B-Complex Vitamins and Nerve Pain

Betty Chaffee/ March 9, 2022/ Medication Management/ 2 comments

Nerve pain, especially in the legs, feet, and hands, is common among adults in the United States. Also called peripheral neuropathy, it affects up to 30% of adults, and nearly 10% of those over age 65. There are many causes of peripheral neuropathy, including:

    • diabetes

    • vitamin deficiencies

    • trauma

    • Infection

    • immune diseases

    • medications or chemicals

If you or someone you love has nerve pain, you know it can interfere with daily activities. Symptoms of burning or shooting pain, numbness and tingling in the hands and feet can be debilitating. Numbness in the feet can result in non-healing wounds when a small blister or sore isn't noticed quickly enough. That numbness can also make it hard to know where your feet are in space, making it tough to keep your balance or go up and down steps.

Very often nerve pain can be chronic. There are quite a few prescription medications that can be used to decrease the pain and discomfort. But B-vitamins are often prescribed too. We're going to take some time here to talk about B-vitamins and their use in treating the discomfort of peripheral neuropathy.


Vitamin B Complex

It turns out that Vitamin B is actually a family of different chemicals. That's why you see it referred to as "Vitamin B Complex". The most common B vitamins are:

        • Thiamine - Vitamin B-1

        • Riboflavin - Vitamin B-2

        • Pyridoxine - Vitamin B-6

        • Folic Acid - Vitamin B-9

        • Cyanocobalamin - Vitamin B-12

All the B vitamins have important roles in keeping us healthy. But when it comes to healthy nervous systems, it's vitamins B1, B6, and B12 that are the most critical. In fact, deficiencies of Vitamins B1 and B12 often cause symptoms of numbness, tingling, and pain in the hands and feet. So it makes sense to think that these vitamins might be able to improve symptoms of peripheral neuropathy or prevent them from getting worse.


What does the research say about efficacy?

It's often hard to find conclusive studies about the effects of dietary supplements. Vitamin B complex is no different. There are lots of reasons for that, one of the biggest being that manufacturers don't need to do research to market dietary supplements. So we have to draw conclusions based on limited information.

B vitamins, especially B1, B6, B12, and folic acid, have been studied as treatments for the discomfort of peripheral neuropathy. But thus far, the only thing we know for sure is that if nerve discomfort is caused by an actual deficiency of B vitamins in the body, it can be at least partially corrected by replacing those vitamins. But if it's a result of diabetes, trauma, or any cause other than vitamin B deficiency, it doesn't seem to respond reliably to vitamin B supplementation. Some studies suggest there is a role, others find that it doesn't seem to make a difference.

There is ongoing research that will hopefully bring better answers. But for right now, studies don't clearly indicate that vitamin B supplementation is effective in treating nerve pain or keeping it from getting worse. So why do many doctors recommend supplementation with vitamin B?

Balancing risks and benefits

The health benefits of B vitamins in treating peripheral neuropathy, especially B1, B6, B12, and folic acid are unclear. But in theory, these vitamins seem like they should be beneficial. What if the ongoing studies actually prove that they work? What's the risk of using B vitamins to help patients if in the end we're going to find out they're helpful?

Well, it turns out that the health risks of supplementing the diet with B vitamins are minimal. B vitamins are water-soluble, so they're easily eliminated from the body and don't accumulate.  They're also quite safe, with the exception of vitamin B6, which can cause a variety of adverse effects when taken in higher-than-recommended doses. Generally speaking, when B vitamins are taken in recommended doses, there are no serious problems to be concerned about.

Doctors want to help their patients. Why not recommend a treatment that's clearly safe, and may just provide some benefit that hasn't been proven by research yet? If the potential health benefits outweigh the risks, it may be worth a try.

On the other hand, there are other issues to think about. Maybe you already take lots of pills and don't want to take more (or you just don't like taking pills at all). Maybe you can't afford your medicine. In those cases, you may find that the disadvantages of using B vitamins outweigh the possible benefits.

The decision to supplement with B vitamins will always be a personal one. There's no right or wrong answer. If your doctor has recommended B vitamins for nerve discomfort, talk with them about their reason for the recommendation. The two of you can work together to decide the best course of action.


And don't forget about a balanced diet!

Whether you suffer from painful neuropathy or not, it's always important to make sure you're getting all the nutrients you can through your daily diet. B vitamins are contained in many foods. Eating a balanced diet with a variety of foods will help you get all the nutrients your body needs to stay healthy.

As always, we welcome your questions and comments. Post them just below this article for others to respond to, or contact us directly at Better My Meds. We love hearing from you!



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About Betty Chaffee

Betty Chaffee, PharmD, is owner and sole proprietor of BetterMyMeds, a Medication Management service devoted to helping people get the maximum benefit from their medications.


  1. Sad that u do not know ***Cyanocobalamin **- Vitamin B-12 is not the good b12. methylcobalamin is best.

    1. Thanks for your comment Veronica,
      I’d be interested to hear more detail on that thought. Certainly methylcobalamin is an active form of B12, in fact cyanocobalamin is metabolized to methylcobalamin before the vitamin can be used by the body. But typically that conversion happens without a problem, so anyone who takes a cyanocobalamin supplement will end up with methylcobalamin circulating through their body. And since methylcobalamin is sensitive to light it’s harder to keep on store shelves, so cyanocobalamin is the most common form used for supplementation. Let me know your thoughts on this!

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