even at highest doses. Opiate medications don’t touch the pain. I wouldn’t wish this nerve pain on Satan himself! I have begun taking 300 mgs benfotiamine and 600 mgs ALA daily, with little noticeable relief. Any suggestions from anyone who’s found relief from RSD pain in their feet would be most welcome! Thank you for taking the time to read my post.

    • Barbara

      To the poster with RSD. Benfotiamine is supposed to be for blood sugar health, not for nerve pain. I have terrible, crippling RSD in my hand and nothing has helped. I will start having nerve blocks in my neck by a pain management dr. because some RSD patients are helped by having these blocks in their neck.
      But why would anyone think benfotiamine would relieve any kind of nerve pain? Why is this use for nerve pain even mentioned by Peoples’ Pharmacy?

    • Barbara

      I have had relief from RSD pain with frequent daily self-hypnosis and meditation to lessen stress. I use visualization to imagine my hand well again. RSD is a terrible condition, a life-altering condition. Tricking the brain may work for some.
      My hand is nearly useless with stiffness, swelling and pain…I cannot drive, can’t even comb my hair. I have been told that in 70% of RSD patients it spreads to the other hand and elsewhere in the body. Little is known about RSD.
      RSD is now called CRPS..Chronic Regional Pain Syndrome.
      The pain is so horrible it can lead to suicide.

    • Barbara

      I have CRPS, previously named RSD, since hand surgery in July. I can now move my hand, close my fingers nearly normally but not quite, and I can not pick up something very light. My hand did look like a huge boxing glove. After three months of daily occupational and physical therapy on my hand,
      I see slight improvement weekly. Only therapy is recommended, but some go to a pain dr. and have ganglion (nerve blocks) that frequently give relief and can lead to real improvement. I am going to try it. Also, I bought the Bentofiamine-V and alpha lipoic acid to try for 6 weeks to see if it helps. It is supposed to only help with diabetic neuropathy, but perhaps there is a chance it will work with RSD for some people, although it did not work for you. I hope you keep searching and find relief. There is no pain worse than RSD! Thanks for sharing your experience with Bentofiamine. I also have peripheral neuropathy in my feet and maybe it will help that. I do not have diabetes.
      Good luck!!

      • Barbara

        I meant to type I can NOW pick up something very light. I have used occupational therapy and physical therapy and mirror box therapy and self hypnosis. I slowly get better, every week there is measurable improvement. But I have a ways to go to tame RSD (CRPS)

    • Shelley

      To the poster with CRPS, I have CRPS in the RT hand from surgery and spread to the RT foot from surgery. I also have diabetic neuropathy in both feet. You have to remember that the mechanism for the nerve pain of the conditions are different so they are going to respond to different treatments. Currently I am finding the best relief for the CRPS with the 4% topical Lidocaine liquid..I’ve had CRPS Type II for 16yrs and have had 13 Stellate Ganglion Nerve blocks, which only work temporarily. Best of luck.

      • Barbara

        Shelley, Thank you for posting. I appreciate what you wrote. Did you ever try Lyrica? A foot surgeon tells me he sees patients, especially the young and teenagers, recover from taking Lyrica for CRPS. It costs about $400 a month, so some people won’t take it. I tried gabapentin, but it made me too woozy, I didn’t like the feeling. I was unsteady in the body and numb in the mind! I rarely take meds, so I am very sensitive to altered feelings from drugs…I don’t like them.
        I do two hours therapy on my CRPS damaged hand, including mirror box therapy four times a day for 6-7 mins. and it is improving and I was encouraged, then I read CRPS frequently improves for two years, then gets much worse with atrophy and dystrophy and increasing pain.
        Did you ever try an anti-depressant? I have never taken one and would be concerned about doing so. I wonder which anti-depressant is the least dangerous and if any have helped CRPS. I am also trying Curcumin to see if it relieves CRPS.
        Thank you again,

  2. Annie

    I was having terrible nerve pain in my legs which turned out to be from a disc pressing on a nerve in my spine. I read about benfotiamine on this web-site and started with 300 mg. daily. It took 3 weeks to kick in, and all the nerve pain went away, but then 3 weeks later started coming back. I gradually increased the dosage and am now taking 900 mg. a day – 300mg morning, noon, and night, and that has eliminated all the nerve pain, and have had no side effects. What a relief!

    • Annie

      An update: I have been able to reduce the dosage of benfotiamine from 900 mg. to 600 mg. and am still getting very good results.


      Do add GLA and B12 methylcobalamin to this mix for optimum results.

  3. sylvia f.
    spokane wa

    I am looking for info on Benfotiamine with ala. I want to know more about it before I try it. I would never take gabapentin.

  4. Joan

    My elderly father had a laminectomy for spinal stenosis few years ago. He continues to complain of numbness and pain. Has a problem with allergies to medication. Would there be a problem taking these supplements?

  5. John
    Cincinnati Ohio area

    Benfotiamine did nothing for me but I have had great results fighting neuropathy by rebuilding my methalation pathway, specifically with B2 (100 mg spread over the day), 50 mg B1 as allithiamine (penertrates the blood brain barrier .. other B1 does not), methalated versions of B6 (100 mg), and B9 (folate, at 3 mg a day spread out), and lastly TMG/betaine. I also take some B12, which is always a good idea when you take a lot of B9/folate.

    Have some patience with it, and it should come around. Some changes are immediate, like regaining some smell and better balance, while neuropathy may take a few weeks to see a change.

    When I started this I had neuropathy for years and had started losing pain sensations .. I guess you could say a lot of sensation. I did not know, for instance, that I had lost my sense of smell till the next morning after taking my first B2 supplement. That was quite an eye opener and prompted me to study B vitamins a lot more. I decided that I needed to treat the entire methylation process, and thus selected these specific B vitamins and TMG, which is what’s called a methyl donor.

    Best of luck to everyone.

    Liberty, Texas

    I have neuropathy also, mu doc put me on licra. I cant function on the pill and I want a natural help. I’m 62 and still working. have a 30 mil commute to work and can’t take the pill. Sometimes it bothers me so bad it throws me into a panic attack. I need help without drugs.

  7. Laura

    This will sound too simple to work. I started to have really bad nerve pain in my feet from sitting at work too much. I was diagnosed with neuropathy . I randomly started to try different things. I discovered vinegar tablets worked. They are cheap you can avoid drinking the stuff. My personal theory on why it works the muscles from not being used are building up some sort of acid from non use and it is attacking the nerves.

  8. Joyce

    I am looking to try anything to help with the pain, I have tingling, burning, spasms, numbness on a daily basis. I have a herniated disc in my back. Dr. prescribed 900mg of gabapentin 3 times a day. I can only take at bedtime to help me sleep, makes me sleepy if I take throughout the day. This pain is unbearable, I can hardly walk, no more running for me, it hurts so bad. Please respond!

  9. Carolyn

    I have three questions about benfotiaomine and alpha lipoic acid. First, are they both considered effective for idiopathic peripheral neuropathy (e.g., for non-diabetics)? Second, if so, what are the recommended dosages for each? Third, should alpha lipoic acid be taken with food or on an empty stomach? I have seen instructions both ways. Thank you.

    • PM

      Did you get a reply? This would be my question also. I do not have diabetes but I have variable foot pain which I think has to do with a vitamin deficiency but not sure.

    • Barbara

      I don’t believe benfotiamine has relieved nerve pain. It is to control blood sugar, not for nerve pain. Who started the rumor that benfotiamine relieves nerve pain? Isn’t that a cruel hoax?

      • Kathg
        Washington State

        Benfotiamine stopped my nerve pain within 20 minutes!! After years of pain w that would keep me up nights, after using a tenz unit would no longer work and I was ready to scream with pain and frustration and exhaustion…. I found Benfotiamine, and it works like magic!! I am no longer diabetic, since I had a pancreas transplant, no blood sugars are not a problem. The horrible pain in my feet was, though. I’m so grateful for Benfotiamine!!

        I also recommended it to an older friend who has diabetes and neuropathic pain… and it has been a great help for him as well!

        $22 for two months is a cheap fix… without filling your body full of toxic chemicals!

  10. Trent

    I am new here, was interested if anyone had good experience with thiamine for neuropathy.

    • Joy
      Raleigh, NC

      How long do you take 300 mg 2 xs a day of Benfotiamine for non diabetic neuropathy?

  11. Kat

    After hip replacement along with other normal symptoms I have a not so normal one! I am 58 years old just want to be productive again !! Anyway I was put on gabapentin 300mg 3xs day I began go have memory loss so much I felt I would go crazy ! I began walking as if I had MS !! Scared me and got off of it!! My symptom is the top of my feet feel broken ! They are testing me for neuropathy ! Try anything else before you go on gabapentin!! I’m going to be one of the lucky ones ! A long time friend has her Masters in Holistic Med and is guiding me through my long painful journey! On that med I wasn’t me and I no longer wanted to be here!! Thank you Kathy Ann for coming back to me when I needed you most!!! Xoxo

  12. Regine
    United States

    I have the sinus tarsi syndrome for over a year and acute sciatica and nothing gets better. I take vit B12 and gabapentin 3×300 mg per day. I’m kind of desperate, I’m going to try B1, any other suggestion? Thank you

  13. Dan

    There could be many, many reasons or causes for neuropathy. Not sure what to recommend if the pain/tingling is a result of a car accident, but neuropathy can be a result of low B12 levels (especially methylcobalamin), and spinal degeneration can be a result of low b12 levels.
    Neuropathy could be due to poor circulation, so other antioxidants like vitamin E or tocotrienols may help. Dr. Derrick Lonsdale, one of the world’s experts on thiamine, says that he had some patients who became B12 (and folate) deficient, if they were on high doses of thiamine.
    Personally, I would avoid gabapentin, except as a last resort, as it does nothing to repair the possible nerve damage. All it does is temporarily suppress the pain.

  14. Jack

    Unfortunately my daughter has not received much relief with benfotiamine either, not much help but all the best with your treatment.

  15. brenda

    I’ve had neuropathy in my feet for 2 years, and it’s related to an allergic reaction to Bactrim. I’ve been on Gabapentin for 1.5 years, but it hasn’t helped that much. I’ve been taking the Benfotiamine 600 mg for 60 days, and it doesn’t seem to be helping me. I’m also taking Alpha Lipoic Acid 600mg. Any suggestions on anything that might help?

  16. stone

    Does anyone know if the benfotiamine works for tarsal tunnel syndrome? I have had this for several years now and nothing seems to help.

  17. alxzba

    would like to receive future comments. Have neuropathy in feet/lower legs. Any help appreciated. thanks for the lead.

    • teataster

      For diabetics like me suffering from peripheral neuropathic pain, this gel offers some relief. In combination with high doses of methylcobalamin (vitamin B12) + Benfotiamine, a synthetic form of thiamine (vitamin B1) along with evening primrose oil (EPO 300 mg) will in a period of about 2 to 3 months give you good results.

      Note there is no cure but you can halt the degeneration of the nerve endings by supplementation, regular exercise and overall good control of blood sugar levels. Massage therapy helps and so does dipping your feet alternatively in hot and cold water. This enhances micro circulation of blood to the fine blood vessels.

  18. JACK

    I have read with interest the impact on neuropathy pain of benfotiamine. My 20 year old daughter has severe chronic back pain as a consequence of a car accident 2 years ago, just completed a 3 week pain management clinic at leading Australian Hospital. Whilst limited physical issues her brain seems to trigger severe dagger like electric pulses which last for half an hour or so almost on a daily basis, other times a duller sort of pain. Pain Clinic treatment based on desensitisation, NO DRUGS. Just wondering if we should try benfotiamine.

  19. th

    Erhan, have you had any success? I am also interested in an answer to this question.

  20. Lizette

    THANK YOU Dr Charles!
    I appreciate your explanation in layman’s terms…it helps everyone get a little better idea on how nutrients flow in and out of the cells. I knew immediately that the difference was water vs fat soluble, but I did not realize the importance of those differences for treating neuropathy pain until now.
    Thanks again!

  21. Dan

    This may sound insulting…it is not meant as such, but for those asking where they can buy benfotiamine, my goodness, have you ever thought of googling online for sources? It’s been available for YEARS on Amazon, just as one example, and can be purchased at many other online supplement sites.

  22. Ellie

    I am 83 yrs old. Suffered a bout of shingles this past October and PHN ever since. Was put on a low dose of gabapentin which did not seem to help much; however when dose was lowered, pain increased and began in places not affected previously. I have only today read about benfotiamine and R-alpha lipoic acid to treat neuropathy pain. I am anxious to try both in the near future.

  23. susan B

    Jan S. I’m 73 and my dr. put me on Gabapentin the day after Christmas because of an acute attack of peripheral neuropathy. It worked wonders. However, I’m still sexually active and cannot attain an organism. In checking the “crazy” side effects, this is one of them.
    I would recommend it if this is not a problem for you. I’m scheduled for a nerve conduction test next month and will make a decision whether to continue with the Gabapentin or look for another drug.
    My dr. advised against the benfotiaomine for me as I have a fatty liver and, as it’s a fat soluble vitamin the excess doesn’t wash out of the system as a water soluble vitamin will (such as C).

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