Supplements - Benfotiamine, relative of thiamine

Benfotiamine

  • Vitamins & Supplements
  • Updated March 24, 2017

Benfotiamine is a relative of thiamine, which is better known as vitamin B1. Thiamine is critical for the metabolism of our brain's major energy source—glucose. Benfotiamine, which converts to thiamine in the body, enters cells more easily than thiamine. Although a pilot study of benfotiamine has found cognitive improvement in Alzheimer's disease patients, no clinical studies have determined whether it can prevent age-related cognitive decline or dementia in healthy adults. Benfotiamine appears to be safe when used at standard doses.

Evidence

No clinical studies have tested whether benfotiamine can prevent age-related cognitive decline or dementia, though one trial is underway now. Our search identified:

• 1 open-label uncontrolled study in Alzheimer's patients
• 3 preclinical studies

Potential Benefit

Benfotiamine is converted to thiamine, which serves as a key factor for three enzymes involved in generating energy from glucose [1]. Preclinical studies have found that benfotiamine enhances cognitive function and reduces biological markers of Alzheimer's disease [2][3]. These benefits may be due to benfotiamine's ability to suppress the activity of an enzyme that promotes the progression of Alzheimer's [4]. However, benfotiamine's effects on this enzyme have not been confirmed in humans.

At this time, there are no randomized clinical trial data showing that benfotiamine is beneficial for prevention or treatment of age-related cognitive decline or dementia. A phase II clinical trial now underway, however, is testing whether benfotiamine can slow cognitive decline in patients with mild cognitive impairment or Alzheimer's disease [5]. Results have not yet been published.

For Dementia Patients

There is only one small open-label, uncontrolled study which showed that benfotiamine treatment for 18 months resulted in improved cognitive function in Alzheimer's patients [6], though the treatment did not decrease levels of beta-amyloid, a protein common in people with Alzheimer's disease. An ongoing phase II placebo-controlled study, supported in part by the Alzheimer's Drug Discovery Foundation, is testing whether benfotiamine slows cognitive decline in patients with amnestic mild cognitive impairment and Alzheimer's disease [5].

Safety

Benfotiamine is generally considered safe for most people when taken at standard doses, though long-term safety has not been studied. In clinical trials, side effects were mild and included gastrointestinal issues and skin reactions [7]. Because benfotiamine gets converted to thiamine (vitamin B1), and thiamine may cause low blood pressure or low blood glucose, people taking drugs or herbs to lower blood pressure or blood glucose should exercise caution [8].

NOTE: This is not a comprehensive safety evaluation or complete list of potentially harmful drug interactions. It is important to discuss safety issues with your physician before taking any new supplement or medication.

How to Use

Benfotiamine supplements are available over-the-counter, often in capsules containing 150–300 mg. In an open-label uncontrolled trial, a daily dose of 300 mg showed cognitive improvement in Alzheimer’s disease patients [6]. Other studies in clinical populations have used doses ranging from 200–600 mg/day [7][9][10].

Learn More

Information on safety and drug interactions with thiamine from the Mayo Clinic

Evaluation of benfotiamine's potential biological effects from Examine.com

The ADDF is sponsoring a phase II clinical trial led by Dr. Gary Gibson at the Winifred Masterson Burke Medical Research Institute. This trial is testing whether benfotiamine slows cognitive decline in patients with amnestic mild cognitive impairment and Alzheimer's disease. Details of this trial can be found by searching "benfotiamine" in the ADDF's Online Portfolio and at clinicaltrials.gov.

References

  1. Gibson GE, Hirsch JA, Cirio RT et al. (2013) Abnormal thiamine-dependent processes in Alzheimer's Disease. Lessons from diabetes. Mol Cell Neurosci 55, 17-25.
  2. Pan X, Gong N, Zhao J et al. (2010) Powerful beneficial effects of benfotiamine on cognitive impairment and beta-amyloid deposition in amyloid precursor protein/presenilin-1 transgenic mice. Brain 133, 1342-1351.
  3. Markova N, Bazhenova N, Anthony DC et al. (2017) Thiamine and benfotiamine improve cognition and ameliorate GSK-3beta-associated stress-induced behaviours in mice. Prog Neuropsychopharmacol Biol Psychiatry 75, 148-156.
  4. Sun XJ, Zhao L, Zhao N et al. (2012) Benfotiamine prevents increased beta-amyloid production in HEK cells induced by high glucose. Neurosci Bull 28, 561-566.
  5. Gibson GE (2014) Benfotiamine in Alzheimer's Disease: A Pilot Study (Benfotiamine). ClinicalTrialsgov.
  6. Pan X, Chen Z, Fei G et al. (2016) Long-Term Cognitive Improvement After Benfotiamine Administration in Patients with Alzheimer's Disease. Neurosci Bull 32, 591-596.
  7. Stracke H, Gaus W, Achenbach U et al. (2008) Benfotiamine in diabetic polyneuropathy (BENDIP): results of a randomised, double blind, placebo-controlled clinical study. Exp Clin Endocrinol Diabetes 116, 600-605.
  8. (2013) Thiamine (Vitamin B1). Mayo Clinic.
  9. Fraser DA, Diep LM, Hovden IA et al. (2012) The effects of long-term oral benfotiamine supplementation on peripheral nerve function and inflammatory markers in patients with type 1 diabetes: a 24-month, double-blind, randomized, placebo-controlled trial. Diabetes Care 35, 1095-1097.
  10. Haupt E, Ledermann H, Kopcke W (2005) Benfotiamine in the treatment of diabetic polyneuropathy—a three-week randomized, controlled pilot study (BEDIP study). Int J Clin Pharmacy There 43, 71-77.