Clinical review for general practice

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FULLSCREEN > Archive > 2024 > Vol 5, №8 (2024) > Vitamins B analgesic potential

Vitamins B analgesic potential

Olga A. Shavlovskaya

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  • Abstract
  • About the Author
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Abstract

B vitamins are the most important cofactors of axonal transport, neurotransmitter synthesis and many cellular metabolic pathways. B vitamins (B1 – thiamine, B6 – pyridoxine, B12 – cyanocobalamin) neurotropic role has long been discussed as modulators of inflammation and pain. The analgesic effect of neurotropic B vitamins is known for oral administration and parenteral administration, both in animal model experiments and in clinical practice. Each of the B vitamins participates in energy, fat, protein, water-salt metabolism, has a regulating effect on the trophism and the nervous system. Synergistic interactions have been proven: intra-group accumulation of the effects of B vitamins, and potentiation of the action of medicine drugs of other groups (nonsteroidal anti-inflammatory drugs (NSAIDs), anticonvulsants) when administered together with vitamins of group B. Vitamins of group B suppress the activity of proinflammatory mediators, regulate neurotransmitters of nociceptive and neuropathic pain. Some of these processes include targeted activation of the descending pain modulation system and specific intracellular pathways that have anti-inflammatory, antioxidant and regenerating effects on the nervous system. The analgesic efficacy of B vitamins has been demonstrated both in monotherapy and in complex therapy together with NSAIDs in the treatment of patients with lower back pain, polyneuropathy of various etiologies (diabetic, alcoholic, toxic). The effectiveness of the complex of high-dose B vitamins exceeds the effectiveness of monotherapy with one of the vitamins. Vitamin B12 enhances the antinociceptive effect of NSAIDs to a greater extent than B1 and B6, therefore, in clinical practice it is recommended to use a complex of vitamins of this group. The use of a combination of B vitamins (B1, B2, B3, B5, B6, B7, B9, B12) with choline, inosine and paraaminobenzoic acid in chronic pain is justified, since they affect the pathogenetic mechanisms of pain formation. Drug, containing a complex of 11 B vitamins, may be used for chronic pain syndrome.
Keywords: pain, pain syndrome, vitamins B.

About the Author

Olga A. Shavlovskaya 1

1 International Restorative Medicine University, Moscow, Russia

References

1. Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden,
best practices, and new advances. Lancet 2021;397(10289):2082-97.
DOI: 10.1016/S0140-6736(21)00393-7
2. Paez-Hurtado AM, Calderon-Ospina CA, Nava-Mesa MO. Mechanisms
of action of vitamin B1 (thiamine), B6 (pyridoxine), and B12 (cobala-
min) in pain: a narrative review. Nutr Neurosci 2023;26(3):235-53.
DOI: 10.1080/1028415X.2022.2034242
3. Hanna M, Jaqua E, Nguyen V, Clay J. B vitamins: functions and uses in
medicine. Perm J 2022;26(2):89-97. DOI: 10.7812/TPP/21.204
4. Peterson CT, Rodionov DA, Osterman AL, Peterson SN. B-vitamins and
their role in immune regulation and cancer. Nutrients
2020;12(11):3380. DOI: 10.3390/nu12113380
5. Шавловская О.А. Использование витаминов группы В в комплекс-
ной терапии болевых синдромов. Журнал неврологии и психиат-
рии им. С.С. Корсакова. 2017;117(9):118-23. DOI: 10.17116/jnevro
201711791118-123
Shavlovskaya O.A. Neurotropic effect of B vitamins in the complex tre-
atment of pain syndrome. S.S. Korsakov Journal of Neurology and
Psychiatry. 2017;117(9):118-23. DOI: 10.17116/jnevro201711791118-
123 (in Russian). 
6. Шавловская О.А., Бокова И.А. Комбинированные витаминные
препараты в терапии болевого синдрома. Эффективная фармако-
терапия. 2022;18(15):10-6. DOI: 10.33978/2307-3586-2022-18-15-
10-16
Shavlovskaya O.A., Bokova I.A. Combined vitamin preparations in pain
syndrome treatment. Effective pharmacotherapy. 2022;18(15):10-6.
DOI: 10.33978/2307-3586-2022-18-15-10-16 (in Russian).
7. Schloss J, Colosimo M. B Vitamin complex and chemotherapy-induced
peripheral neuropathy. Current Oncology Reports 2017;19(12):76.
DOI: 10.1007/s11912-017-0636-z
8. Julian T, Syeed R, Glascow N et al. B12 as a Treatment for peripheral
neuropathic pain: a systematic review. Nutrients 2020;12(8):2221.
DOI: 10.3390/nu12082221
9. Calderon-Ospina C-A, Nava-Mesa MO, Ariza CEA. Effect of combined
diclofenac and B vitamins (thiamine, pyridoxine, and cyanocobalamin)
for low back pain management: systematic review and meta-analysis.
Pain Med 2020;21(4):766-81. DOI: 10.1093/pm/pnz216
10. Alvarado MA, Navarro AS. Clinical trial assessing the efficacy of gaba-
pentin plus B complex (B1
/B12) versus pregabalin for treating painful
diabetic neuropathy. J Diabetes Res 2016;2016:4078695. DOI:
10.1155/2016/4078695
11. Шавловская О.А., Бокова И.А. Эффективность витаминов группы
В при разных нозологических формах. Эффективная фармакоте-
рапия. 2023;19(1):40-7. DOI: 10.33978/2307-3586-2023-19-1-40-47
Shavlovskaya O.A., Bokova I.A. Vitamins B effectiveness in different
nosological forms. Effective pharmacotherapy. 2023;19(1):40-7. DOI:
10.33978/2307-3586-2023-19-1-40-47 (in Russian).
12. Baltrusch S. The role of neurotropic B vitamins in nerve regeneration.
Biomed Res Int 2021:2021:9968228. DOI: 10.1155/2021/9968228
13. Smith TJ, Johnson CR, Koshy R. Thiamine deficiency disorders: a cli-
nical perspective. Ann N Y Acad Sci 2021;1498(1):9-28. DOI:
10.1111/nyas.14536
14. McNulty H, Pentieva K, Ward M. Causes and clinical sequelae of ribof-
lavin deficiency. Ann Rev Nutr 2023;43:101-22. DOI: 10.1146/annurev-
nutr-061121-084407
15. Мирошниченко А.Г., Крянга А.А. Фармакология витаминов, их
аналогов и антагонистов: учебное пособие. Томск: СибГМУ, 2020.
Режим доступа: http://elar.ssmu.ru/bitstream/20.500.12701/
3253/1/tut_ssmu-2020-9.pdf
Miroshnichenko A.G., Kryanga A.A. Pharmacology of vitamins, their
analogues and antagonists: a tutorial. Tomsk: SibSMU, 2020. Available
at: http://elar.ssmu.ru/bitstream/20.500.12701/3253/1/tut_ssmu-
2020-9.pdf (in Russian).
16. Makarov MV, Trammell SAJ, Migaud ME. The chemistry of the vita-
min B3 metabolome. Biochem Soc Trans 2019;47(1):131-47. DOI:
10.1042/BST20180420
17. Kansakar U, Trimarco V, Mone P et al. Choline supplements: An update. Front
Endocrinol (Lausanne) 2023;14:1148166. DOI: 10.3389/fendo.2023.1148166
18. King JH, Kwan STC, Bae S et al. Maternal choline supplementation al-
ters vitamin b-12 status in human and murine pregnancy. J Nutr Bio-
chem 2019;72:108210. DOI: 10.1016/j.jnutbio.2019.07.001
19. Lee MC, Hsu YJ, Shen SY et al. A functional evaluation of anti-fatigue
and exercise performance improvement following vitamin B complex
supplementation in healthy humans, a randomized double-blind trial.
Int J Med Sci 2023;20(10):1272-81. DOI: 10.7150/ijms.86738
20. Kuroishi T, Sugawara S. Metabolomic analysis of liver from dietary bio-
tin deficient mice. J Nutr Sci Vitaminol (Tokyo) 2020;66(1):82-5. DOI:
10.3177/jnsv.66.82
21. Mahdavifar B, Hosseinzadeh M, Salehi-Abargouei A et al. Dietary in-
take of B vitamins and their association with depression, anxiety, and
stress symptoms: A cross-sectional, population-based survey. J Affec-
tive Disorders 2021;288:92-8. DOI: 10.1016/j.jad.2021.03.055
22. Dagnino APA, Campos MM. Chronic pain in the elderly: mechanisms
and perspectives. Front Hum Neurosci 2022;16:736688. DOI:
10.3389/fnhum.2022.736688
23. McGarel C, Pentieva K, Strain JJ, McNulty N. Emerging roles for folate
and related B-vitamins in brain health across the lifecycle. Proc Nutr
Soc 2015;74(1):46-55. DOI: 10.1017/S0029665114001554
24. Nara S, Parasher G, Malhotra BD, Rawat M. Novel role of folate (vita-
min B9) released by fermenting bacteria under Human Intestine like
environment. Sci Rep 2023;13(1):20226. DOI: 10.1038/s41598-023-
47243-0
25. Buesing S, Costa M, Schilling JM, Moeller-Bertram T. Vitamin B12 as a
treatment for pain. Pain Physician 2019;22(1):E45-E52. PMID:
30700078
26. Шавловская О.А., Бокова И.А., Шавловский Н.И., Юхновская Ю.Д.
Кобаламин в комплексной терапии и профилактике когнитивных
нарушений. Журнал неврологии и психиатрии им. С.С. Корсакова
2021;121(3):120-5. DOI: 10.17116/jnevro2021121031120
Shavlovskaya O.A., Bokova I.A., Shavlovskiy N.I., Yukhnovskaya Yu.D.
Cobalamin in the complex treatment and prevention of cognitive impa-
irment. S.S. Korsakov Journal of Neurology and Psychiatry.
2021;121(3):120-5. DOI: 10.17116/jnevro2021121031120 (in Russian).
27. Кукушкин М.Л. Витамины группы В (B1
, B6, B12) в комплексной те-
рапии болевых синдромов. Российский журнал боли.
2019;17(3):39-45. DOI: 10.25731/RASP.2019.03.31
Kukushkin M.L. Vitamins of group B (B1
, B6, B12) in complex therapy of
pain syndromes. Russian journal of pain. 2019;17(3):39-45. DOI:
10.25731/RASP.2019.03.31 (in Russian).
28. Skiold L-CJ, Estefania R-PP, Carolina G-PMP et al. Synergistic interac-
tion between B vitamins and statins to counter nociception in rats.
Drug Dev Res 2021;82(3):440-7. DOI: 10.1002/ddr.21767
29. Coban O. Several dosage forms containing vitamin B and their use in
therapy. B-complex vitamins – sources, intakes and novel applications.
Intech Open 2022. Available at: https://www.researchgate.net/publi-
cation/355404735_Several_Dosage_Forms_Containing_Vitamin_B_
and_Their_Use_in_Therapy
30. Beltran-Montoya JJ, Herrerias-Canedo T, Arzola-Paniagua A et al. A
randomized, clinical trial of ketorolac tromethamine vs ketorolac tro-
metamine plus complex B vitamins for cesarean delivery analgesia.
Saudi J Anaesth 2012;6(3):207-12. DOI: 10.4103/1658-354X.101209
31. Ziegler D, Keller J, Maier C, Pannek J. Diabetic Neuropathy. Exp Clin
Endocrinol Diabetes 2023;131:72-83. DOI: 10.1055/a-1946-3813
32. Haupt E, Ledermann H, Kopcke W. Benfotiamine in the treatment of
diabetic polyneuropathy – a three-week randomized, controlled pilot
study (BEDIP study). Int J Clin Pharmacol Ther 2005;43:71-7. DOI:
10.5414/cpp43071
33. Bönhof GJ, Sipola G, Strom A et al. BOND study: a randomised double-
blind, placebo-controlled trial over 12 months to assess the effects of
benfotiamine on morphometric, neurophysiological and clinical mea-
sures in patients with type 2 diabetes with symptomatic polyneuro-
pathy. BMJ Open 2022;12(2):e057142. DOI: 10.1136/bmjopen-2021-
057142
34. Rembe J-D, Fromm-Dornieden C, Stuermer EK. Effects of vitamin B
complex and vitamin C on human skin cells: is the perceived effect
measurable? Adv Skin Wound Care 2018;31(5):225-33. DOI:
10.1097/01.ASW.0000531351.85866.d9
35. Suzuki K, Tanaka H, Ebara M et al. Electrospun nanofiber sheets incor-
porating methylcobalamin promote nerve regeneration and functional
recovery in a rat sciatic nerve crush injury model. Acta Biomater
2017;53:250-9. DOI: 10.1016/j.actbio.2017.02.004
36. Sun H, Yang T, Li Q et al. Dexamethasone and vitamin B(12) synergi-
stically promote peripheral nerve regeneration in rats by upregulating
the expression of brain-derived neurotrophic factor. Arch Med Sci
2012;8:924-30. DOI: 10.5114/aoms.2012.31623
37. Kopruszinski CM, Reis RC, Bressan E et al. Vitamin B complex attenua-
ted heat hyperalgesia following infraorbital nerve constriction in rats
and reduced capsaicin in vivo and in vitro effects. Eur J Pharmacol
2015;762:326-32. DOI: 10.1016/j.ejphar.2015.05.063
38. Fonseca VA, Lavery LA, Thethi TK et al. Metanx in type 2 diabetes with
peripheral neuropathy: a randomized trial. Am J Med 2013;126:141-9.
DOI: 10.1016/j.amjmed.2012.06.022
39. Давыдов О.С., Яхно Н.Н., Кукушкин М.Л. и др. Невропатическая
боль: клинические рекомендации по диагностике и лечению Рос-
сийского общества по изучению боли. Российский журнал боли.
2018;4(58):5-41. DOI: 10.25731/RASP.2018.04.025
Davydov O.S., Yakhno N.N., Kukushkin M.L. et al. Neuropathic pain:
clinical guidelines on the diagnostics and treatment from the Russian
association for the studying of pain. Russian journal of pain.
2018;4(58):5-41. DOI: 10.25731/RASP.2018.04.025 (in Russian).
40. Дедов И.И., Шестакова М.В., Майорова А.Ю. и др. Алгоритмы спе-
циализированной медицинской помощи больным сахарным диа-
бетом. Сахарный диабет. 2019;24(S1):1-222. DOI: 10.14341/
DM221S1
Dedov I.I., Shestakova M.V., Mayorov A.Yu. et al. Standards of specia-
lized diabetes care. Diabetes mellitus. 2019;24(S1):1-222. DOI:
10.14341/DM221S1 (in Russian).
41. Скелетно-мышечные (неспецифические) боли в нижней части
спины. Клинические рекомендации. 2023. Режим доступа:
https://cr.minzdrav.gov.ru/recomend/778_1
Musculoskeletal (non-specific) pain in the lower back. Clinical guideli-
nes. 2023. Available at: https://cr.minzdrav.gov.ru/recomend/778_1
(in Russian).

For citation:Shavlovskaya O.A. Vitamins B analgesic potential. Clinical review for general practice. 2024; 5 (8): 72–78 (In Russ.). DOI: 10.47407/kr2024.5.8.00462


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