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Moderate evidenceHeart & metabolic

Benfotiamine

Benfotiamine is a fat-soluble thiamine derivative that genuinely reaches the bloodstream far better than ordinary thiamine. The absorption advantage is real; the clinical payoff in diabetic neuropathy is modest and short-trial-dependent, and the longer, harder-endpoint trials have mostly disappointed.

What the science says

  • Absorbed several-fold better than thiamine hydrochloride Strong evidence

    Benfotiamine is S-benzoylthiamine monophosphate: the gut strips the phosphate, leaving a lipid-soluble molecule that crosses membranes passively instead of relying on the saturable thiamine transporter. A single-dose crossover pharmacokinetic study found roughly 3- to 5-fold higher plasma thiamine exposure (Cmax and AUC) from benfotiamine versus an equal dose of thiamine HCl. This part of the marketing is accurate.

  • Reduces diabetic polyneuropathy symptoms Moderate evidence

    BENDIP randomised 165 patients to 300 mg/day, 600 mg/day or placebo for 6 weeks. Only the 600 mg/day arm improved the Neuropathy Symptom Score significantly versus placebo (per-protocol analysis, p≈0.03); the 300 mg/day arm did not separate from placebo. The trial was short, the effect size small, and no benfotiamine trial has yet shown improvement in objective nerve conduction or long-term function.

  • Prevents diabetic complications by blocking AGE formation Limited evidence

    The mechanism — transketolase activation diverting glycolytic intermediates away from advanced glycation and hexosamine pathways — is well documented in cell and animal work. It has not translated: randomised trials of 300–900 mg/day in patients with type 1 diabetes and nephropathy found no reduction in urinary albumin excretion, tubular damage markers, or endothelial dysfunction over 6–12 weeks.

  • Improves cognition in Alzheimer's disease Limited evidence

    A 12-month pilot RCT of 600 mg/day in mild cognitive impairment and early Alzheimer's did not meet its primary cognitive endpoint, though the trend and imaging signals were considered promising enough to justify a larger trial. Nothing here supports using benfotiamine as a cognitive supplement today.

Dosage & safety

Studied doseStudied doses are 300–600 mg/day for neuropathy (BENDIP used 300 or 600 mg/day for 6 weeks, split into 2–3 doses with food) and up to 900 mg/day in nephropathy and cognition trials. Common supplement doses of 150–300 mg/day are at or below the level that showed anything in trials. Take with a meal; there is no benefit to megadosing beyond the studied range.
SafetyWell tolerated in trials; the main reported effects are mild nausea, GI upset and rare rash. Thiamine has no established upper limit and no known toxicity, and benfotiamine does not accumulate. Important caveats: it is not a treatment for acute thiamine deficiency states such as Wernicke encephalopathy, which require parenteral thiamine; and self-treating numbness or tingling with benfotiamine can delay diagnosis of B12 deficiency, spinal disease or other treatable causes. It does not lower blood glucose and is not a substitute for glycaemic control. Not banned in sport. Safety in pregnancy at supplemental doses is not established.

Scientific references

Where to buy

Double Wood Supplements, Benfotiamine, 120 Capsules (150 mg per Capsule)

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