Welcome to another edition of the Doctor’s Note, where we talk about what’s on our minds when it comes to your health. 

Continuing with our “Stay Healthy Protocol” series, I want to talk about another vitamin that I really like, Vitamin B1 (Thiamine). I’ve recently become very interested in Vitamin B1 because it’s a good treatment for Covid if you’re really ill. 

Vitamins are the most important part of my food pyramid. 

In this Doctor’s Note, we will cover how Vitamin B1 (Thiamine) is used in treatment of peripheral neuropathy, plus the essential role it plays for nerves and the heart.   

Beri Beri, a disease caused by extreme lack of Vitamin B1, was discovered over 100 years ago in sailors who were only eating white rice. Muscular weakness, incoordination, swelling, and heart failure were caused by a B1 deficiency in those sailors. 

Today B1 deficiency is mostly seen in alcoholics, extreme nutritional deprivation, and sometimes in gastric bypass patients. 

The B vitamins are some of my favorite vitamins because they are responsible for energy and regulating your immune system. 

Thiamine is definitely on my recommended vitamin list for people with neuropathy, diabetics, alcoholics, and people who are currently on a ventilator with Covid-19. It may actually reverse things pretty quickly. 

Note: Patients in the hospital with Covid-19 can get deficient in B1 and many other vitamins. 


Vitamin B1 For Type 2 Diabetes


I’ve always been interested in Diabetes and Metabolic Syndrome. There are so many people who have diabetes and don’t know it. 

If you’re overweight, you either already have Type 2 Diabetes or most likely are going to have Type 2 Diabetes. 

Many people with diabetes have complications with neuropathy. This is when your nerves in the hands and feet start to tingle, get numb, and also hurt.

Neuropathy also causes endothelial damage (the endothelium is the lining of the blood vessels). 

Diabetes doesn’t just affect your heart, kidneys, and eyes. It also affects your peripheral nerves. 

This can be one of the most troublesome aspects of being a diabetic. 

Diabetic neuropathy is extremely common in people with Type 2 diabetes who have poor control over their diabetes.  

Vitamin B1 is a precursor to an enzyme called TPP, which is required for glucose metabolism. That’s how it relates to diabetes. 

What it does is helps prevent glycation.

Glycation is when sugar is added to a fat or a protein. It has somewhat of a browning effect like in food. Think of putting barbecue sauce on the grill. It browns the meat, and makes it taste sweeter.

That is not good when it happens in your body. Too much sugar combined with protein and fats can cause advanced glycation end products. These are very harmful to your macro (large) and micro (small) vasculature (blood vessels).

It leads to increased risks of artery disease, heart disease, peripheral artery disease, and certainly neuropathy. 


My Favorite Form of Vitamin B1


Vitamin B1 is a water soluble vitamin, so it’s not very bioavailable. Turns out there is a synthetic form that they make that is more lipophilic and more stable. 

This is the only synthetic vitamin that I really like. It’s 120 times more active than the natural form of B1. It gets into your nerves and vasculature better to protect them. 

It’s called Benfotiamine, which is the form of Thiamine that you want because it’s more bioavailable. I think every person with diabetes should take it, and anyone with peripheral neuropathy. 

Benfotiamine, Vitamin B6, and Vitamin B12 are the perfect triad to combat peripheral neuropathy. 

Note: You want Methyl B12. B6 is also interesting because if you get too much it can cause MORE neuropathy. Limit B6 to 100-200mg, or it may make it worse. 

Other vitamins for neuropathy: 

  • ALA
  • Curcumin 
  • NAC

L-Carnitine can also help with neuropathy, but be careful because it can increase your blood levels of TMAO (marker for heart disease). More on this in another article. 


Final Thoughts on Vitamin B1


I recommend a good B complex vitamin for almost everyone!  If you have peripheral neuropathy or alcoholism, you definitely should consider taking a separate higher dose of benfotiamine (up to 500-600mg per day). 

Peripheral neuropathy is not a rare disease. 

The pain from peripheral neuropathy has been described as “pins and needles in your hands and feet”. Thiamine can be helpful in combating that painful numbness. 

Think about this stuff! Thiamine is a fascinating vitamin and essential for staying healthy!