Originally Posted by Idiopathic PN

Is there a VIt D overdose? I am supposed to take a 1200mg of calcium a day. But since I am taking gabapentin 3x a day, I could not follow now the 3x a day dosage of calcium ( (less window of squeezing in between gabapentin without compromising absorption) . Instead I only take calcium 1x a day. To help in the absorption of the calcium I take vitd3
2000IU.

Thank you for time.

Originally Posted by mrsD

Benfotiamine is a lipid soluble form of water soluble common Thiamine (B1).

Historically B1 was the only treatment for neuropathy for many years. The typical dose is 100-300mg daily in divided doses.
Then the SSRI antidepressants emerged and also Neurontin (followed by Lyrica) and the treatment for PNs changed and doctors dropped the thiamine. This I believe is a mistake.

Thiamine is easily found in most grocery stores and pharmacies. It remains inexpensive as well. Starting just over a decade ago, this new form called Benfotiamine started appearing in studies.
For quite a while it was not available in US and then when it did start becoming so, it was ferociously expensive. That has now changed.

Here is an informative website on it:
http://www.benfotiamine.org/FAQ.htm

I find it affordable at iherb.com and I use the Doctor's Best brand. The website above endorses much higher doses, than I use and typically recommend. I think for many people 300mg a day is adequate. But we have had some posters here who used 900mg-1200mg daily. At that level, cost will become an issue for many.

I recommend benfotiamine for neuropathies that are not responding to B12 and/or Vit D. Also some people have metabolic problems with the genes that metabolize alcohol. These patients also can benefit from benfotiamine.

I'll also add that beriberi (thiamine deficiency) does occur in some patients and go unrecognized by doctors. This is due to taking some medications that deplete thiamine, like the strong loop diuretics. But it can be due to low dietary intake, high alcohol consumption, or a genetic flaw that then requires higher daily intake. Malabsorption from gluten intolerance/Celiac or inflammatory changes in the GI tract like Crohn's may also cause beriberi. The genetic issue is called vitamin "dependency" and occurs with other vitamins ---B6 for example. People with a vitamin dependency require higher amounts of the vitamin compared to the majority of others.
Here is a link to a medical site on beriberi:
http://emedicine.medscape.com/article/116930-overview

Since the link I gave at the beginning of this post, is very complete, there is not much more for me to say at this point, other than benfotiamine remains a good option to add to any supplement list you may be considering.

edit to add some more links from PubMed on this subject:

http://www.ncbi.nlm.nih.gov/pubmed/20188835

This study does give doses:
http://www.ncbi.nlm.nih.gov/pubmed/18473286
And does reiterate what I post that it takes TIME to show benefits. People often push the dose UP to get faster response IMO.

This is a chemical explanation:
http://www.ncbi.nlm.nih.gov/pubmed/18384109

http://www.ncbi.nlm.nih.gov/pubmed/18220605
Before gabapentin and SSRIs drugs, thiamine was the main treatment for PN. I believe it should remain high in the list for
any PNer and befotiamine is superior IMO. However, benfotiamine at one time was super expensive and few could afford it. That has changed in the last 3 yrs or so.
Thiamine remains inexpensive, but it makes some people have a body odor that limits its use.

This PDF gives some good data:
http://www.altmedrev.com/publications/11/3/238.pdf

This is an older paper:
http://www.ncbi.nlm.nih.gov/pubmed/16359659

This is from 1999:
http://www.ncbi.nlm.nih.gov/pubmed/10219465

I used to use thiamine in bursts. A month or two at a time, in the past. When Benfotiamine became affordable, I changed to it.
I only use 150mg a day now, but I started at 300mg in the beginning. I don't feel it is a cure...but it sure does prevent progression, and take care of alot of the discomfort for me.
I do think some people have a higher genetic requirement for it.

This one from 1996: Germany where the beginning studies originate.
http://www.ncbi.nlm.nih.gov/pubmed/8886748

Edit:
Here is a new link... discussing the better absorption and bioavailability of Benfotiamine vs thiamine:



http://www.ncbi.nlm.nih.gov/pubmed/8929745

Originally Posted by mrsD

I'd get the Doctor's Best Benfotiamine 150mg.

If you are worried about high doses, just do 150mg a day.

If you get no negative reactions, you can increase to 300 for a couple of months and see if that helps.

I'd stay away from mixtures of things. You cannot control mixtures or see what is really doing what.

I say this about "reactions". I had great hopes for NAG-- n-acetyl glucosamine, but it seems to inflame my nerves worse.
I never expected that, since I have used glucosamine in the past (with not much results). I've tried 3 times, and got inflamed nerves all 3 times!

Originally Posted by mrsD

@IdopathicPN

You want to make sure your kidneys are working normally with all those supplements.

And check your multivitamin to see if it has selenium in it.
If so 200mcg daily extra is a bit much... you could take it every other day instead. The new suggestions on selenium today are more conservative than they were 5 yrs ago. 100mcg daily is
now the suggestion upper limit.

Originally Posted by mrsD

Selenium also is a cofactor in conversion of T4 to active T3.

So some IS needed. I would keep it at 100mcg a day by using the 200mcg only occasionally. As I figure it 325mcg a week (7 day period) would bring you up the the RDA.

So taking 1 of those 200mcg selenium a week would do it pretty closely.