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Alzheimer’s patient’s brain being supported by benfotiamine

Benfotiamine Improves Cognition in Alzheimer’s Patients

Elevated blood sugar impacts the brain and can lead to cognitive conditions such as Alzheimer’s. A groundbreaking study showed that benfotiamine can improve cognition in these patients.

Scientifically reviewed by: Dr. Amanda Martin, DC, in August 2023. Written by: Richard Helena.

Alzheimer’s disease is one of the most feared of all age-related conditions.

To date, no drug therapy has been shown to alter the course of Alzheimer’s, much less prevent it.

A groundbreaking study published in 2016 showed that a dietary supplement called benfotiamine could improve cognition in Alzheimer’s patients.1

What makes this study exciting is not just benfotiamine’s ability to improve cognitive function, but how the authors of the study believe it worked: by improving the brain’s glucose metabolism and protecting against its harmful effects on the brain.1

Increasingly, research has shown that elevated blood sugar impacts the brain and can lead to cognitive conditions such as Alzheimer’s.2-8

Data from this study—as well as a host of other human, lab, and animal studies—suggest that this novel approach to Alzheimer’s could open a new front in our fight against cognition-robbing neurodegenerative diseases.

What you need to know

  • Alzheimer’s disease is now being referred to as “type III diabetes” because of its close connection with the effects of chronically elevated blood-sugar levels.
  • Studies show that excessive blood glucose damages the endothelial lining of blood vessels, a factor that can contribute to cognitive decline, dementia, and Alzheimer’s.
  • Endothelial dysfunction and the changes associated with high blood glucose are known to alarmingly raise the risk of cognitive decline, dementia, and Alzheimer’s disease.
  • The connection between the effects of excessive blood sugar and dementia offers an entirely new approach to prevention: the use of natural supplements that can shield the body from the harmful effects of AGEs, and prevent the harm they could do to the blood vessels and the brain.
  • Benfotiamine, a highly bioavailable form of vitamin B1, has many properties that may help explain how it was able to improve cognition in patients with Alzheimer’s disease.
  • A groundbreaking clinical study found that supplementation with benfotiamine improved cognitive function scores in individuals with mild-to-moderate Alzheimer’s.
  • A natural product with a long safety record, benfotiamine belongs on the short list of supplements recommended for maintaining brain health well into old age.

Challenges in Treating Alzheimer’s

Despite millions of dollars and decades of research spent on Alzheimer’s disease, the only drugs available for Alzheimer’s are those that may reduce symptoms. There is no treatment that meaningfully alters the course and progression of the disease.1

In fact, no new drugs of any kind have been approved for use in Alzheimer’s in nearly 15 years.9,10

During that time, we’ve learned a lot more about the underlying factors in Alzheimer’s disease—especially the impact of chronically elevated blood sugar.11 The connection is so strong that many scientists are now referring to Alzheimer’s disease as “type III diabetes.”2-8

Connecting the dots between Alzheimer’s disease and the damage caused by high blood sugar highlighted a solution that had been sitting under researchers’ noses all along: an especially potent form of vitamin B1 called benfotiamine.

A Brain-Protecting Vitamin

A Brain-Protecting Vitamin  

Thiamine (vitamin B1) is profoundly involved in maintaining healthy brain function.12 It is an absolute requirement for normal cellular growth and function and vital metabolic processes.13,14

A deficiency in thiamine impacts most organs in the body, but it is especially damaging to the brain. There, it triggers a cascade of events that lead to oxidative stress and inflammation—which are major contributors to Alzheimer’s, Parkinson’s, and other dementia-producing disorders.13

Researchers have used experimental thiamine deficiency for years to model many of these age-related brain diseases, and research shows that a deficiency in thiamine leads to many of the same brain abnormalities associated with those disorders.13

In addition to its known importance in brain function, benfotiamine, a synthetic derivative of thiamine, has the dual ability to help with sugar metabolism while also helping protect against the damage caused by elevated blood sugar1,15—two properties that make it an ideal candidate for intervening in glucose-induced brain dysfunction.

Because of these findings, scientists wanted to determine whether supplementation with benfotiamine might be of use in preventing, slowing, or reversing some of the underlying factors that contribute to neurodegenerative disorders.

A team of researchers recently took an important first step to answering that question.

Cognitive Improvements in Alzheimer’s Patients

The researchers performed a pilot study to determine whether or not benfotiamine would have a beneficial impact on cognitive impairment in patients with Alzheimer’s disease.1 A pilot study is essentially a small-scale trial run to find out if there’s enough evidence to warrant a larger-scale study.

The study included five patients who were suffering from mild-to-moderate Alzheimer’s disease. They had detectable cognitive decline as measured by the standard Mini-Mental Status Examination (MMSE), a 30-point scale that measures cognitive function.

Prior to any treatment, patients underwent a specialized type of PET scan (positron emission tomography) that can predict progression of Alzheimer’s disease and detect the toxic Alzheimer’s protein beta-amyloid.

All subjects showed evidence of beta-amyloid. This damaging protein builds up in the brain, where it triggers brain inflammation, imposes oxidative stress, and has been closely associated with changes caused by long-term exposure to excessive blood glucose.

Subjects received 300 mg of benfotiamine per day over the course of 18 months. At the end of the study period, they retook the Mini-Mental Status Examination and the PET scan to see if the benfotiamine supplementation led to any improvements.

The results were impressive. Every single patient demonstrated cognitive improvement on the MMSE (with an average increase of nearly 19%).

This study demonstrates for the first time how a low-cost nutritional supplement can improve cognitive function in Alzheimer’s disease victims.1

The study provided new insight into the possibility that benfotiamine might have a significant beneficial impact for Alzheimer’s patients, and definitely warrants a larger-scale study in the future.

The AGE/RAGE Induces Oxidative Stress
The AGE/RAGE Induces Oxidative Stress

Advanced glycation end products, or AGEs, result from chemical reactions that link free glucose molecules to proteins and other bioactive molecules.

Studies have shown that AGEs bind to specialized cell-surface receptors, called receptors for AGE, or RAGE.14

The AGE/RAGE interaction induces oxidative stress, activates inflammatory reactions, and promotes deposition of the toxic beta-amyloid proteins associated with Alzheimer’s disease.38,39

A form of RAGE, called soluble RAGE (sRAGE), on the other hand, acts as a decoy, trapping AGEs and preventing them from activating the cell-bound RAGE.38

A recent study demonstrated that people with mild cognitive impairment, a condition that frequently progresses to dementia, had higher AGE, and lower sRAGE levels, than did those without mild cognitive impairment.38

Together these data indicate the urgency of reducing AGE formation using the safe nutritional supplement benfotiamine.

Benfotiamine’s Track Record

Previous studies on benfotiamine may have predicted this favorable result, as shown by studies of people with two common conditions that serve as useful models of accelerated aging: diabetes and alcohol dependence.

In both cases, cognitive impairment appears early, and both conditions significantly raise the risk of Alzheimer’s and other forms of dementia.16,17

One especially relevant area of this clinical research has been in diabetic neuropathy, a painful, debilitating, and typically irreversible condition in which nerves throughout the body become damaged. A randomized controlled trial found that taking 400 mg/day of benfotiamine for three weeks significantly reduced pain and neuropathy.18

This is an excellent example of benfotiamine’s ability to help protect nerve tissues in diabetics.

People with alcohol dependency also display rapid acceleration of brain aging. This is because excessive alcohol leads to thiamine deficiency.12,17

Two clinical trials have now shown that benfotiamine supplementation (600 mg/day) reduces alcohol consumption (a sign of reduced impulsivity) and improves psychiatric distress.19,20 These may be very important findings for people with Alzheimer’s who often suffer from increased impulsivity.21

The Impact of Elevated Sugar on the Brain

Impact of Elevated Sugar on the Brain  

To appreciate benfotiamine’s benefits, it’s helpful to understand how elevated blood sugar impacts the brain.

Growing evidence supports a strong link between elevated glucose levels in the brain and the development of Alzheimer’s disease.22,23 Many people don’t realize that you don’t have to have diabetes to develop the glucose-induced brain dysfunction that eventually produces Alzheimer’s.

Most people have blood-sugar levels that are higher than optimal, even if they are technically below the threshold for diagnosable diabetes. This is called prediabetes, which the American Diabetes Association defines as fasting blood sugar between 100 to 125 mg/dL.24

Prediabetes is now recognized to be associated with increased risk for Alzheimer’s and other dementias.25-27

The good news is that supplementation with benfotiamine has been shown to improve cognition in patients with Alzheimer’s disease.

Protection Against Blood-Sugar Damage

Given all these impressive results, there is now excellent evidence that benfotiamine supplementation may reduce and prevent many of the problems that lead to cognitive decline, dementia, and Alzheimer’s disease — particularly among diabetics and prediabetics.

Since many people may find the lifestyle changes that would help prevent the formation of AGEs quite difficult, something as simple as taking benfotiamine can help shield our bodies from their damaging effects.

Higher doses of thiamine (achievable through the use of benfotiamine), have been recommended in order to avoid diabetic complications.

How Benfotiamine Works

One of the most damaging effects of chronic elevated blood glucose is the formation of advanced glycation end-products (AGEs). AGEs occur when sugar molecules chemically react with proteins and other critical biomolecules, altering their structure and impairing their function.14

Benfotiamine mounts an all-out attack against AGEs. It has the ability to prevent AGEs from forming, but also to neutralize oxidative stress.28 This unique combination powerfully protects against blood vessel and tissue damage. At the same time, it reduces their impact on inflammatory processes that contribute to dementia.29,30

AGEs can lead to dysfunction of the critically important endothelial lining of arteries and smaller blood vessels.31,32 The endothelium regulates many aspects of blood flow and pressure.33 When chronic endothelial damage occurs in the brain, it can result in cognitive decline, strokes, and neurodegenerative diseases like Alzheimer’s disease.34-37

A human study demonstrated that benfotiamine supplementation completely prevented the endothelial dysfunction that results from AGEs in food.31

For the first part of the study, a group of type II diabetics was given a meal with a high AGE content from meat cooked at a high temperature (AGEs from such foods are one reason that experts recommend limiting their intake).31 The researchers found that the AGE-rich meal impaired large-vessel endothelial function by 35.1% and small-vessel endothelial function by an alarming 60%.

For the second part of the study, the subjects supplemented with benfotiamine (1,050 mg/day) for three days and then ate the same meal again. Amazingly, taking benfotiamine completely prevented the endothelial dysfunction caused by the AGE-rich meal. It also significantly reduced blood markers of chemical stress and endothelial dysfunction.31



Studies over the past decade have revealed astonishing connections between Alzheimer’s disease and the damaging changes associated with blood-glucose elevations, leading some experts to consider Alzheimer’s as type III diabetes.

Recognizing the blood sugar/dementia connection suggests a new use for a proven supplement, benfotiamine.

A new human study has shown that supplementation with 300 mg/day of benfotiamine produced significant cognitive improvement over 18 months.

Benfotiamine acts by preventing the formation of advanced glycation end products (AGEs), fighting oxidative stress, and thereby reducing inflammatory processes that contribute to dementia.

Benfotiamine is simply a highly bioavailable form of thiamine, or vitamin B1, which has a known track record of safety and effectiveness in metabolic disorders.

Benfotiamine represents a powerful way to help protect nerves, blood vessels, and the brain from damaging effects associated with elevated blood glucose.

If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.


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