American Diabetes Association Guide to Herbs and Nutritional Supplements. Laura Shane-McWhorter

be cautious about low blood glucose when taking banaba with diabetes medications or other dietary supplements that may lower blood glucose. As with any supplement, tell your doctor or pharmacist if you’re planning to take or are taking banaba.

      OTHER NAMES • Vitamin Bl • Allithiamines •

BENFOTIAMINE

      For many decades, neurological disorders such as diabetes and alcohol-related nerve damage have been treated with vitamin B1. However, vitamin B1, which is also called thiamine, is not absorbed by the body very well, and high levels are needed for successful treatment. Benfotiamine, a fat-soluble form of the vitamin, provides much higher levels of thiamine in the blood and tissues and thus may be more effective.

      These vitamins are also called allithiamines because they are found in the Allium vegetable family, which includes garlic, onions, shallots, and leeks. Other foods that may contain thiamine include whole-grain cereals and breads, peas, beans, and nuts, as well as potatoes and certain meats (pork and liver). Consuming large quantities of raw freshwater fish and shellfish may decrease your level of thiamine.

      USES

      Benfotiamine may relieve the effects of certain diabetes-related complications such as neuropathy (nerve damage), retinopathy (eye disease), and nephropathy (kidney disease). It may correct thiamine deficiencies in these conditions, even in people with end-stage renal (kidney) disease on dialysis.

      Benfotiamine enhances the activity of an important enzyme involved in glucose metabolism called transketolase. By enhancing this activity, it prevents glucose from being metabolized in a way that can cause damage. It may also diminish or even correct cell damage by normalizing cell division rates and decreasing apoptosis, or programmed cell death.

      DOSE

      The dose studied in diabetes-related neuropathy is 300–450 mg daily, administered in divided doses. For example, 100 or 150 mg benfotiamine three times a day. The dose used for alcohol-related neuropathy is higher.

      STUDIES

      Most studies of benfotiamine have been done in people with diabetes and neuropathy.

      • In a well-designed pilot study (randomized, double-blind, placebo-controlled), researchers studied 40 patients with neuropathy. Twenty patients received 100 mg of benfotiamine four times a day, and 20 patients received a placebo (dummy pill). After 3 weeks, neuropathy symptoms improved in the benfotiamine-treated group, although vibration-sensation scores did not improve.

      • In another study, a preparation of 100 mg of benfotiamine plus other B vitamins was given four times a day to 30 neuropathy patients for 9 weeks, followed by a lower dose for 3 more weeks (50 mg four times a day). A control group of patients took a conventional B vitamin for the entire 12 weeks. The benfotiamine-treated patients had significant neuropathic pain relief and improvements in vibration perception (a sensation test), whereas the B-vitamin-only group had only minor improvements.

      • Another 6-week study was conducted in 36 people with diabetes and painful neuropathy. Twelve patients were given a combination of 80 mg of benfotiamine plus other B vitamins four times a day. Another group of 12 patients received a similar combination that contained only 40 mg of benfotiamine four times a day. The other 12 patients received a supplement containing only 50 mg of benfotiamine three times a day. All groups had improvements in pain relief and sensation, but the best results were reported in those patients taking the highest dose of benfotiamine.