Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Jun;28(6):2054-2064.
doi: 10.1111/ene.14786. Epub 2021 Mar 15.

Association between neuropathy and B-vitamins: A systematic review and meta-analysis

Johannes Stein  1   2 , Juergen Geisel  2 , Rima Obeid  2
Affiliations
Meta-Analysis

Association between neuropathy and B-vitamins: A systematic review and meta-analysis

Johannes Stein et al. Eur J Neurol. 2021 Jun.

Abstract

Background: Peripheral neuropathy (PN) is common in patients with diseases that are in turn associated with deficiency of the B-vitamins, and vitamin treatment has shown mixed results.

Methods: This systematic review and meta-analysis studied the association between PN/pain and B-vitamin biomarkers and investigated whether vitamin treatment can ameliorate the symptoms. PubMed and Web of Science were searched according to the study protocol.

Results: A total of 46 observational and seven interventional studies were identified and included in the data synthesis. The presence of PN was associated with lowered B12 levels (pooled estimate [95% CIs] = 1.51 [1.23-1.84], n = 34, Cochran Q Test I2 = 43.3%, p = 0.003) and elevated methylmalonic acid (2.53 [1.39-4.60], n = 9, I2 = 63.8%, p = 0.005) and homocysteine (3.48 [2.01-6.04], n = 15, I2 = 70.6%, p < 0.001). B12 treatment (vs. the comparators) showed a non-significant association with symptom improvement (1.36 (0.66-2.79), n = 4, I2 = 28.9%). Treatment with B1 was associated with a significant improvement in symptoms (5.34 [1.87-15.19], n = 3, I2 = 64.6%, p = 0.059). Analysis of seven trials combined showed a non-significant higher odds ratio for improvement under treatment with the B-vitamins (2.58 [0.98-6.79], I2 = 80.0%, p < 0.001).

Conclusions: PN is associated with lowered plasma vitamin B12 and elevated methylmalonic acid and homocysteine. Overall, interventional studies have suggested that B-vitamins could improve symptoms of PN. Available trials have limitations and generally did not investigate vitamin status prior to treatment. Well-designed studies, especially in non-diabetes PN, are needed. This meta-analysis is registered at PROSPERO (ID: CRD42020144917).

Keywords: diabetes; homocysteine; peripheral neuropathy; vitamin B1; vitamin B12; vitamin B6; vitamin deficiency.

PubMed Disclaimer

References

REFERENCES

    1. Hanewinckel R, Drenthen J, van Oijen M, et al. Prevalence of polyneuropathy in the general middle-aged and elderly population. Neurology. 2016;87:1892-1898.
    1. Staff NP, Windebank AJ. Peripheral neuropathy due to vitamin deficiency, toxins, and medications. Continuum (Minneap Minn). 2014;20:1293-1306.
    1. Sommer C, Geber C, Young P, et al. Polyneuropathies. Dtsch Arztebl Int. 2018;115:83-90.
    1. Obeid R, Herrmann W. Mechanisms of homocysteine neurotoxicity in neurodegenerative diseases with special reference to dementia. FEBS Lett. 2006;580:2994-3005.
    1. Kalita J, Chandra S, Bhoi SK, et al. Clinical, nerve conduction and nerve biopsy study in vitamin B12 deficiency neurological syndrome with a short-term follow-up. Nutr Neurosci. 2014;17:156-163.

Publication types

LinkOut - more resources