Recommendation

Benfotiamine and Neuropathy

For neuropathy in general, I recommend Benfotiamine, the fat-soluble form of vitamin B1. Benfotiamine is very beneficial for diabetic and other neuropathies in doses from 200-600 mg/day, with greater improvement at the higher doses.1,2 I would also add a broad-spectrum high-dose B-complex to this regimen.

In addition, a combination of alpha-lipoic acid, in a daily dose of about 1,000 mg,3 and N-acetylcysteine (NAC) (2,400 mg/day), may also help. NAC is a precursor of the body’s “master antioxidant,” glutathione, and has been used to prevent neuropathy from neurotoxic chemotherapy regimens.4

Finally, I suggest the use of pulsed electromagnetic therapy (PEMF)5 or DiaPulse treatment.6-8 Unfortunately, I no longer have access to a DiaPulse instrument in the clinic, but I have seen it work wonders in many cases of chronic, intractable neuropathies.

Ward Dean, MD

References

  1. Haupt E, Ledermann H, Köpcke W. Benfotiamine in the treatment of diabetic polyneuropathy–a three-week randomized, controlled pilot study (BEDIP study). Int J Clin Pharmacol Ther. 2005 Feb;43(2):71-7.
  2. Stracke H, Gaus W, Achenbach U, Federlin K, Bretzel RG. Benfotiamine in diabetic polyneuropathy (BENDIP): results of a randomized, double blind, placebo-controlled clinical study. Exp Clin Endocrinol Diabetes. 2008 Nov;116(10):600-5.
  3. Papanas N, Ziegler D. Efficacy of -lipoic acid in diabetic neuropathy. Expert Opin Pharmacother. 2014 Dec;15(18):2721-31.
  4. Deepmala D, Slattery J, Kumar N, Delhey L, Berk M, Dean O, Spielholz C, Frye R. Clinical trials of N-acetylcysteine in psychiatry and neurology: A systematic review. Neurosci Biobehav Rev. 2015 August; Volume 55:294–321.
  5. Graak V, Chaudhary S, Bal BS, Sandhu JS. Evaluation of the efficacy of pulsed electromagnetic field in the management of patients with diabetic polyneuropathy. Int J Diabetes Dev Ctries. 2009 Apr-Jun; 29(2): 56–61.
  6. Wilson DH, Jagadeesh P, Newman PO, Harriman DGF: The effects of pulsed electromagnetic energy on peripheral nerve regeneration. Ann N Y Acad Sci. 238:575-580, Oct 1973. (Presented: Electrically mediated growth mechanisms in living systems. Sept 1973).
  7. Wilson DH, Jagadeesh P: Experimental regeneration in peripheral nerves and the spinal cord in laboratory animals exposed to a pulsed electromagnetic field. Paraplegia. 14: 12-20 (England), 1976.
  8. Young W: Pulsed electromagnetic fields (Diapulse) alter calcium in spinal cord injury. Abstracts: The First International Symposium on Central Nervous System Trauma: Restoration, Plasticity, Regeneration, 127.

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