Ingredient Type: Vitamin
Also Known As: Vitamin B1, Vitamin B-1, S-Benzoylthiamine O-monophosphate, BenfoPure®
Benfotiamine is a synthetic derivative of Vitamin B-1 (Thiamine). It is, unlike other forms of the vitamin, fat-soluble, which enables it to passively diffuse across cell membranes. The fat-solubility of benfotiamine makes it much more easily absorbed and bioavailable than other forms of thiamine (1,2).
The history of Vitamin B-1, and therefore benfotiamine, is actually pretty interesting. Before the 1880s scientists understood that people needed proteins, fats, salt, and carbohydrates to stay healthy; but no one really knew anything about vitamins or the role that they played in maintaining health. Then, in the late 1880s, a Dutch scientist by the name of Christiaan Eijkman discovered that chickens fed polished rice (rice that had had its outer skin removed) developed a sickness known as beriberi. He found, by accident, that beriberi could be prevented or healed by adding rice skin back into the diets. He concluded that polished white rice was poisonous and that rice skins contained an antidote that he termed the “anti-beriberi factor.” Through continued research, Eijkman’s successor discovered that polished white rice wasn’t actually toxic but that it, instead, lacked some kind of vital substance. Under the assumption that this substance was a vital amine it was given the name “vitamine”. The term later came to denote all similar substances. A few years later the vital anti-beriberi “vitamine” became the first vitamin ever characterized when it was finally isolated in 1926. Shortly thereafter it was given the name of Thiamine or Vitamin B-1 (3).
Vitamin B-1 is an essential cofactor for several enzymes involved in glucose and amino acid metabolism. As such, it plays a critical role in producing energy from carbohydrates and proteins. It cannot be synthesized by the human body and must, therefore, be obtained through dietary sources. Signs of early stage vitamin B-1 deficiency include anorexia, weight loss, mental problems including short-term memory loss, confusion, muscle weakness, and cardiac problems (4). Although rare in developed countries today, vitamin B-1 deficiency can also lead to beriberi, which is primarily characterized by muscle wasting and peripheral neuropathy (5).
Vitamin B-1 deficiency can also be manifested as Wernicke-Korsakoff syndrome. The early symptoms of this syndrome include confusion, dysfunction of the eye muscles, and lack of coordination in muscle movements usually resulting in poor balance while walking. Left untreated it can be fatal or lead to permanent Korsakoff’s psychosis (5).
Vitamin B-1 was first isolated in 1926 and first synthesized in 1936. As such, it does not have a long history of use as a supplement (3). Since the 1930s, however, it has been used traditionally to treat conditions relating to thiamine deficiency like beriberi, Wernicke-Korsakoff syndrome, optic neuropathy, Leigh’s disease, and maple syrup urine disease. It has also been used for digestive problems like diarrhea, ulcerative colitis, irritable bowel disease; diabetic nerve pain, cataracts and glaucoma, increasing energy, and preventing memory loss (6).
WHAT DOES SCIENCE TELL US?
Ethanol consumption reduces vitamin B-1 absorption and internal conversion of the vitamin into its bioactive forms. Chronic alcohol abuse is also frequently associated with reduced food intake. It is not surprising, therefore, that most cases of vitamin B-1 deficiency in Western countries are attributable to chronic alcohol misuse. Studies indicate that between 30% and 80% of all alcoholics have some level of vitamin B-1 deficiency (5,7,8,9).
Conditions, disorders, or diets associated with reduced food intake, prolonged vomiting or diarrhea, reduced gastrointestinal absorption of thiamine, or increased metabolic requirements can also cause vitamin B-1 deficiency (9). Some of the conditions and disorders that fall into this category and have reported cases of associated low vitamin B-1 levels are:
- Irritable bowel disease especially when patients are on long-term parenteral therapy (10,11)
- Bariatric surgery especially when associated with persistent vomiting (5,12,13)
- Pregnancy especially when associated with severe morning sickness/hyperemesis gravidarum (8,14)
- HIV infection (5,8)
Vitamin B-1/Benfotiamine is Effective for Vitamin B-1 Deficiency:
It is well established in the scientific community that supplementation with vitamin B-1 is the appropriate treatment for vitamin B-1 deficiency. It should be noted, however, that this condition is relatively rare in developed countries.
Vitamin B-1/Benfotiamine Possibly Helps with Fatigue:
One small, open-label, pilot study administered 600-1500mg/day of thiamine to 12 patients suffering from IBD related chronic fatigue. All of the subjects had either quiescent phase Crohn’s disease or Ulcerative colitis in remission and chronic fatigue syndrome scale scores indicating medium-low to severe fatigue. 20 days after beginning the thiamine therapy, 10 out of the 12 patients exhibited complete regression of fatigue and the remaining two showed almost complete regression (15). While these results are promising they should be interpreted with caution based on the fact that the study included a very small number of patients, lacked a control group, and was performed almost exclusively on women.
- Volvert ML, et al. Benfotiamine, a synthetic S-acyl thiamine derivative, has different mechanisms of action and a different pharmacological profile than lipid-soluble thiamine disulfide derivatives. BMC Pharmacol. 2008;8:10. Doi:10.1186/1471-2210-8-10.
- The Panel on Food Additives and Nutrient Sources added to Food (ANS). Commission on benfotiamine, thiamine monophosphate chloride and thiamine pyrophosphate chloride, as sources of vitamin B1. The EFSA Journal. 2008;864:1-31.
- Christiaan Eijkman, Berberi and Vitamin B1. Nobel Media AB. 2014. https://www.nobelprize.org/educational/medicine/vitamin_b1/eijkman.html. Accessed March 27, 2018.
- Food and Nutrition Board of the Institute of Medicine. Dietary reference intakes; thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. National Academy Press. 1998
- Thiamin fact sheet for health professionals. National Institutes of Health Office of Dietary Supplements. Updated 2018. https://ods.od.nih.gov/factsheets/Thiamin-HealthProfessional/. Accessed March 28, 2018.
- Thiamine. MedlinePlus. Reviewed 2017. https://medlineplus.gov/druginfo/natural/965.html. Accessed March, 28, 2018.
- Mancinelli R and Ceccanti M. Biomarkers in alcohol misuse: their role in the prevention and detection of thiamine deficiency. Alcohol & Alcoholism. 2009;44(2):177-182.
- DynaMed Plus editors. Thiamine deficiency. EBSCO Information Services. Updated May 31, 2017. http://www.dynamed.com/login.aspx?direct=true&site=DynaMed&id=116008. Accessed March 29, 2018.
- Harper C. Thiamine (vitamin B1) deficiency and associated brain damage is still common throughout the world and prevention is simple and safe! Eur J Neurol. 2006;13(10):1078-82.
- Yoon SM. Micronutrient deficiencies in inflammatory bowel disease. Intest Res. 2016;14(2):109-110. doi:10.5217/ir.2016.14.2.109.
- Filippi J, Al-Jaouni R, Wiroth JB, Hebuterne X, Schneider SM. Nutritional deficiencies in patients with Crohn’s disease in remission. Inflamm Bowel Dis. 2006;12(3):185-191.
- Aasheim ET. Wernicke encephalopathy after bariatric surgery: a systematic review. Ann Surg. 2008;248(5):714-720. doi: 10.1097/SLA.0b013e3181884308.
- Milone M, Di Minno MN, Lupoli R, et al. Wernicke encephalopathy in subjects undergoing restrictive weight loss surgery: a systematic review of literature data. Euro Eat Disor Review. 2014;22(4):223-229
- Kantor S, Prakash S, Chandwani J, Gokhale A, Sarma K, Albahrani MJ. Wernicke’s encephalopathy following hyperemesis gravidarum. Indian J Crit Care Med. 2014;18(3):164-166.
- Costantini A, and Immacolata Pala M. Thiamine and fatigue in inflammatory bowel diseases: an open-label pilot study. J of Alt and Compl Med. 2013;19(8). doi:10.1089/acm.2011.0840
See the Examine.com entry for benfotiamine for more information.